Der Nervenarzt最新文献

This paper commemorates the careers and the scientific influence of the clinical neurologists Kurt Goldstein and Friedrich Heinrich Lewy including their forced migration in the mid-1930s. Goldstein (1878-1965) set up independent neurological departments in Frankfurt/Main and Berlin, adopting a decidedly holistic approach in medical care, research and teaching. He is therefore considered a co-founder of modern neuropsychology and neurorehabilitation. Goldstein came into the focus of the National Socialists as a Jew, socialist and adherent of psychotherapeutic methods. After a short incarceration he fled via Switzerland and Holland to the USA. Lewy (1885-1970) for his part specialized in neuropathological examinations and in 1912 quickly discovered the inclusion bodies in the cytoplasm of nerve cells named after him. As head of a neurological institute in Berlin with inpatient beds, he decided to leave Germany as early as 1933 and arrived after a stopover in England in the United States one year later. The biographies of the two highly innovative neurologists illustrate that career opportunities for doctors of Jewish descent were already clearly limited during the Weimar Republic and that they had to face anti-Semitic tendencies even after their arrival in the USA.

Before 1933 Berlin was considered a center of clinical neurology and neuroscientific research in the German Reich. Using a group biographical approach and drawing upon scattered secondary literature as well as upon various archival documents, this article provides an overview of 12 less well-known physicians and researchers who were forced into exile during the nationalsocialist (NS) era, primarily for racist reasons. Among those affected by NS persecution were Franz Kramer and Fredy Quadfasel (Charité), Ernst Haase, Carl Felix List, and Lipman Halpern (Moabit Hospital), Paul Schuster (Hufeland Hospital), and Clemens Ernst Benda (Augusta Hospital). Others who were forced to emigrate were Franz Josef Kallmann (Herzberge Sanatorium), Max Bielschowsky, and Hans Löwenbach (Kaiser Wilhelm Institute for Brain Research), Otto Maas (Berlin-Buch Clinic), and Kurt Löwenstein (Lankwitz). A total of 6 neurological departments at municipal hospitals were run by (in NS terminology) "non-Aryans" in 1933. With their expulsion, the existence of neurological treatment and training centers outside the university ended and did not resume until the 1960s.

Archival documents and further biographical testimonies reveal that dismissal and expulsion on racist grounds also affected neurologists in leading clinical positions and at an advanced age. Alfred Hauptmann (1881-1948), full professor for neurology and psychiatry in Halle/Saale, member of the Leopoldina and discoverer of phenobarbitone treatment for epilepsy, emigrated first to Switzerland and then to the USA after the anti-Jewish pogroms in November 1938 and a subsequent "protective custody" imposed on him at the age of 58 years. Adolf Wallenberg (1862-1949), a self-made neurologist, described the syndrome later named after him in 1895. As a clinician he carried out research in the field of neuroanatomy until the National Socialists ousted him from his workplace in Danzig. At the age of 77 years, he emigrated to the USA via Great Britain, but did not manage to settle down again in his profession. For both physicians, neurology was their purpose in life, they felt patriotically attached to their home country and saw no future for themselves after their late forced emigration. Hauptmann is today commemorated by an award for experimental and clinical research on epilepsy, Wallenberg by the German Neurological Society award for outstanding achievements in the fields of cerebrovascular diseases, brain circulation and brain metabolism.

Neurologists as victims of National Socialist extermination policies have been rarely addressed as a special group in historical research. On the basis of archival documents and biographical literature, this essay presents 9 exemplary fates of a group of victims of violence whose number and structure so far cannot be estimated. These neurologists died in the ghettos of Lwów (e.g. Lucja Frey) and Theresienstadt (Alexander Spitzer/Vienna), were murdered in the concentration or extermination camps of Mauthausen (e.g. Raphael Weichbrodt/Frankfurt, Hans Pollnow/Berlin) and Auschwitz (e.g. Otto Sittig/Prague), or were executed in the East (e.g. Arthur Simons/Berlin). Others whose attempts to emigrate failed or whose deportation was imminent, chose to commit suicide. This group included the neuroserologist Felix Plaut (Munich), the encephalitis researcher Felix Stern (Göttingen), and presumably Fritz Chotzen (Breslau). In all these cases it was an eponym or a relationship to university medicine that prompted the investigations; however, the fate of innumerable colleagues employed in communal departments and medical practices remains unknown to date. Future studies will have to undertake a deeper look at the suffering of neuroscientists who perished in the Holocaust.

The persecution and expulsion of German-speaking neurologists were not limited to research centers, such as Berlin, Vienna, Frankfurt am Main and Hamburg. The exclusion from science, teaching and clinical care also occurred at other (university) sites. The different aspects and implementation of the exclusion are presented here exemplified by 10 physicians involved in neuroscience. These ranged from forced internal emigration (Georg Stertz/Kiel), racially motivated removal from office (Max Isserlin and Karl Neubürger/both Munich, Ernst Grünthal/Würzburg, Gabriel Steiner/Heidelberg, Rudolf Altschul and Francis Schiller/both Prague) to publicly staged denunciation and humiliation (Otto Löwenstein/Bonn). Furthermore, without being directly persecuted themselves, individual physicians reacted to the poisoned political and academic climate in that they either sooner or later left their homeland (Eduard Heinrich Krapf/Cologne, Hartwig Kuhlenbeck/Jena). The results and conclusions summarized in this article for university clinics and institutes represent only a narrow section of the neurological scene in 1933-1939; however, they emphasize how necessary an expansion of the historical research perspective is on the fate of neurologists at communal hospitals, in field practices and other professional areas.

The neurologists Sir Ludwig Guttmann and Robert Wartenberg had a number of things in common, e.g., both enjoyed high international recognition for the clinical care they provided to paraplegics and for their contributions to the development of neurological diagnostics. Both were born before 1900. Both were classified as "Jewish" by the National Socialist regime because of their origins. Both had to flee from Germany in the 1930s but nevertheless did not appear to harbor any grudges after 1945; however, both also show differences even more than similarities. Guttmann (1899-1980) stood up for those persecuted, for instance during the November pogroms in 1938. After his late emigration, he soon found a new home in England. His skills in neurosurgery enabled him to convert a military hospital into the world's leading treatment center for spinal cord injuries. He was the founder of the Paralympic Games and received a knighthood from Queen Elizabeth II. In 1971 the German Neurological Society (DGN) awarded him with a late honorary membership during the presidency of the former SS captain Helmut Bauer. In contrast, Robert Wartenberg (1886-1956) found a new neurological home at the University of California in San Francisco and published numerous books, some of which also attracted attention in the German translation. On various occasions, he opposed the remembrance of National Socialist injustice and even justified the "concurrent research" in conjunction with "euthanasia".

The German Neurological Society (DGN) has commissioned historical research related to the expulsion and murder of German-speaking neurologists during the National Socialism era (NS). Intended as an introduction to the following background essays and biographies in this special issue of Der Nervenarzt, this article summarizes the results and perspectives of medical historical research addressing the persecution of German physicians. Additionally, it shows how the current project of the DGN fits into the context of an interdisciplinary culture of commemoration by a confrontation with National Socialism. Of particular importance for the DGN is that it was founded as the successor to the Society of German Neurologists (GDN), which was dissolved in 1935. In the early stages of the NS era, the GDN was the professional home of numerous Jewish specialists and those labeled "Jewish" by NS law, who were expelled from Germany and (after the "Anschluss" of 1938) from Austria, deported to concentration camps or driven to suicide. With this in mind, "persecution", "expulsion", and "extermination" raise not only questions of collegiality, decency, and morality. Investigating and remembering this era also affects today's public image of the neurological specialist society and constitutes an important part of its culture of remembrance and its history politics.

This article focuses on the historical context of the emigration of "Jewish" doctors during the "Third Reich". The approximately 9000 Jewish physicians, who were still able to emigrate, represented 17% of the German medical profession in 1933. Around three quarters of them left the German Reich by 1939, mainly for the USA, Palestine and Great Britain. Initially, Jewish organizations fueled hopes of a temporary exile; however, in the wake of the events of 1938 ("Anschluss" of Austria, failure of the Evian Conference, establishment of the Central Office for Jewish Emigration headed by Adolf Eichmann in Vienna, maximization of economic plundering etc.) emigration via the intermediate step of forced emigration had turned into a life-saving flight. Scientists could appeal to special aid organizations for support. Among the best known are the Emergency Community of German Scientists Abroad initiated in Zurich, the Academic Assistance Council founded in England, from which originated the Society for the Protection of Science and Learning as well as the Emergency Committee in Aid of Displaced German Scholars created in New York. Their help was often subject to criteria, such as publication performance, scientific reputation and age. Promising researchers who were awarded a scholarship before 1933 could rely on a commitment from the Rockefeller Foundation. The historical analysis of options and motivations but also of restrictions and impediments affecting the decision-making process to emigrate, provides the basis for a retrospective approach to individual hardships and fates.

Background: Chronic pain is a common non-motor symptom in patients with Parkinson's disease (PD).

Aim: To facilitate the diagnosis of pain in PD, we developed a new classification system the Parkinson's disease pain classification system (PD-PCS) and translated the corresponding validated questionnaire into German.

Methods: A causal relationship of the respective pain syndrome with PD can be determined by four questions before assigning it hierarchically into one of three pain categories (neuropathic, nociceptive and nociplastic).

Results: In the initial validation study 77% of the patients (122/159) had PD-associated pain comprising 87 (55%) with nociceptive, 36 (22%) with nociplastic and 24 (16%) with neuropathic pain. The study revealed a high validity of the questionnaire and a moderate intrarater and interrater reliability. The questionnaire has been adapted into German and employed in 30 patients.

Discussion: The PD-PCS questionnaire is a valid and reliable tool to determine the relationship of a pain syndrome with PD before classifying it according to the underlying category, facilitating further diagnostics and treatment.