Robert Remak (medic)

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Robert Remak

Robert Remak (born July 26, 1815 in Posen , † August 29, 1865 in Kissingen ) was a German doctor , embryologist and neurophysiologist and Germany's first private lecturer in Jewish medicine. He was one of the founders of electromedicine and identified the Erbgrind as a fungal infection. He realized that the frog egg is a cell and develops through cell division . He also discovered the axial cylinder ( axon ) of medullary nerves as well as the medullary nerves. In embryology he added a third to the two cotyledons known up to that point .

family

Robert Remak was the son of the Poznan Jewish merchant Salomon Meyer Remak and his wife Friederike Caro. He had an older sister and two younger brothers. On July 8, 1848, he married Feodore Meyer (1828–1863), the daughter of the banker Eli Joachim Meyer. His son was the neurologist Ernst Julius Remak .

Medical studies in Berlin

Remak attended the Royal High School in Poznan and graduated from high school in 1833. Then Remak began his medical studies at the Friedrich Wilhelm University in Berlin. It is unclear why Remak went to Berlin to study medicine and not to Vienna, Prague or another city where Jews were also allowed to study. Since 1730, Jewish citizens were allowed access to the Collegium medico-chirurgicum , i. H. 82 years before the Prussian Jewish edict of 1812 , which also offered qualified Jews in Germany free access to university teaching positions. The emancipation edict was the formal requirement for equality of Jews with Christians in Prussia. The background to this was the wish of the Prussian government that “civil and military service should be open to excellent talent in every class and relationship” .

However, the “proof of qualification” for admission to the state service was not specified in the Emancipation Edict, so that the Prussian administration over the years included proofs of the required qualification in the approval catalogs of individual offices, which were then more and more concretized and expanded and so on z. Sometimes the administration could act restrictively - without the involvement of higher-level control bodies - at will. Only ten years later after the edict of emancipation was established, on August 18, 1822, a royal ordinance completely forbade Jewish citizens from having access to teaching posts.

During these ten years of attempted equality between Jews and Christians, no more than three Jewish scholars had completed their habilitation and taught at Prussia's universities. Possible reasons for this change of attitude in the Prussian government to deny Jews access to teaching posts at the university - but not access to the Academy of Sciences - could have been the concerns of the Christian ultra-conservative administrative structures of the royal Ministry of Culture, which could have been a danger saw in the emerging liberalism of the educated Jewish bourgeoisie. With this historical background of restricting a future academic career, Remak began his medical studies at the Friedrich Wilhelm University in Berlin in the winter semester of 1833/34, in which 2,561 students were enrolled at that time.

The fees for Remak's lectures in the amount of 87 talers and 15 groschen have been deferred, which is documented on Remak's certificate of departure from 1838. Already during his medical studies Remak showed himself to be very interested in novel examination and research methods, as can be seen in the work on the microscopic structure of the nervous system, which he published independently at the age of 21.

During his student days, Remak u. a. for the first time the “primitive ligament”, the axon as the conductive part of nerve fibers.

Remak's scientific interest, talent and craftsmanship were recognized early on by his university professors, who willingly provided him with a microscope, dissecting tools and examination material for his student research work, and who later actively promoted and protected him against attacks by state-sponsored professorships and those who distrusted him opposite administration of the Ministry of Culture of the Prussian government. The main and long-term sponsors of Remak included a. the anatomists and pathologists Johannes Peter Müller and the Berlin clinic director Johann Lukas Schönlein . Both enabled his research work in the field of embryology .

1838 Robert Remak with, the fine structure of nerve tissue treated work Observationes anatomicae et de microscopicae systematis nervosi structura doctorate . On May 11, 1839 he was approved - limited to the province of Posen - and in November he swore a state oath for the establishment as a doctor in the province of Posen.

Embryology and Cell Pathology

After completing his studies, Remak was employed for several years in Schönlein's Berlin clinic from 1842 onwards for payment (200 thalers per year), where he was able to pursue further research on the microscopic representation of cell development, embryogenesis and cell pathology . During this time he was in close contact with the then head of the University Polyclinic Moritz Heinrich Romberg , who was the first civil assistant at the Charité to introduce numerous patients to him for treatment. He received tissue samples for his research into embryogenesis and cell pathology from Johann Friedrich Dieffenbach and the director of the Obstetrics Clinic Joseph Hermann Schmidt, as well as from numerous colleagues in private practices in Berlin who were very open to Remak's work.

Based on this work, Remak identified the three cotyledons, ectoderm , mesoderm and endoderm, as a system for the formation of the individual organ systems. This discovery by Remak is the basis of modern embryology . In 1843 he was elected a member of the Leopoldina .

Robert Remak also had a pioneering role in the knowledge about the growth of tissue and cell reproduction. The pathologist Friedrich Günzburg from Breslau and Remak pointed out in essays as early as 1842 and 1852, respectively, that tumor and embryonic cells multiply by dividing the cell nucleus, and not, as was the opinion of Theodor Schwann and Rudolf Virchow in the cytoblastema theory up to that point, by multiplication and sequestration of the cytoplasm in order to then synthesize the cell nucleus with the help of the cytoplasm. In science, however, Günzburg's and Remak's early findings about cell division proceeding from the nucleus were attributed solely to Virchow on the basis of his essay on the origin of cell proliferation, in which he forgot to mention the earlier achievements of his colleagues. This postponement of his scientific work and ultimately Rudolf Virchow's preference for the appointment of the chair of pathological anatomy and therapy at the Berlin University in 1856 could have led to a certain bitterness at Remak, which showed itself in a tense relationship with Virchow. From this point of view, Virchow's 1858 faculty report on Remak's galvanotherapeutic experiments with detoxification, which is not exactly advantageous, could also be seen, although these basic galvanotherapeutic experiments found their later, advantageous clinical, realization in iontophoresis and the Stangerbad .

Galvanotherapy

Rudolf Virchow was awarded the newly created full professorship by the medical faculty of the Charité Berlin, which Remak had also sought. He then turned to the then new field of galvanotherapy . Galvanotherapy found its way into the medical treatment of diseases in Europe with the invention of the volta element by the Italian Alessandro Volta , who was able to generate a constant direct current voltaic column using zinc-copper plates immersed in a conductive dielectric . Systematic investigations of the effect of galvanic current on the healthy and sick were published in Paris by the revolutionary Jean-Paul Marat and in London by John Wesley , who in 1780 published a book on the clinical application of galvanotherapy. Golding Bird , a doctor, established the first galvanotherapy department at Guy's Hospital in London, which was incorporated into the London Academy of Sciences.

In the early days of galvanotherapy around 1800, it was still difficult to generate a reproducible electrical current for therapeutic purposes with constant strength. The doctor Franz Heinrich Martens recognized that a reproducible, galvanic current was essential for therapeutic use, which was in contrast to Bischoff (Jena) and Grapengießer (Berlin). In the Galvani-Voltaschen column he described, oxidation processes repeatedly reduced the galvanic currents, which made it difficult to reproduce the treatment results.

Inspired by these first promising galvanotherapy attempts, Remak tried to establish this new type of therapy at the Charité. He was supported in his efforts by various scientists: the physicists Johann Georg Halske and Werner von Siemens provided Remak with the equipment and materials necessary for the construction of his galvanotherapeutic device, the galvanoscope . They also helped him assemble and operate this device. Remak used Martens' knowledge of the voltaic column and developed his galvanoscope, which produced the desired reproducible current flow using galvanisometers (ammeters) and improved electrodes. Remak's galvanoscope consisted of a direct current source, ampere and voltameter , electrode material and dielectric in which the patient's body part to be treated was immersed. At the same time that Remak published his work on galvanotherapy in 1858, the Boston doctors William F. Channing and AC Garrat each published a comprehensive work on the fundamentals, application and therapeutic effects of galvanic direct current based on their own experiences had gained in the last twenty years of their work. Here, too, there are extensive lists of indications for the use of galvanic direct current.

Remak found broad support for his galvanotherapy in the resident doctors in Berlin, who referred numerous patients to him for treatment. The Berlin ophthalmologist Albrecht von Graefe hoped that the application of galvanoscope in his patients new therapeutic possibilities of ocular nystagmus also Moritz Heinrich Romberg , Head of the former clinic of the medical faculty, Berlin, showed great interest in Remaks attempts to galvanotherapy in the diagnosis and treatment of neurological disorders such as migraine, paralysis, paralysis agitans ( Parkinson's disease ) and tabes dorsal (neuro- syphilis ). In his work, Remak also dealt with the therapeutic indications of galvanotherapy, which are based on his more than 1000 therapeutic applications. If one compares the indications Remaks with those for the application of iontophoresis , or the Stangerbad , then there are great similarities such as e.g. B. the application in the prevention and treatment of inflammation, skin diseases and rheumatism, which Martens already pointed out for his voltaic column. For all of the indications established by Remak, scientifically based explanations in human use and examples of treatments are given in his work. Remak clearly points to the medical competence required by Martens in the use of galvanotherapy in humans. In his galvanotherapeutic research, Remak worked closely with private and state commercial doctors in Berlin, who referred patients to his private practice for treatment. Numerous visits to Vienna, Paris (with Guillaume-Benjamin Duchenne ) and London, where he lectured on his galvanotherapy work at the Academy of Sciences, established a connection to the international environment in galvanotherapy.

As part of this research work, which was carried out intensively from 1856 until his death in 1864, Remak was the first to provide a scientific explanation for the “catalytic effects of the constant galvanic current” in therapeutic use on humans. He thus described the direct effect of the electric current on "inflammatory conditions" of numerous acute and chronic clinical pictures in connection with the indirect effect of the electromagnetic field, which Jean Louis Jallabert and Marat in Paris could find but not explain. Remak described the use of the galvanoscope to stimulate the entire metabolism with increased removal of extracellular fluid from diseased tissue via the lymph. Remak referred to this process as "endosmotic sap flow", caused by the active ion effect. This galvanotherapeutic active ion effect and the therapeutic result achieved were described by Remak as beneficial in chronic and rheumatic inflammation with joint edema. Martens already knew that the use of galvanic current on the anode would turn litmus paper (anode oxidation with release of hydrogen ions) and on the cathode it would turn blue due to the reduction and release of hydroxide ions.

However, the therapeutic effects of these electrochemical active ion effect effects with the release of activated metal ions into the dielectric used by Remak had not yet been scientifically investigated because of the novelty of this process and were first explained by Remak. His 461-page work on galvanotherapy covers almost all questions about this new type of therapy. It is understandable that Remak, with his then very progressive approach of holistic therapy without taking individual organ systems into account, did not meet with an understandable response from most members of the Charité's medical faculty. The university opinion leaders of the Charité, to whose inner circle Remak felt attracted throughout his life, rather represented the opinion of the individual therapy related to individual, diseased organs, which stood in contrast to Remak's holistic therapeutic approach in the form of the new galvanotherapy. Possibly for this reason, his request, made several times, for an own galvanotherapy-oriented hospital ward in the Charité, similar to the model of the Guy's Hospital in London, was refused. Remak found support for his holistic galvanotherapeutic approach with activity and effect from his European colleagues in Paris and London. The negative attitude of the conservative medical circles of the Charité, Berlin towards the new type of galvanotherapy is possibly to be understood from the conflict of interests between the classical medical procedures of the time and the rapidly developing technical innovations in electricity theory.

Habilitation

With the completion of his medical studies in 1838, Remak made efforts to get a permanent professorship in the medical faculty of the Berlin University and thus recognition, regular salary, research funding, examination competence and social security for his previously unusually successful scientific work. Remak's efforts in this direction coincided with the emancipation of the educated Jewish bourgeoisie , which lasted until the revolution of 1848. Due to formal legal discrimination, citizens of the Jewish faith were not permitted between 1822 and 1848 to take up a state teaching position such as B. to take up a professorship.

With his ideas that were liberal-revolutionary for the time, Remak refused to convert to Christianity only in order to gain advantages. Remak explained: "Also, I have always had the greatest aversion to the idea of ​​gaining external advantages through a change of religion."

While admission to the Academy of Sciences was largely dependent on academic achievements, appointment as professor at state-funded universities was fundamentally dependent on political good behavior and, secondarily, on academic qualifications. The conservative-Christian administrative officials of the Prussian Ministry of Culture, who were responsible for the appointment of state-funded professors and teachers, viewed the neoliberalism of the educated Jewish bourgeoisie with deep suspicion. Specifically, the state Christian culture minister Karl vom Stein zum Altenstein (1770-1840), his successor Johann Albrecht Friedrich von Eichhorn and the arch-Christian-anti-Judaic culture minister Karl Otto von Raumer (1805-1859) should be mentioned Postdoctoral qualifications delayed remaks by specifying formal legal concerns regarding his liberal worldview. For example, the demands of Remak and his colleagues for the public to be involved in doctoral and medical examinations or in the award of academic positions at the university, or scholarships and research funding, must have met with great distrust and doubts among the ministers of education about Remak's loyalty to the state.

Such, quite legitimate, demands for publicity at medical examinations and faculty meetings were rejected by Rudolf Virchow, as is still the case today in individual medical associations of the Federal Republic of Germany, namely the Bavarian State Medical Association, Munich, with the argument that it was only a matter of "formalities" and whose implementation is a "loss of time". From a historical point of view at Remak, the rather advanced arguments were, as they are today, grounds for allegations of manipulation and fraud in the admission to the specialist doctor or the ordinariate .

The natural scientist Alexander von Humboldt repeatedly supported Remak against the professional restrictions of his opponents in the Prussian Ministry of Culture. Only the written instructions from King Friedrich Wilhelm IV of Prussia, dated March 8, 1847, to the Ministry of Culture paved the formal legal path for Remak's university career. Remak's longtime sponsor, Alexander von Humboldt, had turned to the king with a request to intervene in Remak's habilitation. The high recognition that the medical faculty of the Friedrich-Wilhelms-Universität Berlin showed for Remak's scientific achievement can be seen in the fact that Remak was one of the very few habilitation candidates to be awarded the Venia legendi in 1847 by unanimous decision of the faculty without a habilitation examination. He had only his drafted in Latin Habilitation inaugural speech with the theme: "De exudatione materiae fibrinosae in membranis mucosis et glandulis quibusdam occurrente." Hold.

Virchow recommended Remak with a benevolent letter for a full professorship at the University of Cracow , to which he had been invited by the Dean of the Medical University of Cracow, Fryderik Kasimir Skobel . Remak rejected this position, however, with the written pleading in Polish on November 28, 1850 to Skobel on the grounds that he could not hold an academic lecture in Polish.

However, the scientific successes achieved at a young age as a student could not only have aroused admiration but also envy among Remak's colleagues. Remak was rightly perturbed by Virchow's treatise on nucleus division without him and Günzburg being named as co-founders in this famous work, although Günzburg and Remak had demonstrably pointed out nucleus division as the reason for tissue increase years before Virchow's publication. The subsequent preference for Virchow as a full professor at the Charité in 1856 could also have met with incomprehension from Remak, especially since no anti-Jewish rejection could be recognized here. Remak's turn to galvanotherapy as a new medical discipline removed him from his fellow professors, who were more concerned with tangible issues from pathology, surgery and internal medicine. This distance was also evident at a physical distance from everyday academic life at the Charité by outsourcing his galvanotherapeutic activity studies to his private practice, as he was not allowed to have his own hospital ward for experimental purposes at the Charité.

Remak was appointed associate professor in 1859.

Fonts (selection)

  • Preliminary reports of microscopic observations on the internal structure of the cerebrospinal nerves and on the development of their formal elements . In: Archives for Anatomy, Physiology and Scientific Medicine . 1836, pp. 145-161.
  • Observationes anatomicae et microscopicae de systematis nervosi structura . Dissertation Berlin, 1838. ( Google Books )
  • On the physiological importance of the organic nervous system, especially according to anatomical facts . In: Monthly for Medicine, Ophthalmology and Surgery 3 . 1840, pp. 225-265.
  • On the contents of the primitive nerve tubes . In: Archives for Anatomy, Physiology and Scientific Medicine . 1843, pp. 197-201.
  • Neurological explanations . In: Archives for Anatomy, Physiology and Scientific Medicine. , 1844, pp. 463-472.
  • De exudatione materiae fibrinosae in membranis mucosis et glandulis quibusdam occurrente . Habilitation thesis, Berlin 1847.
  • About the extracellular origin of animal cells and about their multiplication by division In: Archives for Anatomy, Physiology and Scientific Medicine . 1852, pp. 47-57.
  • Investigations into the development of vertebrates . Berlin, 1850–1855.
  • On the genetic significance of the upper cotyledon in the vertebrate egg . Arch. Anat. Physiol, Leipzig 1851.
  • Galvanotherapy of muscular and nervous diseases . Published by August Hirschwald, Berlin 1858.

Individual evidence

  1. ↑ Ilse Jahn (ed.): History of Biology . Special edition of the 3rd edition, Nikol, Hamburg 2004, pp. 338 and 935.
  2. ↑ Lexicon of Biology : Remak, Robert .
  3. ↑ Heinz-Peter Schmiedebach: Robert Remak (1815-1865). A Jewish doctor in the field of tension between science and politics. Gustav Fischer, Stuttgart 1995 (= Medicine in History and Culture , 18)
  4. ↑ H.-P. Schmiedebach: Robert Remak, a Jewish doctor in the field of tension between science and politics . In R. Toeller and N. Tsouyopoulos (eds.): Medicine in history and culture . Vol. 18, Gustav Fischer Verlag, Stuttgart 1995, p. 152.
  5. ↑ Moritz Kalisch: The Jewish question in its true meaning for Prussia . Leipzig 1860.
  6. ↑ R. Remak: Preliminary communications from microscopic observations on the internal structure of the cerbrospinal nerves and on the development of their formal elements . Arch. Anat. Physiol. (= Mueller's Arch.) Leipzig 1836, pp. 145–159.
  7. ↑ R. Remak: Further microscopic observations on the primitive fibers of the vertebrate nervous system . N. Notiezen Natur-Heilk. 3 (= Frorieps N. Notiezen) 1837, pp. 36-41.
  8. ↑ R. Remak: Mixed anatomical observations . N. Notiezen Natur - Heilk. 3 (= Frorieps N. Notiezen) 1837, pp. 150-154.
  9. ↑ R. Remak: Neurological Notiezen . N. Notiezen Natur-Heilk. 3 Frorieps N. Notiezen, 1827, p. 216.
  10. ↑ R. Remak: About the performance of the organic nervous system . N. Notiezen Natur - Heilk. 7 (= Frorieps N. Notiezen), 1838, pp. 65-70.
  11. ↑ Dissertation: Observationes anatomicae et microscopicae de systematis nervosi structura . GoogleBooks
  12. ↑ H.-P. Schmiedebach: Robert Remak, a Jewish doctor in the field of tension between science and politics . In R. Toeller and N. Tsouyopoulos (eds.): Medicine in history and culture . Vol. 18, Gustav Fischer Verlag, Stuttgart 1995, p. 118.
  13. ↑ R. Remak: About the genetic significance of the upper cotyledon in the egg of the vertebrate animals . Arch. Anat. Physiol, Leipzig 1851, pp. 209-210.
  14. ↑ R. Remak: Investigations into the development of the vertebrates . Berlin 1855.
  15. ↑ R. Remak: A contribution to the history of the development of cancerous tumors . German Klin. 6 (1854), pp. 170-175.
  16. ↑ R. Virchow: Cellular Pathology . Virchow's Arch. Path. Anat., Berlin 8 (1855), pp. 3-39.
  17. ↑ R. Virchow: About the division of the cell nuclei . Virchow's Arch. Path. Anat., Berlin 11 (1857), pp. 89-92.
  18. ↑ H.-P. Schmiedebach: Robert Remak, a Jewish doctor in the field of tension between science and politics . In R. Toeller and N. Tsouyopoulos (eds.): Medicine in history and culture . Vol. 18, Gustav Fischer Verlag, Stuttgart 1995.
  19. ^ SH Licht: History of Electrotherapy . In: SH Licht (ed.): Therapeutic Electricity and Ultraviolet Radiation . 2nd Edition, New Haven 1967, pp. 1-69.
  20. ↑ a b F.H. Martens: Complete instructions for the therapeutic use of galvanism and a history of this remedy . In the Boeseschen Buchhandlung, Meissenfels and Leipzig 1803, pp. 155–158.
  21. ^ R. Remak: Galvanotherapy of muscle and nervous diseases . Berlin 1858, third section: Technical and therapeutic preliminary remarks, I. Devices . P. 253 ff.
  22. ^ AC Garratt: Medical Electricity: Embracing Electrophysiology and Electricity as a Therapeutic . Boston 1858, Philadelphia 1866.
  23. ^ WF Channing: Notes on the medical application of electricity . Boston 1849.
  24. ↑ a b c d R. Remak: Galvanotherapie, 1858, VII. Therapeutischer Werth des Constant Strom , p. 267ff.
  25. ↑ JW Shriber: A manual of electrotherapy . Lea & Febiger, Philadelphia 1979, USA, p. 132 ff.
  26. ↑ FH Martens: Complete instructions for the therapeutic use of galvanism along with a history of this remedy . In the Boeseschen Buchhandlung, Meissenfels and Leipzig 1803, p. 13 f.
  27. ^ R. Remak: About the use of electric currents in practical medicine . Oesterr. Zschr. Prakt. Heilk., 7, 1861, pp. 717-721.
  28. ^ R. Remak: Remarques sur laction du Courant galvanique continu . J. Physiol. Paris, 3 (= Brown-Sequards Journal), 1860, pp. 439-442.
  29. ^ Duchenne: De l'electrisation localisee . Paris 1850, p. 8.
  30. ^ R. Remak: On the therapeutic action of the constant galvanic current . Medical Times and Gazette, London 1858, Vol 14, No 410, pp. 479-480.
  31. ↑ R. Remak: Galvanotherapie, 1858, VII. Therapeutischer Werth des Constant Strom , p. 317.
  32. ↑ FH Martens: Complete instructions for the therapeutic use of galvanism along with a history of this remedy . In the Boeseschen Buchhandlung, Meissenfels and Leipzig 1803, p. 98.
  33. ↑ Moritz Kalisch: The Jewish question in its true meaning for Prussia . Leipzig 1860, p. 23.
  34. ↑ H.-P. Schmiedebach: Robert Remak, a Jewish doctor in the field of tension between science and politics . In R. Toeller and N. Tsouyopoulos (eds.): Medicine in history and culture . Vol. 18, Gustav Fischer Verlag, Stuttgart 1995, p. 47.
  35. ↑ Moritz Kalisch: The Jewish question in its true meaning for Prussia . Leipzig 1860, p. 26.
  36. ↑ Moritz Kalisch: The Jewish question in its true meaning for Prussia . Leipzig 1860, 2. 24–26.
  37. ↑ Habilitation thesis: De exudatione materiae fibrinosae in membranis mucosis et glandulis quibusdam occurrente
  38. ^ UA HU Berlin, Med. Fak., No. 36, Bl. 27, Faculty meeting on September 28, 1847.
  39. ^ R. Virchow: Letter from Virchow to Remak about professorship in Cracow . December 8, 1850, StaBi Preussischer Kulturbesitz in Berlin, Autographsabteilung, NL Remak 187, box 5.
  40. ↑ H.-P. Schmiedebach: Robert Remak, a Jewish doctor in the field of tension between science and politics . In R. Toeller and N. Tsouyopoulos (eds.): Medicine in history and culture . Vol. 18, Gustav Fischer Verlag, Stuttgart 1995, p. 253.
  41. ↑ Barbara I. Tshisuaka: Remak, Robert. 2005, p. 1232.

literature

Web links

personal data
SURNAME Remak, Robert
BRIEF DESCRIPTION German zoologist, neurologist and physiologist
DATE OF BIRTH July 26, 1815
PLACE OF BIRTH Poses
DATE OF DEATH August 29, 1865
Place of death Bad Kissingen