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 DOI: 10.1258/jmb.2010.010037

2011 19: 32J Med BiogrSharma Vishal, Aggarwal Sourabh and Singh Harkirat

1915) and the Alzheimer syndrome−Alois Alzheimer (1864  

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PSYCHIATRISTS

Alois Alzheimer (1864–1915) and the Alzheimer syndrome

Sharma Vishal, Aggarwal Sourabh and Singh Harkirat

Summary: Alois Alzheimer is known for his seminal work in recognizing a form of preseniledementia. His early interests were natural history and botany. He started his medicaleducation in Berlin and attended the universities of Wurzburg and Tubingen. Nissl andAlzheimer worked together on extensive investigation of the pathology of the nervous system,especially the anatomy of the cerebral cortex. In 1902 Emil Kraepelin invited Alzheimer towork with him in the university psychiatric clinic in Heidelberg. In 1903 both moved to workin the university psychiatric clinic in Munich. It was during these years that Alzheimerdescribed the Alzheimer’s disease. He also described brain changes in arteriosclerosis, loss ofnerve cells in Huntington’s disease in the corpus striatum and brain changes in epilepsy.Alzheimer presented a preliminary report of his histological findings in 1906 at Tubingenabout a 51-year-old lady who had developed presenile dementia and died within four yearsof onset of the disease. He published his findings in 1907, reporting the atrophic brain withneurofibrillary deposits and areas in the cerebrum resistant to staining. During the later yearsof his career Alzheimer concentrated on the study of changes in glial cells. His best-knownworks from this period were on Westphal-Strumpell pseudo-sclerosis of the brain, nowassumed to be the same as Wilson’s Disease. His death, at age 51, was the result of cardiacfailure following endocarditis.

Alois Alzheimer, born in the small Bavarian town ofMarktbreit am Main, is known for his seminal work inrecognizing a form of presenile dementia that bears hisname. His early interests were natural history andbotany. He started his medical education in Berlinand attended the universities of Wurzburg and Tubingen,and then back to Wurzberg where he was granted amedical degree in 1887. In 1888 he joined the staff of thecity mental asylum in Frankfurt am Main and workedwith Franz Nissl (1860–1919). Much of Alzheimer’slater work on brain pathology especially of patients withAlzheimer’s disease made use of Nissl’s method ofsilver staining of the histological sections of specimensof nervous system. Nissl and Alzheimer workedtogether on extensive investigation of the pathology ofthe nervous system, especially the anatomy of the cere-bral cortex. This work resulted in the major six-volumework entitled Histologische und histopatologische Arbeitenuber die Grosshirnrinde (Histologic and HistopathologicStudies of the Cerebral Cortex); he published six volumesbetween the years 1906 and 1918.Alzheimer was a very dedicated laboratory worker

who supported his ideas by the use of histology.He was appointed director of the Irrenanstalt, the citymental asylum, in 1895 where he continued hisresearch on a wide range of subjects including clinicalstudies of manic depression and schizophrenia.In 1902 Emil Kraepelin (1856–1926) invited Alzheimer

to work with him in the university psychiatric clinic in

Heidelberg. In 1903 Alzheimer and Kraepelin movedtogether to the University Psychiatric Clinic in Munich.In 1908 he joined the staff of the Psychiatric Instituteas Ausserordentlicher (Associate Professor) and thenbecame the Director of the clinic’s anatomical laboratory.It was during the years in Munich that Alzheimerdescribed the disease that was to bear his name.He also described brain changes in arteriosclerosis, lossof nerve cells in Huntington’s disease in the corpusstriatum and brain changes in epilepsy. Alzheimer pre-sented a preliminary report of his histological findingsin 1906 at Tubingen in a 51-year-old lady who haddeveloped presenile dementia and died within fouryears of onset of the disease. He published his findingsin 1907, reporting the atrophic brain with neurofibril-lary deposits and areas in the cerebrum resistant tostaining. It was Kraepelin, his guide in Munich, whoagreed with his concept and proposed that Alzheimer’sname should be attached to the condition. Italianwriters favoured the term Alzheimer-Perusini diseasebut the single eponym is now in general use.During the later years of his career, Alzheimer con-

centrated on the study of changes in glial cells. Hisbest-known works from this period were on Westphal-Strumpell pseudo-sclerosis of the brain, now assumedto be the same as Wilson’s disease. In 1912 KingWilhelm II of Prussia signed his certificate of appoint-ment as Professor of Psychiatry at the University ofBreslau. Alzheimer accepted the invitation andleft Munich but felt ill on the way and had to behospitalized immediately upon arrival. He devotedthe last three years of his life to research and clinicalwork but was never able to commence his universityduties in Breslau as intended. His death at the age of51 was the result of cardiac failure followingendocarditis.

Sharma Vishal is a Senior Resident in Medicine, University Collegeof Medical Sciences, New Delhi, India. Aggarwal Sourabh is a MBBSstudent, University College of Medical Sciences, New Delhi. SinghHarkirat is a MBBS student at the All India Institute of MedicalSciences (AIIMS), New Delhi. Correspondence: Aggarwal Sourabh,257/6, Central Town, Jalandhar City, Punjab 144001, India (email:drsourabh79@gmail.com)

Journal of Medical Biography 2011; 19: 32–33. DOI: 10.1258/jmb.2010.010037

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The diagnosis of Alzheimer’s disease today is stillbased generally on the investigative methods used in1906. This seems remarkable when compared with thedevelopment of investigative methods for otherdiseases and it says a lot about the high quality ofAlzheimer’s discovery.1

Acknowledgement: We would like to thank our parentsfor their support.

Reference and note

1 See http://www.whonamedit.com/doctor.cfm/177.html, (last accessed31March 2010)

S Vishal et al. Alois Alzheimer (1864–1915) and the Alzheimer syndrome 33

GLIMPSES

A Glimpse at Dr William Evans

(1895–1988)

‘Willie’ Evans was a great teacher. Early in life he realizedthe importance of teaching in medical education and hedrew up a list of requirements of a good lecture thatshould always be fully prepared. As a result, he was avery popular lecturer.He visited America in 1954 and, among other places,

lectured in Evanston, Illinois, and gave the GarrishMilliken Lecture in Philadelphia. He also lectured inLondon, Scotland, Ireland, Stockholm, Copenhagen,Brussels, Paris, Rome and Montreal, to name but a fewplaces (Figures 1 and 2). He visited Australia and receivedthe Sydney Gold Medal for work in cardiology in 1954.He told amusing stories of his travels in his 1964 autobio-graphy Journey to Harley Street.1

He was also a natural research worker and gained plea-sure in putting his thoughts on paper. He wrote five booksand some 100 scientific publications. Sometimes thesewere written with a colleague and they covered the wholeof cardiology, including electrocardiography, auscultationand cardioscopy. I shall always be grateful to him for start-ing me on writing professional papers. He showed greatcourage in opposing the view, generally accepted, thatanticoagulants were indicated in cardiac infarction – hecalled them rat poisons – but he was not always right!He believed that hypertension was harmless, cardiac cathe-terisation would soon be abandoned and the electrocardio-gram was always abnormal with cardiac pain. However,with Clifford Hoyle he was the first to use the controlledtrial on the Comparative Value of Drugs used in the

Continuous treatment of Angina Pectoris and he coined theterm ‘The Placebo Effect’. His publications were collectedand annotated in 1990 in a biography entitled A Rare Hero –Dr William Evans by Buddug Owen.2 This includesvarious quotations of Evans that made his name well knownin medical circles: ‘No patient should be worse for seeing adoctor’; ‘Better Health than Wealth’. He was a religious manbut remained a loner and difficult to get to know. He didnot receive any honour – it is possible he refused one, for hecertainly deserved one. I think that his writings were soahead of his time that much of what he said was notaccepted by his contemporaries and indeed he was notalways right, which made him enemies among his col-leagues. He would make statements (and teach) about ideasthat were quite new and uncertain. He would say ‘if that iswrong I shall soon hear about it’. Although he made it clearthat he was not sure about some of these ideas, they werequoted by his juniors and this upset some of his colleagues.

Acknowledgements: I wish to thank Jonathan Evans,Archivist of The Royal London Hospital, MalcolmTowers and Josephine Viney.

Geoffrey StoreyRose Cottage, 45 Lewes Road,

Ditchling, East Sussex, BN6 8TU, UK(email: info@cartmel camping.co.uk)

DOI: 10.1258/jmb.2009.009081

References and notes

1 Evans W. Journey to Harley Street. London: David Rendel Ltd, 19682 Owen B. A Rare Hero – Dr William Evans. Denbigh: Gee & Sons

Ltd, 1999

Figure 1 Dr William Evans; last teaching session in the Bearsted

Lecture Theatre, The London Hospital, 1973 (reproduced courtesy ofThe Royal London Hospital Archives)

Figure 2 Dr Williams Evans, last teaching session in the Bearsted

Lecture Theatre, The London Hospital, administers Trinitrin to DrRichard Bomford, 1973 (reproduced courtesy of The Royal LondonHospital Archives)

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