German neurologist and neurosurgeon
Otfrid Foerster
(9 November 1873 ? 15 June 1941) was a German
neurologist
and
neurosurgeon
, who made innovative contributions to
neurology
and
neurosurgery
, such as
rhizotomy
for the treatment of
spasticity
, anterolateral
cordotomy
for
pain
, the
hyperventilation test
for epilepsy,
Foerster's syndrome
, the first
electrocorticogram
of a
brain tumor
,
[1]
and the first surgeries for
epilepsy
.
[2]
He is also known as the first to describe the
dermatomes
(an area of
skin
that is supplied by a single pair of dorsal nerve roots), and he helped map the motor cortex of the cerebrum.
[3]
[4]
Life
[
edit
]
Foerster was born in Breslau (now
Wrocław
) to
Richard Foerster
, and studied in the Maria Magdalenen Gymnasium, graduating 1892. From 1892 to 1896 he studied
medicine
in
Freiburg
,
Kiel
and Breslau, obtaining his licensure by state examination in 1897 and his doctorate in the same year. Upon completion of the doctoral studies, he spent two years studying abroad, following a suggestion by
Karl Wernicke
(1848-1905): in the summer he went to
Paris
, studying with
Joseph Jules Dejerine
and attending classes by
Pierre Marie
and
Joseph Babinski
(1857-1932); and in the summer with
Heinrich Frenkel
in Switzerland, in order to study
physical therapy
of neurological patients there.
Foerster's student years occurred in a time when neurology was starting to develop independently from
internal medicine
and
psychiatry
under the influence of, among others,
Jean-Martin Charcot
(1825-1893),
Wilhelm Heinrich Erb
,
William Richard Gowers
(1845-1912) and particularly Karl Wernicke, who became well known by his direction toward functional localization approaches. By cooperating with Wernike, Foerster's great interest on the
anatomy
of the
central nervous system
was excited. The two researchers published together in 1903 an anatomical atlas of the brain (
Atlas des Gehirns
). At the time, the several schools of neurology were focused essentially on to
diagnosis
; because achieving an effective therapy was hardly possible. It was Foerster who took forward the idea of using physical therapy as a new way of treating patients with neurological disturbances. From this work arose his theoretical interest on the disturbances of
motor coordination
in the execution of movements: this resulted in the topic of his dissertation in 1902, a work which attained a great actuality in connection with the systematic introduction of
rehabilitation medicine
into neurology. The involvement of
spinal reflexes
in the genesis of muscular
spasticity
suggested its possible treatment by surgical interruption of the sensory branch of the thoracic and lumbar nerves (
rhizotomy
), and Foerster developed in 1908 an operation to cut the posterior sensory root in order to alleviate spasticity.
In 1915 Foerster first reported on his innovative results concerning the
surgical treatment
of
nerve damage
by shot
wounds
, as well as other kinds of
spinal cord
and
brain
damage.
From 1922 to 1924 Foerster went to Russia as he attended
Lenin
after his stroke.
[1]
When his most famous patient died, he was asked to suggest a scientist who could examine Lenin’s brain after the autopsy. He recommended
Oskar Vogt
. As the most important of all the foreign consultants, his signature appeared on all the documents about the treatment and the death of Lenin.
[2]
[5]
Even if he has not cooperated with the National Socialists, his finances were restricted and his professional activities curtailed.
[2]
He was put under surveillance by the german authorities.
[5]
This was due to : his past connections to Lenin; the fact that his wife was partly Jewish;
[6]
and the 1932's Rockefeller Foundation grant,
[2]
urged by Foerster’s American friends, who funded the modern laboratory building of the Institute of Neurology. In 1934, the same year the building was built, he was deprived of his extraordinary professorship and in 1938 was relieved of the function of university professor.
[2]
In the time between the two world wars (1925 to 1935) Breslau became a place of attraction for training neurologists and neurosurgeons, particularly those coming from the United States. One of his early students coming from that part of the world was
Wilder Penfield
(1891-1976), who continued Foerster's work on the analysis of the
cerebral cortex
's command of movement and the study of
epilepsy
. Other students were
Percival Bailey
, who developed a new classification of
brain tumors
, and
Paul Bucy
, discoverer of the famous
Kluver-Bucy syndrome
, who made fundamental work on the organization of
motor cortex
, and
Robert Wartenberg
(1897-1956, discoverer of the
Wartenberg's syndrome
). Other eminent visitors were
Alfred Adson
,
Max Peet
,
Edgar Kahn
,
John Fulton
and
Margaret Kennard
.
[5]
One of Foerster's important methods was to use local anaesthesia to keep brain surgery patients awake. While they lay there, Foerster would poke at their brain with an electronic needle, and use the subsequent motor reactions (hand movement, finger movement, etc.) to learn about the brain's
motor cortex
.
He received the
Hughlings Jackson
Memorial Medal, which he cherished the most of all his academic honors during the second International Neurological Congress in London in 1935.
[7]
But he received no single German honor between 1933 and his death.
[2]
Foerster died in 1941 in Breslau, at age 67.
Recognition
[
edit
]
Thus, Foerster's prominent position in the neurology of Germany was recognized in 1924. His prominence was at the same level of
Max Nonne
(1861-1959) and Foerster succeeded him as the president of the
German Society of Neurology
for eight years until 1932. From 1925 to 1935 Foerster brought all available analytic methods into his research, such as
electrophysiology
, which measures or induces electrical voltage among tissues, such as the brain.
[8]
Fundamental work was developed about the electrical phenomena occurring in the reflex disturbances in the
pyramidal system
syndromes, such as lesions in the
pallidum
lesions etc. With the help of donations from the
Rockefeller Foundation
and the support of the State of
Prussia
, Foerster was able to open a new Institute of Neurological Research in 1934, which was later renamed after him (University of Breslau's
Otfrid Foerster Institut Fur Neurologie
). Otfrid Foerster was, together with
Oswald Bumke
, co-editor of a monumental textbook of neurology, in which he wrote several chapters.
Described by his biographers as a giant of neurosurgery, a man of towering intelligence, kindness and charm, he commanded several languages fluently and was a prolific lecturer and writer, having published more than 300 papers and several books. His name has been honoured by the German Society of Neurosurgery by the
Otfrid-Foerster-Medaille und -Gedachtnisvorlesung
(Otfrid Foerster Medal and Memorial Lecture), created on August 26, 1953.
Works
[
edit
]
- Physiologie und Pathologie der Coordination
, Jena 1902
- Atlas des Gehirns
, herausgegeben von Karl Wernicke, Berlin 1903
- Beitrage zur Hirnchirurgie
, Berlin 1909
- Die Kontrakturen bei den Erkrankungen der Pyramidenbahn
, Berlin 1909
- Uber die operative Behandlung spastischer Lahmungen mittels Resektion der hinteren Ruckenmarkswurzel
, Berlin 1911
- Foerster (1911).
"Resection of the Posterior Spinal Nerve-roots in the Treatment of Gastric Crises and Spastic Paralysis"
.
Proceedings of the Royal Society of Medicine
.
4
(Surg Sect): 226?246.
doi
:
10.1177/003591571100401548
.
PMC
2004804
.
PMID
19975563
.
- Zur Pathogenese und chirurgische Behandlung der Epilepsie
, Leipzig 1925
- Foerster, O (1926). "Die Pathogenese des epileptischen Krampfanfalles".
Deutsche Zeitschrift fur Nervenheilkunde
(in German).
94
(1): 15?53.
doi
:
10.1007/BF01652996
.
S2CID
12765661
.
- Penfield, Wilder; Foerster, Otfrid (1930). "The structural basis of traumatic epilepsy and results of radical operation".
Brain
.
53
(2): 99?119.
doi
:
10.1093/brain/53.2.99
.
hdl
:
11858/00-001M-0000-002B-0D28-A
.
- Foerster, O (1933). "The dermatomes in man".
Brain
.
56
(1): 1?39.
doi
:
10.1093/brain/56.1.1
.
- Der Schmerz und seine operative Behandlung
, Halle 1935
References
[
edit
]
- ^
a
b
Sarikcioglu, Levent (June 2007).
"Otfrid Foerster (1873?1941): one of the distinguished neuroscientists of his time"
.
Journal of Neurology, Neurosurgery, and Psychiatry
.
78
(6): 650.
doi
:
10.1136/jnnp.2006.112680
.
ISSN
0022-3050
.
PMC
2077957
.
PMID
17507449
.
- ^
a
b
c
d
e
f
Piotrowska, Natalia; Winkler, Peter A. (August 2007). "Otfrid Foerster, the great neurologist and neurosurgeon from Breslau (Wrocław): his influence on early neurosurgeons and legacy to present-day neurosurgery".
Journal of Neurosurgery
.
107
(2): 451?456.
doi
:
10.3171/JNS-07/08/0451
.
ISSN
0022-3085
.
PMID
17695406
.
- ^
Foerster, O. (1936). "The motor cortex in man in the light of Hughlings Jackson's doctrines".
Brain
.
59
(2): 135?159.
doi
:
10.1093/brain/59.2.135
.
ISSN
0006-8950
.
- ^
Foerster O. Motorische Felder und Bahnen. In: Bumke H, Foerster O, eds. Handbuch der Neurologie IV. Berlin: Springer-Verlag;1936; 49?56
- ^
a
b
c
Compston, Alastair (February 2017).
"The structural basis of traumatic epilepsy and results of radical operation. By O. Foerster, Breslau, and Wilder Penfield, Montreal"
.
Brain
.
140
(2): 508?513.
doi
:
10.1093/brain/aww354
.
ISSN
0006-8950
.
- ^
Something hidden : a biography of Wilder Penfield.
Jefferson Lewis, Doubleday and Co., 1981.
ISBN
0-385-17696-1
. (
read online
) Page 159
- ^
Tan, T.-C.; Black, P.M. (2014), "Foerster, Otfrid",
Encyclopedia of the Neurological Sciences
, Elsevier, pp. 335?338,
doi
:
10.1016/b978-0-12-385157-4.00873-3
,
ISBN
9780123851581
- ^
"Wilder Graves Penfield"
.
Bibliography
[
edit
]
- Otfrid Foerster 1873?1941: An Appreciation.
J Neurophysiol
5: 1-17, 1942
Full text PDF
- Zulch, K.J. (October 1971). "Otfrid Foerster, Physician and Naturalist (1873?1941)".
Med Hist
.
15
(4): 412?413.
- Tan, Tze-Ching; Black, Peter (November 2001). "The Contributions of Otfrid Foerster (1873-1941) to Neurology and Neurosurgery".
Neurosurgery
.
49
(5): 1231?1236.
doi
:
10.1227/00006123-200111000-00038
.
PMID
11846917
.
- Wichert-Ana, L.; Carlotti, C.G.; Assirati, J.A.; Meneghelli, U.G.; Sakamoto, A.C.; Machado, H.R. A Brief History of the Epilepsy Surgery. e-Childrens Brain.
Full text
- Greenberg, S.A. (2003). "The History of Dermatome Mapping".
Arch Neurol
.
60
(1): 126?131.
doi
:
10.1001/archneur.60.1.126
.
PMID
12533100
.
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