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Rightly forgotten

Many of the men and women of science and medicine have been honored by having their names associated with the fruits of their labors. We have Paget disease of bone and breast (Sir James Paget 1814 – 1899), Pasteurization (Louis Pasteur 1822 – 1895), Koch’s postulates (Robert Koch 1843 – 1910), and the Curie, a unit of radiation (Marie Curie 1867 – 1934). And then we have Phillipp Lenard, Hans Reiter, Eduard Pernkopf and Hans Asperger, all of whom made significant contributions to science and/or medicine, but whose names are all but forgotten. Lenard was awarded the Nobel Prize; Reiter and Asperger had syndromes named for them; and Pernkopf produced the most realistic anatomy atlas. Why then, have their memories been relegated to the dung heap of history? At one time in their careers, they all embraced an evil philosophy, Nazism, and its false messiah, Adolf Hitler.

I have long had an interest in medical history. I teach a course on the history of medical imaging for the Osher program at CMU and I have written an editorial on Roentgen’s discovery of x-rays for the Bulletin to commemorate the 125th anniversary of this event. I hope to write future historic vignettes for the Bulletin. While doing research for my course, I came across an interesting footnote to medical history in the work of Phillipp Lenard. So, what did Lenard and the others contribute to medical science, and when did they turn toward “the dark side?” 2020 is the 75th anniversary of the end of World War II (WWII), in which Lenard and the others participated in their own ways in one way or another.

Lenard (1862 – 1947) was a Hungarian-born German physicist, who, like many other European physicists, became fascinated with cathode ray tubes. (In the mid-19th century to the mid-20th centuries, Germany led the world in scientific and medical technology.) Lenard created a thin metal window in his Crookes cathode ray tubes to allow him to study the rays the tubes produced, and he duly reported his findings of their characteristics. He concluded that cathode rays were streams of negatively charged energy particles (electrons). He also found that photographic plates in his laboratory were fogged when he was operating his apparatus and concluded that the fogging was the result of cathode rays. He reported this in a scientific paper in 1894. Wilhelm Conrad Roentgen (1845 – 1923), a colleague of Lenard, and using cathode ray tubes lent by Lenard, made the same observations and proved that the fogging was due to “a new type of ray,” which we now recognize as x-rays. Roentgen proved that x-rays were a distinct entity that had different characteristics than did cathode rays. Roentgen asked why his findings occurred; Lenard did not. Roentgen was awarded the first Nobel Prize in physics in 1901. Lenard, who felt he should have shared the prize, became Roentgen’s enemy and aired his anti-Semitic feelings by publicly saying that Roentgen behaved like a typical Jew in not acknowledging the help received. (Roentgen was not Jewish.) Lenard was awarded his own Nobel Prize in 1905 in recognition of his other scientific contributions.

Lenard was a strong German nationalist and joined the National Socialist (Nazi) Party in the 1920s. He was an outspoken promoter of “Deutsche Physik,” as opposed to “English physics,” which he believed to have stolen its ideas from Germany, as well as “Jewish physics” – primarily the theories of Albert Einstein. He became an advisor to Hitler, who named him Chief of Aryan Physics. In 1933, he published a book, “Great Men in Science, a History of Scientific Progress,” and omitted listing Einstein and Roentgen. Lenard held the post of emeritus professor of theoretical physics at the University of Heidelberg until he was expelled, in 1945, by the Allied occupation forces as part of their denazification campaign. He died in obscurity in 1947.

Hans Conrad Reiter (1881 – 1969) was a German physician who despite impeccable medical credentials became a Nazi war criminal for conducting medical experiments at the Buchenwald concentration camp. His claim to medical fame owes to his having served as a physician in the German army in World War I (WWI), where he described a soldier with non-gonococcal urethritis, arthritis and uveitis. This triad became known as Reiter syndrome. Reiter was interested in politics after WWI and became an early supporter of Hitler and the Nazis. He joined the party officially in 1932 and was named director of the Kaiser Wilhelm Institute of Experimental Therapy in 1933. He also was a strong supporter of the Nazi’s racial policies and eugenics, and an enthusiastic supporter of Hitler’s anti-smoking campaign.

During WWII, Reiter became a member of the SS and was the chief medical officer at the Buchenwald concentration camp. There, he conducted medical experiments on the inmates. He claimed to “know” of sterilization, euthanasia and the murder of mental hospital patients, but denied direct participation. He, like many other “good” Nazis were “only following orders.” Following the war, he was arrested by the Soviet Red Army and was tried at Nuremberg. Although he was convicted as a war criminal and sentenced to prison, he received an early release for assisting the Allies with his knowledge of germ warfare. After his release, he conducted research in rheumatology. He died in 1969. In 1977, a campaign was launched to replace the term “Reiter syndrome” with “reactive arthritis,” the term that is in common use today.

Eduard Pernkopf (1888 – 1955) was an Austrian anatomist who was rector (the highest academic official) of the University of Vienna. He is best known for his seven-volume “Atlas of Topographical and Applied Human Anatomy.” The “Pernkopf atlas,” as it is commonly called, was the result of 20 years of work by Pernkopf and four additional medical artists. Despite its tainted provenance, it is still considered an artistic and scientific masterpiece for its lifelike and accurate display of human anatomy. Why tainted? Most anatomy atlases are based on dissections performed on embalmed cadavers. The full color drawings in the Pernkopf atlas appeared so realistic because they were created from fresh corpses, the bodies of executed political prisoners and concentration camp internees.

Pernkopf began his medical studies at the University of Vienna in 1907 and it was there that he became a member of the German nationalistic Student Academic Fraternity of Germany. Following WWI, where he served as a military physician, Pernkopf returned to Vienna, where he quickly rose through the ranks on the faculty of his alma mater to become the director of the medical school’s anatomical institute. In 1933, he joined the foreign organization of the Nazi party, and a year later became a member of the SA, the Storm Troopers (“brownshirts”). Following the Anschluss (Germany’s annexation of Austria into the Third Reich) in 1938, he was named dean of the medical school. It was here that he put his Nazi beliefs into action, purging all Jewish faculty and preaching Nazi racial theories and policies.

Pernkopf hired four artists to collaborate on his atlas. All were members of the Nazi Party and were committed to its principles and goals. Interestingly, these artists cleverly incorporated Nazi symbols into their work. One of them, Erich Lepier, inserted a swastika at the end of his signature; another, Karl Endtresser used the SS lightning bolt runes for the “ss” in his name. The first volume of the anatomy atlas was completed in 1937 and the second in 1941. At the end of the war, Pernkopf was arrested by American authorities and spent three years as a POW. Upon his release, he returned to Vienna to take up his work on his atlas when he was reunited with his four artists, all of whom also had been interned in POW camps. Pernkopf died in 1955 while working on a new volume to the set.

A two-volume edition of the atlas was published in five languages, with the first American edition published in 1963. In 1995, Pernkopf and his atlas became the focus of an ethics investigation following the publication of a paper that described the Nazi takeover of the University of Vienna and  Pernkopf’s role in the human experimentation that followed. In 1996, it was revealed that the subject bodies portrayed in the atlas may have been those of executed political prisoners, LGBT men and women, Romani (Gypsies) and Jews. (Interestingly, similar issues have been raised about the “Bodies … The Exhibit” from China). Later editions of the atlas had the Nazi symbols removed. There is still a debate whether it is ethical to use the atlas, which, although out of print, is still available on eBay.

Johann (Hans) Friedrich Karl Asperger (1906 – 1980) was an Austrian pediatrician who also dabbled in medical theories and eugenics. After earning his medical degree in 1931 from the University of Vienna, he became director of the special education section of the university’s pediatric clinic the next year. Asperger was fascinated with psychologic disorders in children and wrote more than 300 scientific papers, mostly concerning a condition he termed “autistic psychopathy.” Interestingly, his work went generally unnoticed outside of Vienna during his lifetime. It was only after his death in 1980 that his contributions to psychiatry were recognized. These contributions included autism spectrum disorders and Asperger syndrome that was named after him following his publishing a paper in the German literature in 1944.

Asperger’s work, however, was considered controversial in two areas. The first was disagreement with the scientific merits of his studies, that were published in German and rarely translated into English. Despite a resurgence of interest in his work in the 1990s, the diagnosis of Asperger syndrome remains controversial due to an unclear relationship to the autism spectrum. This is based on the inability of contemporary researchers to replicate his results.

The second controversy arose more recently (2018) with the publication by Edith Scheffer of “Asperger’s Children: The Origins of Autism in Nazi Vienna.”1 Asperger joined the Austrofascist Fatherland Front in 1934 and later accommodated himself to the Nazi regime, although never actually becoming a member of the Nazi Party. He is alleged to have publicly promoted the Nazi racial hygiene policies, including forced sterilizations and active cooperation with the euthanasia program for children (and adults) with mental disorders. It is mainly for these reasons that the “syndrome” is now referred to as autism spectrum disorder.

Four men of science, who were lured into following a false god and accepting that god’s pseudoscientific rantings about racial purity and eugenics, made significant contributions to medicine. However, those contributions and the memories of the men who made them were forever lost in the dung heap of history. Interestingly, these men were not alone. A more complete list of medical eponyms with Nazi associations is available.2,3

References 1. Scheffer E. Asperger’s Children: The origins of Autism in Nazi Vienna. New York, W.W. Norton and Company, 2018. 2. Strous RD, Edelman MC. Eponyms and the Nazi era: time to remember and time for change. Israel Med Assn J 2007; 9:207 – 214. 3. Kondziella D. Thirty neurologic eponyms associated with the Nazi era. European Neurology 2009; 62: 56 – 64.

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