The link between reversible cerebral vasoconstriction syndrome and transient global amnesia.

Reversible cerebral vasoconstriction syndrome (RCVS) and transient global amnesia (TGA) are acute and self-limiting intra-cerebral conditions. Although previously studied as independent phenomena, there are increasing reports of co-occurrence of these two pathologies. We report a 55-year-old male who presented to the hospital with recurrent thunderclap headaches over the course of 1 week with sudden onset of anterograde memory loss. His medications included a selective serotonin reuptake inhibitor and intermittent use of pseudoephedrine. On examination he was amnestic to recent events and notably perseverating. Magnetic resonance imaging of the brain without contrast showed a small, punctate focus of restricted diffusion in the left hippocampus. He was diagnosed with TGA based on his clinical presentation. His headaches and amnesia resolved over the next 12 h throughout the course of his stay with acetaminophen and oral verapamil and he was discharged. Repeat computed tomography angiogram at 2 weeks revealed diffuse and segmental narrowing of the anterior and posterior intracranial circulation, which resolved on follow-up imaging at 3 months, confirming RCVS. The acute and reversible nature of these conditions and increasing reports of co-occurrence suggests a common pathophysiologic link. We review the literature highlighting similar cases and the presumed pathophysiology.

[The exclusion of "non-Aryan" scientists: universities, clinics and professional organizations]. / Der Ausschluss "nichtarischer" Wissenschaftler: Universitäten, Kliniken, Standesorganisationen.

With the implementation of the Law for the Restoration of the Professional Civil Service (1933), including the Third Implementation Decree (1934), the Regulation for Obtaining a Teaching License (1934) and the Law for the Dismissal and Transfer of University Teachers (1935), the National Socialist (NS) government created legislative instruments to ban university staff (from lecturers to full professors) labelled as Jewish or considered politically unwanted from teaching and research. Whereas around 20% of the staff at the universities were affected by these measures after 1933, at various medical faculties the figures reached 30-40% and at neurological departments and institutes sometimes up to 90%. Student Nazi activists played a significant role in expelling faculty members from office. As beneficiaries of the expulsions, young doctors often improved their career prospects and established professors remained silent out of political conviction, opportunism or fear. A (self) coordination (Gleichschaltung) with immediate or gradual exclusion of "non-Aryan" members and boards is documented for numerous medical organizations and associations (e.g. Deutscher Ärztevereinsbund, Hartmannbund, German Medical Women's Association, Association of Statutory Health Insurance Physicians) as well as for scientific academies (e.g. Leopoldina) and research societies (Kaiser Wilhelm Institutes, German Research Foundation). The NS-loyal Society of German Neurologists and Psychiatrists, which had been founded in 1935, tolerated "Jewish" members until 1938. As a whole, the picture that emerged from everyday medical (and neurological) practice is one of drastic changes that massively affected not only the lives of many doctors but also the moral standards in terms of patient care, teaching, research and collegiality.

[Context of the emigration of Jewish neurologists (1933-1939)]. / Rahmenbedingungen der Emigration jüdischer Neurologinnen und Neurologen (1933­1939).

This article focuses on the historical context of the emigration of "Jewish" doctors during the "Third Reich". The approximately 9000 Jewish physicians, who were still able to emigrate, represented 17% of the German medical profession in 1933. Around three quarters of them left the German Reich by 1939, mainly for the USA, Palestine and Great Britain. Initially, Jewish organizations fueled hopes of a temporary exile; however, in the wake of the events of 1938 ("Anschluss" of Austria, failure of the Evian Conference, establishment of the Central Office for Jewish Emigration headed by Adolf Eichmann in Vienna, maximization of economic plundering etc.) emigration via the intermediate step of forced emigration had turned into a life-saving flight. Scientists could appeal to special aid organizations for support. Among the best known are the Emergency Community of German Scientists Abroad initiated in Zurich, the Academic Assistance Council founded in England, from which originated the Society for the Protection of Science and Learning as well as the Emergency Committee in Aid of Displaced German Scholars created in New York. Their help was often subject to criteria, such as publication performance, scientific reputation and age. Promising researchers who were awarded a scholarship before 1933 could rely on a commitment from the Rockefeller Foundation. The historical analysis of options and motivations but also of restrictions and impediments affecting the decision-making process to emigrate, provides the basis for a retrospective approach to individual hardships and fates.

[Persecuted and forgotten? The neurologists Kurt Goldstein and Friedrich Heinrich Lewy]. / Verfolgt und vergessen? Die Neurologen Kurt Goldstein und Friedrich Heinrich Lewy.

This paper commemorates the careers and the scientific influence of the clinical neurologists Kurt Goldstein and Friedrich Heinrich Lewy including their forced migration in the mid-1930s. Goldstein (1878-1965) set up independent neurological departments in Frankfurt/Main and Berlin, adopting a decidedly holistic approach in medical care, research and teaching. He is therefore considered a co-founder of modern neuropsychology and neurorehabilitation. Goldstein came into the focus of the National Socialists as a Jew, socialist and adherent of psychotherapeutic methods. After a short incarceration he fled via Switzerland and Holland to the USA. Lewy (1885-1970) for his part specialized in neuropathological examinations and in 1912 quickly discovered the inclusion bodies in the cytoplasm of nerve cells named after him. As head of a neurological institute in Berlin with inpatient beds, he decided to leave Germany as early as 1933 and arrived after a stopover in England in the United States one year later. The biographies of the two highly innovative neurologists illustrate that career opportunities for doctors of Jewish descent were already clearly limited during the Weimar Republic and that they had to face anti-Semitic tendencies even after their arrival in the USA.

[" no reservations against the dismissals": the expulsion of neuroscientists from Berlin]. / " keinerlei Bedenken gegen die Entlassungen": die Vertreibung von Neurowissenschaftlerinnen und Neurowissenschaftlern aus Berlin.

Before 1933 Berlin was considered a center of clinical neurology and neuroscientific research in the German Reich. Using a group biographical approach and drawing upon scattered secondary literature as well as upon various archival documents, this article provides an overview of 12 less well-known physicians and researchers who were forced into exile during the nationalsocialist (NS) era, primarily for racist reasons. Among those affected by NS persecution were Franz Kramer and Fredy Quadfasel (Charité), Ernst Haase, Carl Felix List, and Lipman Halpern (Moabit Hospital), Paul Schuster (Hufeland Hospital), and Clemens Ernst Benda (Augusta Hospital). Others who were forced to emigrate were Franz Josef Kallmann (Herzberge Sanatorium), Max Bielschowsky, and Hans Löwenbach (Kaiser Wilhelm Institute for Brain Research), Otto Maas (Berlin-Buch Clinic), and Kurt Löwenstein (Lankwitz). A total of 6 neurological departments at municipal hospitals were run by (in NS terminology) "non-Aryans" in 1933. With their expulsion, the existence of neurological treatment and training centers outside the university ended and did not resume until the 1960s.

[Radicalization and "forced emigration": the dismissal and expulsion of neuroscientists and neuropsychiatrists from Vienna]. / Radikalisierung und "forcierte Emigration": die Entlassung und Vertreibung von Neurowissenschaftlern und Neuropsychiatern aus Wien.

Austria's so-called annexation (Anschluss) to Germany from March 1938 was followed by the ousting of "Jewish" doctors out of Vienna which happened faster and with more brutality than in the "Old Reich". According to National Socialist (NS) criteria, 92% of the neurologists at Vienna University were understood as being "non-Aryan". Victims of these expulsions were prominent figures, such as the head of the Neurological Institute Otto Marburg (1874-1949), a renowned multiple sclerosis researcher, and his pupil Ern(e)st Spiegel (1895-1985), a pioneer of stereotaxis. Similar to Berlin, nonuniversity departments of neurology were run by doctors who served as professors at the university, e.g., Josef Gerstmann (1878-1967) and his assistant Ilya Mark Scheinker (1902-1954). While these four continued their careers in the USA, the founder of neuroradiology Arthur Schüller (1874-1957) was able to flee to Australia. Hans Hoff (1897-1969) was part of the small group of returning emigrants, who in 1950 was appointed as the chair of psychiatry and neurology. The fate of the neurologists Ernst Sträussler (1872-1959) and Erwin Stransky (1877-1962) appears to be exceptional: both were dismissed and banned from teaching and practicing, but being married to "Aryan" wives spared them further persecution. Overall, within a short period of time neurology in Vienna lost a large number of its highly respected clinicians and researchers. Some of them refined their ideas and innovations abroad after 1945.

["Impossible to be part of this system any longer": the expulsion of neuroscientists from Frankfurt am Main (1933-1939)]. / "Impossible to be part of this system any longer": die Vertreibung von Neurowissenschaftlerinnen und Neurowissenschaftlern aus Frankfurt am Main (1933­1939).

In the 1920s, the situation of neuropsychiatry in Frankfurt was characterized by the rivalry between two institutions (Edinger Institute and University Neurology Clinic), two subdisciplines (neurology and psychiatry), and the physicians Kurt Goldstein (1878-1965) and Karl Kleist (1879-1960). After the National Socialists' assumption of power, university neuropsychiatric institutions in Frankfurt showed the highest number of dismissed university teachers and personnel in the German Reich. In neurology and psychiatry alone the university lost almost 50% of the personnel. Among those persecuted on racist grounds was Leo Alexander (1905-1985), who carried out genetic studies before 1933, prepared the "Alexander Reports" on behalf of the Allies after the Second World War, and was one of the prosecution counselors in the Nuremberg Doctors' Trial. His colleague Walther Riese (1890-1976) fled via France also to the USA and dedicated himself to the historical and ethical principles of neurology. Alice Rosenstein (1898-1991) was the first woman to specialize in neuroradiology and neurosurgery. In contrast to her male colleagues who were also dismissed in 1933, she committed herself to psychiatry after her arrival in North America and belonged to the early campaigners for the rights of homosexuals. Ernst (1905-1965) and Berta (1906-1995) Scharrer finally left Germany because of the prevailing political climate in the country. They excelled as co-founders of neuroendocrinology and neuroimmunology on the other side of the Atlantic.

[" without a visible sign of protest or at least solidarity from colleagues": the expulsion of neuroscientists from Hamburg]. / " ohne ein sichtbares Zeichen des Protestes oder wenigstens der Solidarität der Kollegen": die Vertreibung von Neurowissenschaftlern aus Hamburg.

In Hamburg, the National Socialists' racially motivated exclusion principally hit neurologists from two institutions: the Eppendorf Neurological Clinic (director until 1934 Max Nonne) and the Psychiatric and Neurological Clinic of Friedrichsberg State Hospital (director Wilhelm Weygandt). The chief physician of the neurological department of Barmbek Hospital, Heinrich Embden (1871-1941), who had been trained by Nonne, emigrated to Brazil, whereas Friedrich Wohlwill (1881-1958), another Nonne pupil who had been a pathologist at St Georg since 1924, lived for many years in Lisbon, before he found a new scientific home at the Harvard Medical School. The cerebrospinal fluid researcher Victor Kafka (1881-1955), a Freemason and intermittent member of the Communist Party, was briefly in so-called protective custody (Schutzhaft) in Fuhlsbüttel then fled via Norway to Sweden. Hermann Josephy (1887-1960) and Walter R. Kirschbaum (1894-1982), both imprisoned in the Sachsenhausen concentration camp after the November pogroms in 1938, could successfully continue their professional careers in Chicago. Richard Loewenberg (1898-1954) first opted to continue his career in China, then changed his mind and also went to the USA after the Japanese invasion. With the exception of the latter all were full members of the Society of German Neurologists. The broad scope of their research work clearly illustrates that in addition to clinical core competence, former neurologists could intensively follow scientific interests in the neighboring disciplines of pathology, serology, and psychiatry.

["There are no worthy life opportunities from a human, professional or scientific viewpoint": expelled neurologists outside the centers of German-speaking neuroscience]. / "Weder menschlich noch beruflich, noch wissenschaftlich würdige Lebensmöglichkeiten": vertriebene Neurologen außerhalb der Zentren der deutschsprachigen Neurowissenschaft.

The persecution and expulsion of German-speaking neurologists were not limited to research centers, such as Berlin, Vienna, Frankfurt am Main and Hamburg. The exclusion from science, teaching and clinical care also occurred at other (university) sites. The different aspects and implementation of the exclusion are presented here exemplified by 10 physicians involved in neuroscience. These ranged from forced internal emigration (Georg Stertz/Kiel), racially motivated removal from office (Max Isserlin and Karl Neubürger/both Munich, Ernst Grünthal/Würzburg, Gabriel Steiner/Heidelberg, Rudolf Altschul and Francis Schiller/both Prague) to publicly staged denunciation and humiliation (Otto Löwenstein/Bonn). Furthermore, without being directly persecuted themselves, individual physicians reacted to the poisoned political and academic climate in that they either sooner or later left their homeland (Eduard Heinrich Krapf/Cologne, Hartwig Kuhlenbeck/Jena). The results and conclusions summarized in this article for university clinics and institutes represent only a narrow section of the neurological scene in 1933-1939; however, they emphasize how necessary an expansion of the historical research perspective is on the fate of neurologists at communal hospitals, in field practices and other professional areas.

["We have to get rid of the Jews, either way": victims of violence among the neuroscientists]. / "Mit den Juden muß so oder so Schluß gemacht werden": Gewaltopfer unter den Neurowissenschaftlerinnen und Neurowissenschaftlern.

Neurologists as victims of National Socialist extermination policies have been rarely addressed as a special group in historical research. On the basis of archival documents and biographical literature, this essay presents 9 exemplary fates of a group of victims of violence whose number and structure so far cannot be estimated. These neurologists died in the ghettos of Lwów (e.g. Lucja Frey) and Theresienstadt (Alexander Spitzer/Vienna), were murdered in the concentration or extermination camps of Mauthausen (e.g. Raphael Weichbrodt/Frankfurt, Hans Pollnow/Berlin) and Auschwitz (e.g. Otto Sittig/Prague), or were executed in the East (e.g. Arthur Simons/Berlin). Others whose attempts to emigrate failed or whose deportation was imminent, chose to commit suicide. This group included the neuroserologist Felix Plaut (Munich), the encephalitis researcher Felix Stern (Göttingen), and presumably Fritz Chotzen (Breslau). In all these cases it was an eponym or a relationship to university medicine that prompted the investigations; however, the fate of innumerable colleagues employed in communal departments and medical practices remains unknown to date. Future studies will have to undertake a deeper look at the suffering of neuroscientists who perished in the Holocaust.

[Persecution, expulsion and extermination of German-speaking neurologists during the NS era: attempt at an assessment]. / Verfolgung, Vertreibung und Vernichtung deutschsprachiger Neurologinnen und Neurologen während der NS-Zeit: Versuch einer Bewertung.

Some 90 years after the beginning of the Nazi regime, the German Neurological Society (DGN) commissioned an investigation into the extent to which persecution, expulsion and extermination during the "Third Reich" also affected neurologists. In total, the biographies of 61 mostly Jewish physicians and scientists, of whom more than 70% were members of the neurological association of the time, could be analyzed. Most of them emigrated, a few remained in Germany or Austria despite persecution, and nine died in the Holocaust or by suicide. The racistically motivated expulsion affected all age groups, especially those who were 30-60 years old in "middle" positions. In close connection with Nazi legislation, three waves of emigration can be distinguished (1933-1934, 1935-1937, 1938-1939) and the clearly preferred destination country was the USA (64.7%). Younger age, knowledge of a universal language, reliable family and academic connections as well as internationally recognized publications, could make it easier to start a career in the country of exile. It was not uncommon for those who were involved in neurological fields before emigration to turn to basic science or psychiatry afterwards. The general "brain-drain"/"brain gain" hypothesis must be expanded by analyses on the biographical microlevel in order to illustrate the difficulties emigrants encountered when trying to start a new career and to publicize a sometimes unsuccessful acculturation. Not a single neurologist returned to Germany and, as far as can be assessed, any compensation, if at all was low. The critical assessment of the racistically motivated persecution between 1933 and 1945 can today be an occasion for the DGN and its members to reflect on collegiality as a value as well as to become more aware of structurally related discrimination and injustice and to counteract it in a timely manner.

Historical review: the German Neurological Society and its honorary members (1952-1982).

BACKGROUND: As part of a larger project commissioned by the German Neurological Society (DGN), this paper focuses on the DGN's German and Austrian honorary members. In particular, the question of whether former membership in the National Socialist German Workers' Party (NSDAP) or other Nazi organizations was an obstacle to becoming an honorary member in the years 1952-1982, and whether victims of the Nazi regime were also considered for honorary membership. RESULTS: From the early 1950s to the early 1980s, the DGN awarded honorary membership to 55 individuals. Of these, 27 were German or Austrian citizens who were physicians during the Nazi era, and 17 of the 27 (63%) were members of the NSDAP, Storm Troopers (SA), or Schutzstaffel (SS). In the early postwar period, honorary membership was much less frequently awarded to former Nazi Party members than in the years around 1980. Sir Ludwig Guttmann, the only neurologist forced to emigrate, received his honorary membership in 1971. Brief biographies of Hans Jacob, Gustav Bodechtel, Karl Kleist, and Ludwig Guttmann outline exemplary careers and life histories, in addition to highlighting key issues such as concurrent research on "euthanasia" victims, denazification procedures, forced emigration, and the contemporary mindset in the Federal Republic of Germany. CONCLUSIONS: Apparently, a "Nazi past" did not play a decisive role in the selection process for honorary members within the DGN until at least the 1980s. Aside from Guttmann, no other neuroscientist expelled from Germany was honored. With these practices, the Society marginalized its Jewish colleagues for a second time.

Acute encephalopathy in children with tuberous sclerosis complex.

OBJECTIVE: We examined the clinical manifestations of acute encephalopathy (AE) and identify risk factors for AE in children with tuberous sclerosis complex (TSC). METHODS: The clinical data of 11 children with clinically diagnosed TSC associated with AE and 109 children with clinically diagnosed TSC alone aged 4 years or older were collected from 13 hospitals. RESULTS: Of the 11 children with AE, 5 had histories of febrile seizures (FS), and all had histories of febrile status epilepticus (FSE). AE developed within 24 h after fever onset in all children with seizures lasting 30 min or longer. All children developed coma after seizure cessation. Head magnetic resonance imaging (MRI) revealed widespread abnormalities in the cerebral cortex, subcortical white matter, corpus callosum, basal ganglia, and thalamus. One child died; seven had severe neurological sequelae; and the other three, mild sequelae. Logistic regression analysis revealed that a history of FSE was correlated with the development of AE. SIGNIFICANCE: AE in children with TSC was characterized by sudden onset after fever, followed by coma, widespread brain edema evident on MRI, and poor outcomes. A history of FSE was a risk factor for the development of AE.

Functional movement disorder comorbidity in Parkinson's disease: Unraveling the web.

Functional movement disorders are commonly seen in neurology services and may coexist with other neurological diseases. This combination is known as "functional overlay" and an increasing interest on this topic has emerged in the past decade as the field of functional neurological disorders has moved forward. Some neurological diseases may be more prone to develop "functional overlay" than others, and within the field of movement disorders, most studies have focused on patients with Parkinson's disease. This review comprehensively summarizes the current body of knowledge on this topic and provides an expert opinion to equip clinicians with a pragmatic approach to recognize functional movement disorders in patients with Parkinson's disease, to communicate the diagnosis and to become familiar with potential therapies in this complex clinical scenario. Potential underlying mechanisms and risk factors that may play a role in increasing the vulnerability of Parkinson's disease patients to develop functional movement disorder comorbidity are also discussed within the framework of modern neurobiological theories of brain functioning.

Historic review: select chapters of a history of stroke.

BACKGROUND: There is no shortage of books, chapters and papers on the history of stroke focusing predominantly on the last 150 years and enumerating endless "milestones". Instead of adding another article to this body of knowledge, this essay aims at ensuring awareness for the "big picture", the "grandes routes", and the "striking breakes" without overloading the reader with too much detail. RESULTS: From a medical point of view, the history of stroke consists of two periods: the early era from the beginnings to 1812, and the following period from 1812 up to the present. It is argued that both periods require different methodical approaches, including disparate historiographical perspectives and varying forms of interpretation. In order to fully understand medical writings of the Greco-Roman era (Hippocratic writings, Galenic corpus) on "apoplexy", a solid knowledge of ancient doctrines concerning health and disease is indispensable. During the Middle Ages, the spiritual perspective can be highlighted by focusing on miracle healing and patron saints. While stroke basically remained a conundrum for many doctors and patients in early modern times (ca. 1500-1800; Platter, Wepfer), the revolutionary perception and definition of the disease as a result of a lesion in the 1810s (Rochoux, Rostan) opened the door to a productive relationship of the upcoming discipline "neurology" with the natural sciences during the nineteenth century and beyond (Virchow et al.). The mostly unwritten history of stroke in the twentieth century should not only include the medical, but also the patient's and the societal perspective. CONCLUSION: A deeper insight into the recent and distant past will produce better educated strokologists - physicians who are able to put their own work into perspective.

The Merging Tracks of Anosognosia and Neglect.

Anosognosia and hemineglect are among the most startling neurological phenomena identified during the 20th century. Though both are associated with right hemisphere cerebral dysfunction, notably stroke, each disorder had its own distinct literature. Anosognosia, as coined by Babinski in 1914, describes patients who seem to have no idea of their paralysis, despite general cognitive preservation. Certain patients seem more than unaware, with apparent resistance to awareness. More extreme, and qualitatively distinct, is denial of hemiplegia. Various interpretations of pathogenesis are still deliberated. As accounts of its captivating manifestations grew, anosognosia was established as a prominent symbol of neurological and psychic disturbance accompanying (right-hemisphere) stroke. Although reports of specific neglect-related symptomatology appeared earlier, not until nearly 2 decades after anosognosia's inaugural definition was neglect formally defined by Brain, paving a path spanning some years, to depict a class of disorder with heterogeneous variants. Disordered awareness of body and extrapersonal space with right parietal lesions, and other symptom variations, were gathered under the canopy of neglect. Viewed as a disorder of corporeal awareness, explanatory interpretations involve mechanisms of extinction and perceptual processing, disturbance of spatial attention, and others. Odd alterations involving apparent concern, attitudes, or belief characterize many right hemisphere conditions. Anosognosia and neglect are re-examined, from the perspective of unawareness, the nature of belief, and its baffling distortions. Conceptual parallels between these 2 distinct disorders emerge, as the major role of the right hemisphere in mental representation of self is highlighted by its most fascinating syndromes of altered awareness.

[Neurologists and neuroscientists: who was a Nazi? Changing perspectives on NS incrimination in the history of German medicine]. / Neurologen und Neurowissenschaftler: Wer war ein Nazi? Zum Umgang mit der NS-Belastung in der Geschichte der deutschen Medizin.

The German Neurological Society (DGN) instigated an investigation into potential incrimination of some of the previous leading members regarding their Nazi involvement. The persons in question include former (honorary) presidents and honorary members of the DGN (or the predecessor organizations) and the name givers of prizes awarded by the DGN. This introduction to the following biographies explains the difficulties and the broad discretionary leeway needed to establish an involvement in Nazi activities going beyond justiciable crimes against humanity on the basis of formal criteria (e.g. membership in the NSDAP and/or other NS organizations, involvement in Nazi crimes) and/or substantive indications (e.g. statements advocating the NS ideology, personal contacts to Nazi functionaries, active support of the system). A longitudinal analysis from 1945 until the present day reveals time-related variations in assessing who and why someone was considered to be a Nazi. A current overview of historical projects initiated by medical societies in Germany demonstrates that the endeavor of the DGN to deal with its Nazi involvement will be an integral part of the interdisciplinary "culture to cope with the past" of medical associations. Finally, it should be borne in mind that the fabric of history consists of a different material than clinical medicine or its natural scientific foundations. Checklists or scores for measuring NS involvement thus cannot and will not exist. Instead, balanced historical interpretations are needed as attempted by the biographical reconstructions presented in this volume.

[Max Nonne (1861-1959) and his attitude towards "euthanasia"]. / Max Nonne (1861­1959) und seine Einstellung zur "Euthanasie".

Max Nonne, an internationally renowned German neurologist, acted from 1918 to 1924 as president of the (first) Society of German Neurologists (GDN). Appointed honorary president in 1925, he held this position in the (second) German Neurological Society (DGN) until his death. Since 1961, this association has honored 16 neurologists with a commemorative medal named after Nonne. His outstanding findings in various fields of neurology are uncontested and some of them live on as eponyms (Nonne-Apelt syndrome, Nonne-Froin syndrome, Nonne-Milroy-Meige syndrome); however, recent archival studies and an analysis of individual publications deeply darkened the image of the "grey eminence" of German neurology. Records kept at the Hamburg State Archive prove that in a memorandum from 1941/1942 following the example of Binding and Hoche, Nonne firmly approved the killing of "life absolutely unworthy of living". In a report addressed to the District Court of Hamburg he attested in 1946 that many physicians charged with manslaughter acted in accordance with the regulations governing "child euthanasia", resulting in the withdrawal of the accusation. In a further statement from 1949 he confirmed that the killing of children and the "euthanasia program" during the NS era were consistent with the state of medical science. An earlier book chapter authored by Nonne immediately after World War I suggested that his social-Darwinistically colored concept of mankind was developed clearly before the Nazi era. Notwithstanding the arrangement to which he came with the new powers after 1933 and his acceptance of tributes to him by them, he repeatedly stood up for his Jewish colleagues. He was never a Nazi, nevertheless, he engaged in activities that fostered NS "euthanasia" going far beyond a "mentality of approval".

[Otfrid Foerster (1873-1941) and his ambivalent attitude towards National Socialism]. / Die ambivalente Haltung Otfrid Foersters (1873­1941) gegenüber dem Nationalsozialismus.

When Adolf Hitler was appointed Chancellor of the Reich Otfrid Foerster was almost 60 years old and an internationally renowned neurologist, neurosurgeon and a pioneer of localization research. Since 1922 he held the chair of neurology in Breslau (Wroclaw) and from 1925 to 1932 he was president (later honorary president) of the first Society of German Neurologists. In 1934 "his" Neurological Research Institute in Breslau was inaugurated. Biographical studies have unanimously established that he has never been a member of the party, that he found himself promptly marginalized after 1933 within his own ranks, and that he never participated in eugenic measures or "euthanasia" activities. A re-reading and analysis of his relevant papers and publications on neurology reveal however reverences paid to the Nazi state, which are surprising in this clarity. A possible explanation for Foerster's overall ambivalent attitude, he was married to a non-Aryan woman (in Nazi jargon), is the threat posed to his relatives by Nazi racial hygiene laws. On the other hand, there are clear indications of his conservative German national patriotism encouraging and supporting a restrengthened state and the National Socialist vision of the German Reich as a "great power". Further investigations will have to show how the numerous influential factors that had a bearing on his biographical characteristics, political attitude, medical research interests and private motivation should be weighted.