Nazi doctors and medical eponyms

Howard Fischer
Uppsala, Sweden

 

Photo of The Am Spiegelgrund Hospital run by Nazi doctors
“Special Children’s Ward” Vienna Am Spiegelgrund. Source.

The tradition in medicine has been to name a pathological condition after the person who first described it in the medical literature. Thus we have Addison’s disease, Down’s syndrome, and several hundred others. The tendency now is to eliminate the possessive,1 giving Addison disease and Down syndrome. Presently, “new” diseases are named for their characteristics, not their discoverers, and old conditions may be given descriptive names: Addison disease is adrenal failure, and Down syndrome is trisomy-21.

As many as twenty2 medical conditions were named after the Nazi doctors who described them. These doctors were also participants in the eugenic and “racial purity” atrocities of the Third Reich. The guiding principles5 of “health leadership” in Nazi Germany were to:

  1. Guarantee that valuable genetic material could be transmitted unaltered
  2. Guarantee that inferior genetic material would be excluded from transmission
  3. Guarantee that mediocre genetic material be improved in whatever way possible

These rules were enacted in 1937 by Hans Reiter, president of the Reich health ministry. In 1939 the Reich Committee for Scientific Registration of Serious Hereditary and Congenital Diseases was established in Berlin.6 This committee ran a secret child “euthanasia” (murder) program. The Am Spiegelgrund Hospital was opened in 1940 in Vienna on the grounds of the Am Steinhof Psychiatric Hospital. It was here that most of the murders of handicapped and “uneducable” children, children that were of no value to the Reich, were committed.7

Hans Asperger (1906-1980) diagnosed and treated children with physical, neurological, and developmental handicaps. In 1938 he described a group of children with certain psychological conditions that he called “autistic psychopathy.”3 He published a more detailed paper on the same topic in 1944. These children, he noted, often had a great capacity for abstract thinking and the potential to prove valuable to society if they could be socialized. Otherwise, they would be unable to function in society and would be without value.4

Dr. Asperger, as well as other physicians, sent children with no chance of recovery to Spiegelgrund. The hospital’s director would inform Berlin of the patient’s status, and a panel of three medical professors decided if the child was to be killed. By sending certain patients to Spiegelgrund—as opposed to other facilities—physicians could be virtually certain that the child would be killed. Children were also sent to Spiegelgrund from orphanages and other institutions. A number of children who were subjects in tuberculosis vaccine experiments were sent there so that pathological findings produced by the vaccine could be discovered.

Children sent to Spiegelgrund were usually poisoned with barbiturates; some were starved to death. Parents were sent a letter stating that their child died of pneumonia, appendicitis, or another fabricated cause of death. Children were usually killed within a few months after admission. Nearly 800 children were killed at Spiegelgrund from 1940-1945.8

After serving in the Wehrmacht from 1944-1945, Asperger returned to practice. He had never been a member of the Nazi party, so he was not subject to denazification. His role in the murder of children was not generally known, and he continued to advance up the academic medical ladder. In 1962 he was promoted to Chair of the Vienna Pediatric Clinic, the highest position in Austrian pediatrics.

Asperger syndrome, denoting a high-functioning category of autistic persons, was first used in the International Classification of Diseases, tenth edition (ICD-10) in 1992. The term, in 1994, entered the fourth edition of the Diagnostic and Statistical Manual (DSM-IV) of the American Psychological Association, but was not in the DSM-5, when Asperger syndrome was integrated into the entity “Autistic Spectrum Disorder.”

Hans Reiter (1881-1964) served as a physician with the Hungarian Army in the First World War. In 1916 he reported on the concurrence of joint, eye, and urethral inflammation in a young officer, a condition that became known as Reiter’s syndrome and made its first appearance in English medical texts in the 1940s.9 Reiter became president of the Reich health ministry in 1937 and was also a member of the SS. He authorized the sterilization of 200,000 people and the “euthanasia” of 170,000.10 He designed medical experiments that killed additional thousands of concentration camp prisoners and approved the testing of a typhus vaccine that killed hundreds in Buchenwald.11 After the war he was tried at Nuremburg and imprisoned by American occupying forces as a war criminal (1945-1947).12 Later, he went back into medicine.

Today, what was known as Reiter syndrome is considered a reactive arthritis with conjunctivitis or uveitis and urethritis or cervicitis in predisposed individuals. This autoimmune inflammation may be triggered by infection with Salmonella, Shigella, Campylobacter, Yersinia, Chlamydia, or group A Streptococcus.13 In 2003 the editors of rheumatology journals stopped the use of Reiter syndrome in their journals and replaced it with reactive arthritis.14 An Israeli study15 indicated that while the term Reiter syndrome is appearing less frequently in medical journals, thirteen of fourteen medical textbooks used in Israel still use it, and the name is taught in two of the country’s four medical schools. The authors state that Reiter’s original triad of findings is too restrictive, that Reiter was not the first to describe the findings, that a more descriptive term is needed, and that to honor a Nazi murderer is an “abomination.” Ackerman16 suggests keeping the eponym but indicating that he was “a Nazi war criminal, who as a physician in the SS was responsible for sadistic medical experiments on inmates of extermination camps, resulting in the deaths of hundreds of them.” Some authors17,18,19 suggest dropping Reiter syndrome and using it only for historical reference.

Hersh20 proposes keeping the tainted eponyms in order to call attention to the victims of their crimes and the “unholy alliance between organized medicine and the Third Reich.” Others 21,22,23 ask that all Nazi doctor eponyms be discarded. There are also calls to stop using eponyms in general.24,25 Inertia makes it hard to change ways of thinking and speaking.26 We are, however, in a time of social flux: statues and university buildings named for eugenicists or slaveholders are being renamed.27 Could evil eponyms be next?

 

References

  1. Jozi Kucharz, “Medical Eponyms from Linguistic and Historical Points of View,” Rheumatologica 58, no.4 (2020): 258-260.
  2. Avi Ohri, “Should We Delete and Change Medical Eponyms Named after Nazi Doctors?”, Harefuah 158, no 8 (August 1 2019): 509-510.
  3. Herwig Czech, “Hans Asperger, National Socialism, and “Race Hygiene”in Nazi-era Vienna,” Molecular Autism 9, no.28 (2018).
  4. Ketil Slagstad, “Asperger, the Nazis and the Children: The History of a Birth of a Diagnosis,” Tidsk Nor Legeforen (24 May 2019).
  5. Robert Proctor, Racial Hygiene: Medicine under the Nazis. Cambridge: Harvard University Press, 1988. p 238.
  6. Slagstad, “Asperger, the Nazis.”
  7. Czech, “Hans Asperger, National Socialism.”
  8. Slagstad, “Asperger, the Nazis.”
  9. Lawrence Altman, “Experts Re-examine Dr Reiter, His Syndrome, and His Nazi Past,” New York Times, March 7 2000.
  10. Richard Panush, Daniel Wallace, Elliot Dorf, and Ephraim Engleman, “Retraction of the Suggestion to Use the Term ‘Reiter’s Syndrome’ Sixty-five Years Later: The Legacy of Reiter, a War Criminal, Should not Be Eponymic Honor, but Rather Condemnation,” Arthritis and Rheumatology, 30 January,2007.
  11. Altman, “Experts.”
  12. Daniel Wallace and Michael Weisman, “The Physician Hans Reiter as a Prisoner of War in Nuremburg: A Contextual Review of His Interrogations (1945-1947),” Semin Arthritis Rheum 32, no.4 (2003): 208-230.
  13. Bernard Ackerman, “Reiter Syndrome and Hans Reiter: Neither Legitimate,” JAAD 60, no.3 (2009): 517-518,
  14. Panush, “Retraction.”
  15. Yoav Keynan and Doron Riman, “Reactive Arthritis – The Appropriate Name,’ IMAJ 4 (April 2008): 256-258.
  16. Ackerman, “Reiter Syndrome.”
  17. Wallace,”The Physician.”
  18. Slagstad,” Asperger, the Nazis.”
  19. Czech, “Hans Asperger, National Socialism.”
  20. Sheldon Hersh, ”Tainted Eponyms: To Retain is To Remember, Neurology Consultant [published online November 19 2019].
  21. Rael Strous and Morris Edelman, “Eponyms and the Nazi Era: Time to Remember and time to Change,” Isr Med J 9, no.3 (2007): 207-214.
  22. Ilana Yurkiewicz, “Modern Medical Terms are Still Named After Nazi Doctors: Can We Change It,” Sci Am, November 15 2012.
  23. 23. SK Jindal, “Nazi Eponyms in Medicine,” JPMER. doi/JPMER/pdf/10.5005/jpmer-46-4-v
  24. Alexander Woywodt and Eric Matteson, “Should Eponyms be Abolished? Yes,” BMJ. doi.org/10.1136/bmj.3908.342639.AD
  25. Jindal, “Nazi Eponyms.”
  26. Altman, “Experts.”
  27. Lauren Bavis, “Universities Rethink Building Names in the Wake of Racial Justice Protests,” aired on Morning Edition, NPR, October 20 2020

 


 

HOWARD FISCHER, MD, retired as a professor of pediatrics from Wayne State University School of Medicine, Detroit, Michigan. He is the co-editor of a textbook, Child Abuse and Neglect, and has always had an interest in the interaction of medicine and society.

 

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