Alzheimer: The Life of a Physician and the Career of a Disease (review)

Little has been written about the history of Alzheimer's disease, and still less about the man for whom it is named—German psychiatrist Alois Alzheimer. In this book, Konrad and Ulrike Maurer show that Alzheimer was a multifaceted man: a generous father and husband who suffered from the early deaths of two wives, a patriotic German who was deeply affected by the coming of World War I, an outstanding clinician devoted to his patients and interested in developments in psychotherapy, and a versatile author who wrote on some of the most vexing issues facing psychiatry.

This clearly written, engaging book traces Alzheimer's life from his ancestral roots through his death at age fifty-one of a heart condition evidently brought on by stress and overwork (he had three years earlier ascended to one of the highest positions in German academic psychiatry at that time: full professorship at the Psychiatric Clinic of Friedrich-Wilhelm University in Breslau). Interestingly, the Maurers show that Alzheimer's reputation did not rest upon his identification in 1906 of the disease that his mentor Emil Kraepelin named for him in 1910. Rather, he was recognized for his broader contributions to psychiatry through the application of the power of the microscope to the clinical problems of psy-chiatry. Alzheimer's description of the puzzling case of fifty-one-year-old Auguste D., who exhibited the symptoms of dementia at an unusually early age, was an integral part of that contribution—but at the time it seemed a minor chapter in his illustrious career, and few of the many obituaries that lamented his early death in 1915 even mentioned the eponym.

Among the revelations of this book is that Alzheimer was deeply committed to the humane and dignified treatment of institutionalized psychiatric patients. During his first clinical post as an intern, and later as chief physician in Frankfurt, he worked with his first supervisor and mentor, Emil Sioli, to establish an open ward system and the nonrestraint of patients. Furthermore, the Maurers show that Alzheimer's extensive clinical interviews allowed him to develop a close, trusting relationship with his patients, particularly Auguste D.

Another revelation is the extent to which Alzheimer published on social issues confronting psychiatry. Although he was an indefatigable researcher, he still found time to write about issues such as aborting the pregnancies of the mentally ill—a practice he opposed except in the rare cases where it could save the life of the mother. In one article Alzheimer clearly rejected the theory of hereditary mental degeneration that would eventually bear such bitter fruit in the Nazi program of "euthanasia," arguing that "there is and must also be . . . a regeneration, a gradual disappearance of pathological dispositions from the genealogical tree, because otherwise humanity probably would already have degenerated completely" (p. 148). Yet an article that he wrote in 1915 makes his opinion about degeneration seem more equivocal: in it he seemed to resort to the theory of degeneration to explain some aspects of the nervous disorders appearing so frequently among soldiers.

This book caps nearly a decade of work by the authors recovering Alzheimer's life and legacy. Konrad Maurer and his colleagues in Frankfurt searched for years before finding the complete file with Alzheimer's original notes; Ulrike Maurer helped to turn the home in which Alzheimer was born into a museum and conference center owned by Eli Lilly. Reflecting the Maurers' commitment to Alzheimer's legacy, the book is aimed at a broad general audience. As a result, scholars may find some of the authors' methods limiting, such as the tendency to compile a chronicle rather than provide an analysis. For example, the precise content of Alzheimer's curriculum vitae is listed verbatim each time he attained a new position, and letters and obituaries are quoted at...