PIONEERS IN NEUROLOGY

Sir Ludwig Guttmann (1899–1980)

Frank W. Stahnisch • Jeremy D. Tynedal

Received: 30 November 2011 / Revised: 17 January 2012 / Accepted: 18 January 2012 / Published online: 2 February 2012

� Springer-Verlag 2012

The historiography of neurology has often endorsed a view

that the development of neurological institutions and

emergence of new methodologies followed rather precon-

ceived trajectories [6]. As compelling as this view may

seem, the working realities of neurological pioneers were

far more complex and not as clear cut in the beginning.

This is particularly true in the case of one of the co-foun-

ders of the field of neurorehabilitation: the German-born

neurosurgeon Sir Ludwig Guttmann, who became a phys-

ical therapist later in his clinical career. His example

intriguingly demonstrates how a basis of broad education,

love for clinical work, and perseverance in continuing

earlier research led to a most important enrichment of

clinical neurology [8].

Born in Tost (Upper Silesia) as the son of the large-

scale distiller Bernhard Guttmann, Ludwig Guttmann

received his education at the German-Jewish High School

of Breslau, a humanistic and pragmatically oriented sec-

ondary college in this mercantile metropolis of Prussia

[9]. At the end of WWI, he graduated early from high

school to become a warden in a coal miners’ hospital in

Konigshutte (Upper Silesia), where he observed his first

cases of spinal cord injuries, concussions, and poly-trau-

matized patients. During the interwar period, he pursued

medical studies at the Universities of Breslau, Wurzburg,

and Freiburg (1918–1923), before becoming a clinical

assistant to the neurological surgeon Otfrid Foerster

(1873–1941) at the Breslau Institute for Neurology

(1924–1928) and marrying Else Samuel—his girlfriend

from university days. For 2 years, he then worked as a

staff attending physician with the renowned neurologist

Max Nonne (1861–1959) in Hamburg before returning to

his hometown of Breslau in 1930, where after receiving

his Habilitation he worked as first physician assistant in

Foerster’s clinic [1]. Guttmann’s life then took many

twists and detours, and at various points it could have

turned out differently, as in 1923:

‘‘I went in search for a job to the Breslau Municipal

Hospital, waiting for an interview with the Chief of

Paediatrics, when I suddenly met a young doctor

friend. He advised me that it would be impossible to

get a job in this overcrowded specialty, but that I

should rather try the floor below to see whether there

would be a vacancy in the Department of Neurology

[.…] More than any others, these words shaped my

whole life and future career’’ [3].

Particularly in Germany after the end of WWI peripheral

nerve centers were being developed, and Foerster empha-

sized the clinical and research advantages of the central-

ization of many neurological patients with similar

conditions. Foerster documented more than 4,000 surgery

cases and outlined the successes his center had experienced

with new operational techniques, followed by treatment

that would ‘‘start the very first day’’—as Canadian neuro-

surgeon Wilder Penfield (1891–1976) remarked after his

visits in 1928 and 1932 [7]. For Guttmann, this offered the

opportunity to see many patients and witness treatment

advances that were not available elsewhere in Europe. It

also prompted him to pursue basic physiological studies on

neuroregeneration after traumatic injuries [10].

However, his life took another turn as a result of the

political developments in Germany. With the enactment of

the Nazi law ‘‘On the Re-Establishment of a Professional

F. W. Stahnisch (&) � J. D. Tynedal

Department of Community Health Sciences, Hotchkiss Brain

Institute, Institute for Public Health, University of Calgary,

3280 Hospital Drive N.W., Calgary, AB T2N 4Z6, Canada

e-mail: fwstahni@ucalgary.ca

123

J Neurol (2012) 259:1512–1514

DOI 10.1007/s00415-012-6431-8

Civil Service’’ on 7 April 1933 he was ousted from his

official academic position with the University of Breslau.

Guttmann was, however, still able to continue to practice as

a physician at the Jewish Hospital until literally months

before the outbreak of WWII. He managed to escape to

England via Portugal—largely owing to a petition of the

Portuguese neurologist Egas Moniz (1874–1955), who had

written to foreign minister Joachim von Ribbentrop

(1893–1946) in Berlin. Between 1939 and 1943 ensued

‘‘four very difficult years,’’ as Guttmann later recalled, in

which he was not allowed to practice but had to continue

research work about the status of UK rehabilitation facili-

ties [2].

The preparations for D-Day (1944) suddenly led to the

founding of new National Spinal Injuries Centres. The

British military, already familiar with Guttmann’s research

reports, appointed him as director of the Stoke Mandeville

Hospital in Aylesbury. As is well known, Sir Ludwig

(knighted in 1966) became a widely renowned rehabilita-

tion specialist and a ‘‘father’’ of the Paralympics in his later

career—initially, between 1945 and 1948, the ‘‘Stoke

Mandeville Games’’ for people with paraplegia (Fig. 1). He

also introduced a variety of new therapeutic approaches,

such as the use of antibiotics and intermittent catheteriza-

tion to reduce urinary infections. Above all, he promoted

sports as a rehabilitative tool.

‘‘After lunch one day in 1945, I came across a group

of patients in their heavy leather padded wheelchairs

[…] hitting a puck with reversed walking sticks. My

eyes brightened as it had become clear to me: Games,

sport, that is what we must have!’’ [4]

Guttmann’s fascinating biography embodies many traits

of the interdisciplinary field of early clinical neuroscience,

which later also integrated aspects of rehabilitation and

sports to enhance neuronal plasticity. Guttmann is a good

example of the social impact of medical refugees on sci-

entific development. Historiographical research has rather

neglected the process of forced migration in neurology,

which in Guttmann’s case even led to the emergence of the

completely new field of neurorehabilitation:

‘‘If ever I did one thing in my medical career it was to

introduce sport in the treatment and rehabilitation of

spinal cord sufferers and others severely disabled.

[… It is useful to] train the body and to prevent

boredom of hospital life; by restoring activity of mind

and body, by instilling self-respect, self-discipline, a

competitive spirit, and comradeship, sport develops

mental attitudes that are essential for social reinte-

gration.’’ [5]

We are grateful for support from the Mackie Family

Collection in the History of Neuroscience, the Hotchkiss

Brain Institute, the Institute for Public Health (all: Cal-

gary), and a standard research grant from the Social Sci-

ences and Humanities Research Council of Canada.

References

1. Goodman S (1986) Spirit of Stoke Mandeville. Collins, London,

pp 11–42

2. Guttmann L (1938/1939) Rescinding of License to Practice

Medicine, Learning English, Translated Transcripts of Docu-

ments, Wellcome Library, London (PP/GUT/A.1/3), box 1, p 6

3. Guttmann L (1964) qtd. after Scruton J (1998) The Legacy of Sir

Ludwig Guttmann. Founder of the British Sports Association for

the Multi-Disabled. Palaestra, p 11 (March 22)

4. Guttmann L (1964) qtd. after Whitteridge D (1983) Guttmann.

Biogr Mem Fellows R Soc 29:227–244

5. Guttmann L (1976) Textbook of Sport for the Disabled. HM & M

Publishers, Aylesbury, p 20

6. Haymaker W, Schiller F (eds) (1970) The Founders of Neurol-

ogy, 2nd rev edn. Charles C Thomas, Springfield

7. Penfield W (1928) Impressions of Neurology, Neurosurgery, and

Neurohistology in Central Europe. In:Osler Library: W/U 17,

Montreal, Wilder Penfield Fonds Folder p 6f

8. Schultke E (2001) Ludwig Guttmann:emerging concept of reha-

bilitation after spinal cord injury. J Hist Neurosci 10:300–307

Fig. 1 Ludwig Guttmann (1899–1980) opening the Hospital Games

for the Paraplegic in Stoke Mandeville (near London) in 1952.

Photograph courtesy of the Wellcome Library for the History of

Medicine in London, England (PP/GUT/B.8/2), box 7, photograph 3

J Neurol (2012) 259:1512–1514 1513

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9. Van Rahden (2008) Jews and Other Germans:Civil Society, Re-

ligous Diversity, and Urban Politics in Breslau, 1860–1925. The

University of Wisconsin Press, Madison, Wi., pp 134–155

10. Wedell G, Guttmann L, Gutmann E (1941) The local extension of

nerve fibres into denervated areas of skin. J Neurol Psychiat

4:206–225

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