Alfred Kirstein – ein Pionier der direkten Laryngoskopie

On 23 April 1895, the Berlin ENT medical specialist Alfred Kirstein performed the first direct examination of the larynx using a Casper esophagoscope equipped with electric lighting, which he called an “autoscope”. The examination of the larynx, which had previously only been possible indirectly using mirror systems, was named by him “autoscopy”. The development of the device enabled a more precise observation than before and laryngeal or tracheal foreign bodies could be removed better and more easily. The new instrumental development and examination technique he described met with rapid approval and great interest in specialist circles. Shortly afterwards the first publications on orotracheal intubation for anesthesia appeared in scientific journals, that should also be possible with the aid of Kirstein’s autoscope. Although he never propagated this himself, it was also possible to perform these under visualization using a tongue depressor equipped with a light, which he had developed a short time later. Both developments are already very close to today’s laryngoscopes. Kirstein’s contribution in this respect has so far hardly been appreciated, especially in German-speaking countries.