Alzheimer, Alois

   (1864–1915)

   Known for describing the type of presenile dementia named after him, Alzheimer was born in a small town in Lower Franconia, Germany, the son of a local bureaucrat. After completing his medical studies in 1888 at the University of Würzburg—and after orienting himself toward neurohistology in a short spell of research in the lab of Rudolf Albert Kölliker (1817–1905) in Würzburg— Alzheimer took a post later in 1888 as assistant physician at the Frankfurt City Asylum, where the director Emil Franz Sioli (1852–1922) at least tolerated scientific work with a microscope. Shortly thereafter Franz Nissl, another young psychiatrist with an interest in central-nervous tissue, joined Alzheimer at the Frankfurt asylum. (Nissl had studied with Bernhard von Gudden [1824–1886] in Munich and was terribly keen on pressing forward with studies of the microanatomy of the brain.) For the next 7 years, Nissl and Alzheimer worked in close cooperation, Nissl doing research on stains for CNS tissues (one of which is named after him) and Alzheimer doing the postmortems on patients who had suffered from psychiatric and neurological disorders. In 1894, Alzheimer began to report his work on the histology of neurosyphilis, an early step in the differentiation of the organic dementias. He collaborated on much of this histological work with Nissl, and in 1898, Alzheimer discovered some unusual changes in the brain tissue of a patient with senile dementia.

   In 1895, Emil Kraepelin had invited Nissl to come and work at the university psychiatry clinic in Heidelberg, where Kraepelin was chief; in March 1903, Alzheimer followed Nissl to Heidelberg. Kraepelin was now following attentively the research of both men.

   In October 1903, Alzheimer went with Kraepelin to Munich, where Kraepelin had just become professor of psychiatry. (Nissl had initially joined them but returned to Heidelberg to become professor of psychiatry there.) Three years later, in 1906, Alzheimer gave a paper on a patient with presenile dementia in which he described what would later be called "tangles and plaques." In 1907, Alzheimer’s much-cited paper "On a Distinctive Disease of the Cerebral Cortex" ("Über eine eigenartige Erkrankung der Hirnrinde") appeared in the General Journal of Psychiatry (Allgemeine Zeitschrift für Psychiatrie). Kraepelin found these findings so interesting that in the next edition of his psychiatry textbook, the eighth edition (the volume published in 1910), he created the disease category "presenile insanity" that later became known as "Alzheimer’s disease": severe dementias with characteristic histological changes but no cerebral arteriosclerosis. For all of these researchers, identifying dementias was marginal to their true interests: finding anatomical differences between dementia praecox and manic-depressive illness, which they never discovered.