Otfrid Foerster
Encyclopedia
Neurologist
A neurologist is a physician who specializes in neurology, and is trained to investigate, or diagnose and treat neurological disorders.Neurology is the medical specialty related to the human nervous system. The nervous system encompasses the brain, spinal cord, and peripheral nerves. A specialist...
and neurosurgeon, who made innovative contributions to neurology
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
and neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
, such as rhizotomy
Rhizotomy
A rhizotomy is a term chiefly referring to a neurosurgical procedure that selectively severs problematic nerve roots in the spinal cord, most often to relieve the symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy...
for the treatment of spasticity
Spasticity
Spasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles...
, anterolateral cordotomy
Cordotomy
Cordotomy is a surgical procedure that disables selected pain-conducting tracts in the spinal cord, in order to achieve loss of pain and temperature perception. This procedure is commonly performed on patients experiencing severe pain due to cancer or other diseases for which there is currently no...
for pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
, the hyperventilation test for epilepsy, Foerster's syndrome
Foerster's syndrome
Foerster’s syndrome is the name used by Arthur Koestler in his account of the compulsive punning first described by the German neurosurgeon Otfrid Foerster....
, the first electrocorticogram of a brain tumor
Brain tumor
A brain tumor is an intracranial solid neoplasm, a tumor within the brain or the central spinal canal.Brain tumors include all tumors inside the cranium or in the central spinal canal...
, and the first surgeries for epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
. He is also known as the first to describe the dermatomes
Dermatomic area
A dermatome is an area of skin that is mainly supplied by a single spinal nerve.There are eight cervical nerves ,twelve thoracic nerves,five lumbar nerves and five sacral nerves....
(an area of skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
that is supplied by a single pair of dorsal nerve roots), and he helped map the motor cortex of the cerebrumhttp://brain.oxfordjournals.org/cgi/reprint/59/2/135?ijkey=a357c93b1af6ac4d2422e6ec3624183cb53f6176&keytype2=tf_ipsecsha
.
Life
Foerster was born in Breslau to Richard FoersterRichard Foerster (classical scholar)
Richard Foerster was a German classical scholar.- Biography :Though born and raised in Görlitz, Foerster never saw himself a Lusatian and felt the strongest allegiance to Silesia, where he studied since winter term 1861 after a semester at Jena. In Breslau he dropped theology and concentrated on...
, and studied in the Maria Magdalenen Gymnasium, graduating 1892. From 1892 to 1896 he studied medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
in Freiburg
Freiburg
Freiburg im Breisgau is a city in Baden-Württemberg, Germany. In the extreme south-west of the country, it straddles the Dreisam river, at the foot of the Schlossberg. Historically, the city has acted as the hub of the Breisgau region on the western edge of the Black Forest in the Upper Rhine Plain...
, Kiel
Kiel
Kiel is the capital and most populous city in the northern German state of Schleswig-Holstein, with a population of 238,049 .Kiel is approximately north of Hamburg. Due to its geographic location in the north of Germany, the southeast of the Jutland peninsula, and the southwestern shore of the...
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
Karl Wernicke
Carl Wernicke was a German physician, anatomist, psychiatrist and neuropathologist. He earned his medical degree at the University of Breslau...
(1848-1905): in the summer he went to Paris
Paris
Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...
, studying with Joseph Jules Dejerine
Joseph Jules Dejerine
Joseph Jules Dejerine , was a French neurologist.Joseph Jules Dejerine was born to French parents in Geneva, Switzerland, where his father was a carriage proprietor. During the Franco-Prussian War Dejerine worked as a volunteer in a Geneva Hospital and in the spring of 1871 decided to pursue his...
and attending classes by Pierre Marie and Joseph Babinski
Joseph Babinski
Joseph Jules François Félix Babinski was a French neurologist of Polish descent. He is best known for his 1896 description of the Babinski sign, a pathological plantar reflex indicative of corticospinal tract damage....
(1857-1932); and in the summer with Heinrich Frenkel
Heinrich Frenkel
Heinrich Sebastian Frenkel was a Swiss physician and neurologist born in Heiden, a town overlooking Lake Constance...
in Switzerland
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
, in order to study physical therapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...
of neurological patients there.
Foerster's student years occurred in a time when neurology was starting to develop independently from internal medicine
Internal medicine
Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. Physicians specializing in internal medicine are called internists. They are especially skilled in the management of patients who have undifferentiated or multi-system disease processes...
and psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
under the influence of, among others, Jean-Martin Charcot
Jean-Martin Charcot
Jean-Martin Charcot was a French neurologist and professor of anatomical pathology. He is known as "the founder of modern neurology" and is "associated with at least 15 medical eponyms", including Charcot-Marie-Tooth disease and amyotrophic lateral sclerosis...
(1825-1893), Wilhelm Heinrich Erb
Wilhelm Heinrich Erb
Wilhelm Heinrich Erb was a German neurologist who was a native of Winnweiler, Rhineland-Palatinate.- Academic career :...
, William Richard Gowers
William Richard Gowers
Sir William Richard Gowers was a British neurologist.The Gowers' tract is named after him....
(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
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...
of the central nervous system
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...
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
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
; 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
Motor coordination
thumb|right|Motor coordination is shown in this animated sequence by [[Eadweard Muybridge]] of himself throwing a diskMotor coordination is the combination of body movements created with the kinematic and kinetic parameters that result in intended actions. Such movements usually smoothly and...
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
Spasticity
Spasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles...
suggested its possible treatment by surgical interruption of the sensory branch of the thoracic and lumbar nerves (rhizotomy
Rhizotomy
A rhizotomy is a term chiefly referring to a neurosurgical procedure that selectively severs problematic nerve roots in the spinal cord, most often to relieve the symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy...
), 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
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
of nerve damage
Nerve Damage
Nerve Damage is a compilation album by Groove Metal band Skinlab, released in 2004. It is a 2CD collection of rare and unreleased material, including a live set, demos, remixes, alternate mixes, and two new tracks.-Disc 1:# "Losing All" – 4:04...
by shot wound
Wound
A wound is a type of injury in which skin is torn, cut or punctured , or where blunt force trauma causes a contusion . In pathology, it specifically refers to a sharp injury which damages the dermis of the skin.-Open:...
s, as well as other kinds of spinal cord
Spinal cord
The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain . The brain and spinal cord together make up the central nervous system...
and brain
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...
damage. 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 USA. One of his early students coming from that part of the world was Wilder Penfield
Wilder Penfield
Wilder Graves Penfield, OM, CC, CMG, FRS was an American born Canadian neurosurgeon. During his life he was called "the greatest living Canadian"...
(1891-1976), who continued Foerster's work on the analysis of the cerebral cortex
Cerebral cortex
The cerebral cortex is a sheet of neural tissue that is outermost to the cerebrum of the mammalian brain. It plays a key role in memory, attention, perceptual awareness, thought, language, and consciousness. It is constituted of up to six horizontal layers, each of which has a different...
's command of movement and the study of epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
. Other students were Percival Bailey
Percival Bailey
Percival Sylvester Bailey was an American neuropathologist, neurosurgeon and psychiatrist who was a native of rural southern Illinois. He originally studied to became a teacher at Illinois Normal University, but transferred to the University of Chicago in 1912, where he became interested in...
, who developed a new classification of brain tumor
Brain tumor
A brain tumor is an intracranial solid neoplasm, a tumor within the brain or the central spinal canal.Brain tumors include all tumors inside the cranium or in the central spinal canal...
s, and Paul Bucy
Paul Bucy
Paul Bucy was an American neuropathologist who was a native of Hubbard, Iowa. He studied medicine at the University of Iowa, and afterwards was an assistant to neurosurgeon Percival Bailey at the University of Chicago...
, discoverer of the famous Klüver-Bucy syndrome
Klüver-Bucy syndrome
Klüver-Bucy syndrome is a behavioral disorder that occurs when both the right and left medial temporal lobes of the brain malfunction. The amygdala has been a particularly implicated brain region in the pathogenesis of this syndrome. The syndrome is named for Heinrich Klüver and Paul...
, who made fundamental work on the organization of motor cortex
Motor cortex
Motor cortex is a term that describes regions of the cerebral cortex involved in the planning, control, and execution of voluntary motor functions.-Anatomy of the motor cortex :The motor cortex can be divided into four main parts:...
, and Robert Wartenberg
Robert Wartenberg
Robert Wartenberg was an American neurologist.Wartenberg was born in 1886 in Grodno, Belarus, then in the Russian Empire. He graduated from the University of Rostock, Germany in 1919. He worked with Max Nonne in Hamburg and Otfrid Foerster in Breslau. In 1933, he became head of the neurological...
(1897-1956, discoverer of the Wartenberg's syndrome
Wartenberg's Syndrome
A specific mononeuropathy, caused by entrapment of the superficial branch of the radial nerve. Symptoms include numbness, tingling, and weakness of the posterior aspect of the thumb....
).
One of Foerster's important methods was to use local aneaestesia 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
Motor cortex
Motor cortex is a term that describes regions of the cerebral cortex involved in the planning, control, and execution of voluntary motor functions.-Anatomy of the motor cortex :The motor cortex can be divided into four main parts:...
.
Recognition
Thus, Foerster's prominent position in the neurology of Germany was recognized in 1924. His prominence was at the same level of Max NonneMax Nonne
Max Nonne was a German neurologist.Max Nonne was educated at the Gelehrtenschule des Johanneums. He studied in Heidelberg, Freiburg, and Berlin, receiving his doctorate at Hamburg University in 1884...
(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
Electrophysiology
Electrophysiology is the study of the electrical properties of biological cells and tissues. It involves measurements of voltage change or electric current on a wide variety of scales from single ion channel proteins to whole organs like the heart...
, which measures or induces electrical voltage among tissues, such as the brain.http://www.whonamedit.com/doctor.cfm/3099.html 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
Rockefeller Foundation
The Rockefeller Foundation is a prominent philanthropic organization and private foundation based at 420 Fifth Avenue, New York City. The preeminent institution established by the six-generation Rockefeller family, it was founded by John D. Rockefeller , along with his son John D. Rockefeller, Jr...
and the support of the State of Prussia
Prussia
Prussia was a German kingdom and historic state originating out of the Duchy of Prussia and the Margraviate of Brandenburg. For centuries, the House of Hohenzollern ruled Prussia, successfully expanding its size by way of an unusually well-organized and effective army. Prussia shaped the history...
, 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 Für Neurologie). Otfrid Foerster was, together with Oswald Bumke, co-editor of a monumental textbook of neurology, in which he wrote several chapters.
He received in 1935 the John Hughlings Jackson
John Hughlings Jackson
John Hughlings Jackson, FRS , was an English neurologist.- Biography :He was born at Providence Green, Green Hammerton, near Harrogate, Yorkshire, the youngest son of Samuel Jackson, a yeoman who owned and farmed his land, and the former Sarah Hughlings, the daughter of a Welsh revenue collector...
Memorial Medal on his 100th birthday. In 1936 he blended physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
, neurology and neurosurgery to create a world famous cytoarchitecture map of the human cerebral cortex.
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 -Gedächtnisvorlesung (Otfrid Foerster Medal and Memorial Lecture), created on August 26th, 1953.
Works
- Physiologie und Pathologie der Coordination, Jena 1902
- Atlas des Gehirns, herausgegeben von Karl Wernicke, Berlin 1903
- Beiträge zur Hirnchirurgie, Berlin 1909
- Die Kontrakturen bei den Erkrankungen der Pyramidenbahn, Berlin 1909
- Über die operative Behandlung spastischer Lähmungen mittels Resektion der hinteren Rückenmarkswürzel, Berlin 1911
- Zur Pathogenese und chirurgische Behandlung der Epilepsie, Leipzig 1925
- Der Schmerz und seine operative Behandlung, Halle 1935
External links
- Literatur von und über Otfrid Foerster, im Katalog der DDB (In German)