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.

[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.

[" 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.

[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.

[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.

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.

[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.

[Georg Schaltenbrand (1897-1979) and his research without moral boundaries on multiple sclerosis]. / Georg Schaltenbrand (1897­1979) und seine "entgrenzte Forschung" zur Multiplen Sklerose.

In 1953 the prominent German neurologist Georg(es) Schaltenbrand became president of the German Neurological Society (DGN) and in 1967 honorary president. Less well known is the fact that from 1933 to 1936 he was member of the "Stahlhelm" and the Storm Troopers (SA). In 1937 he joined the National Socialist German Workers' Party (NSDAP) and other Nazi organizations. For the last three decades Schaltenbrand's name has primarily been associated with human experiments performed in 1940. His objective was to prove the viral etiology of multiple sclerosis (MS). To that end he injected cerebrospinal fluid (CSF) drawn from allegedly infected monkeys and MS patients into severely handicapped patients from the psychiatric asylum Werneck near Schweinfurt as well as into severely ill patients from the University Hospital of Würzburg without their consent. Weeks later he withdrew CSF samples from the recipients, sometimes repeatedly to control parameters of inflammation. Although not all details of his test series can be clarified, there is no doubt that he violated prevailing laws and ethical standards. According to the present state of knowledge, he was the only German professor of neurology during the Nazi era who performed such experiments on humans in terms of "research without moral boundaries". He later justified his actions by arguing that he had intended to exert a positive effect on the mentally ill. Judicial investigations ended in 1948 without an indictment. Long after his death, in 1994 the "Schaltenbrand experiments" became known to a wider public and three years later the Medical Faculty of Würzburg condemned the unethical research and distanced itself from its former member. Today, Schaltenbrand's study is assessed as an unacceptable form of research on particularly vulnerable patients for the benefit of third parties. As a result, ethical norms formulated in the 1930s were reinforced by international guidelines, e.g. the Declaration of Helsinki drafted by the World Medical Association.

[A staunch National Socialist? Paul Vogel (1900-1979)]. / " voll und ganz auf dem Boden des Nationalsozialismus"? Paul Vogel (1900­1979).

Paul Vogel belonged to a group of neurologists born around 1900 who felt particularly attracted by the promises of National Socialism. Shortly after having completed his Habilitation in 1934 he became head of the leading neurology department in Berlin located at the Hansaplatz. Doctors working there reported patients for sterilization according to the Law for the Prevention of Genetically Diseased Offspring. They also acted as experts for Hereditary Health Courts (Erbgesundheitsgerichte). In 1933, Vogel chose to join the NS Medical Association and in 1937 became member of the National Socialist German Workers' Party (NSDAP). Influential medical officials confirmed his "political reliability" and this status made him eligible to succeed Viktor von Weizsäcker, his teacher, at Heidelberg University in 1941. A denazification tribunal classified him in 1946 as a follower (Mitläufer) partly because he was said to have taken a stance against the NS film drama "I accuse" in front of medical students. After WWII Vogel developed the neurological wards in Heidelberg into a fully-fledged neurological department. In 1955 and 1956 he acted as president of the German Neurological Society. In 1978 he became an honorary member.

[SS Captain Helmut J. Bauer (1914-2008)]. / SS-Hauptsturmführer Helmut J. Bauer (1914­2008).

It is well-known that from 1963 Helmut Bauer was head of the department of neurology at the University of Göttingen and was one of the German pioneers in research into multiple sclerosis. During the years 1971-1972 he acted as president, later honorary president of the German Neurological Society (DGN), of which he also became honorary member in 1982. Almost unknown, however, is his career during the "Third Reich" and immediately after the war. After returning from the USA in 1932, he completed his medical studies in the German Reich. In 1940 he again acquired German citizenship, which has to be interpreted as an acknowledgement of the Nazi regime. He was initially active in the Foreign Department of the Reich Medical Council. In 1941 he joined the SS and served as member of the so-called Künsberg special commandos of the SS in France, Greece, and Italy as well as in the Baltic states and the Soviet Union (1941-1943). As a medical case officer, he was in charge of the confiscation of medical material and documents, even of healthcare institutions and of Jewish property. In 1943 and 1944 he worked as SS Captain (Hauptsturmführer) at the Research Center for Medicine in Foreign Countries and Settlement Biology and the Institute for Microbiology at Sachsenburg Castle near Frankenberg in Saxony, a joint establishment of the Wehrmacht, the Ministry of the Interior and the Robert Koch Institute in cooperation with the SS. In addition to the search for a vaccine against Yersinia pestis and the participation in war propaganda, Bauer's research unit was mainly concerned with the statistical evaluation of "racial examinations" of resettlers. After a short time as a prisoner of war (POW), Bauer had to undergo a denazification trial where he succeeded in being exonerated enabling him to pursue his medical career. Recent historical investigations have revealed that he was involved in military and racial hygiene (eugenics) crimes of the Nazis and therefore belonged to the group of persons who were active supporters of the political system.

[Between affirmation and negation: Karl Kleist and Viktor von Weizsäcker between 1933 and 1945]. / Zwischen "Affirmation und Kritik": Karl Kleist und Viktor von Weizsäcker zwischen 1933 und 1945.

In 1954 Karl Kleist (1879-1960) became an honorary member of the German Neurological Society (DGN), an honor that was granted 2 years earlier to his colleague Viktor von Weizsäcker (1886-1957). The attempt to classify and assess their careers between 1933 and 1945 led to diametrically opposed results in historical research. This article summarizes the main lines of argumentation and draws a preliminary conclusion. After 1933 Kleist is said to have felt more and more accountable for his non-Aryan colleagues and that he treated his Jewish patients as long as he could. Publications and third party testimonies confirmed that he circumvented at least occasionally the Law for the Prevention of Genetically Diseased Offspring (GzVeN). Furthermore, he is said to have saved patients from "euthanasia" actions by prudently formulated diagnoses. Simultaneously, he worked as an expert at the Appelate Hereditary Health Court in Frankfurt am Main, in 1940 he joined the National Socialist German Workers' Party (NSDAP) and in 1942 the NS Medical Association. Von Weizsäcker used his scope of action in a similarly contradictory way. Certainly, he kept away from central Nazi organizations and was considered "politically unreliable" by those colleagues who had a penchant for the system. But as professor of neurology he formally headed from 1941 onwards exactly that Neuropathological Research Institute in Breslau (Wroclaw) where one of his colleagues examined the brains of minors who had been killed in the course of "child euthanasia", in what was called "concomitant research". To a certain extent von Weizsäcker was also an advocate of the GzVeN. In his lectures and publications between 1933 and 1935 he chose the pertinent NS terminology and he was the first to speak of a "theory of extermination". In either case, even meticulous research could not answer the question where to exactly assign both biographies in a spectrum between criticism and affirmation of National Socialism.

[Neuroscientists at the Kaiser Wilhelm Institute for Brain Research in the "Third Reich": Oskar Vogt-Hugo Spatz-Wilhelm Tönnis]. / Neurowissenschaftler am Kaiser-Wilhelm-Institut für Hirnforschung im "Dritten Reich": Oskar Vogt ­ Hugo Spatz ­ Wilhelm Tönnis.

The Kaiser Wilhelm Institute (KWI) for Brain Research in Berlin-Buch was one of the key institutions enmeshed in the euthanasia program between 1939 and 1945, generating scientific knowledge by dissecting the brains of murdered patients. As a consequence, this institution and its early years have attracted the attention of historians for years. The neuroanatomist Oskar Vogt (1870-1959), director of the KWI until 1937 and his wife Cécile (1875-1962) who were both appointed honorary members of the German Neurological Society (DGN) in 1952, concentrated on the microstructure and brain architecture of healthy and "elite" brains. Vogt's successor, Hugo Spatz (1888-1969), shifted research activities towards pathology of the central nervous system (CNS) and incorporated psychiatric and military institutions into the institute's network. Spatz had been a member of the National Socialist German Workers' Party (NSDAP) since 1938. As acting director of the KWI he was responsible for the dissections performed by Hallervorden on murdered patients. After the war Spatz tried to justify his actions. Years after the unveiling of these relationships the DGN decided in 1998 to rename the Hugo Spatz award. Wilhelm Tönnis (1898-1978), the German pioneer of neurosurgery had been a member of the National Socialist Air Corps since 1933 and a member of the NSDAP since 1937, finally joining the NS Medical Association in 1938. After the war he played down his affiliation to NS divisions. When his denazification trial had ended he pursued his career in the young Federal Republic of Germany. In 1976 he was elected honorary member of the DGN, 2 years before his death.

[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".