In 1901, the life of the neuropsychiatrist Alois Alzheimer intersected with that of Auguste Deter. The patient, years later, would make the doctor famous all over the world.
Before his eyes, the neuropsychiatrist had a strange case, which he had never seen before.
“The patient is sitting on the bed with her face helpless. What is her name?
—Auguste.
“What is the husband’s name?”
“Auguste, I think. Looks like she didn’t understand the question.”
Loss of memory and understanding, aphasia, disorientation, unpredictable behavior, paranoia and marked psychosocial disability were some of the symptoms manifested by the 51-year-old German housewife.
After accompanying her for a long period, the psychiatrist diagnosed her with an unknown disease at the time, but which today affects millions of people around the world.
He called it “the forgetting disease”.
The beginning
You’ve probably heard the word Alzheimer’s many times in your life.
But it’s also likely that you know little or nothing about the doctor who discovered it (and named it).
Born in a small town in the state of Bavaria, Germany, Alois Alzheimer was born on June 14, 1864.
He began medical studies in Berlin, the capital of Germany, at the express request of his father, a notary by profession.
A year later he decided to return to his hometown to finish his studies at the University of Würzburg in 1887.
Since then he has devoted himself to psychiatry, neuropathology and the study of mental illness. Shortly after graduating at age 23, he was hired as a private physician to a woman suffering from mental disorders. With her, he made a five-month trip that allowed him to closely follow the evolution of the disease.
After that experience, he was hired by a Municipal Asylum for the Demented and Epileptic in the German city of Frankfurt.
There, he specialized in investigating the tissues of the human body and the cerebral cortex.
He also met the prestigious neuropathologist Franz Nissl, with whom he shared a laboratory, establishing a deep friendship.
The two researchers conducted several neuropathological studies in patients with mental disorders.
In 1894, Alzheimer married Nathalie Geisenheimer, with whom he had three children. The scientist was widowed in 1902.
Meeting with Auguste Deter
In the early 1900s, Alzheimer “was obsessed with the idea that psychiatric illnesses were like other illnesses,” Conrad Maurer, emeritus professor of psychiatry at Goethe University in Frankfurt, told the BBC.
He thought that “just as there were diseases of the body, there were also diseases of the brain”.
According to Maurer, the psychiatrist was determined to find a case to prove it.
And that’s where she met Auguste Deter who, from 1901 onwards, had become forgetful, delusional and screaming or crying for hours in the middle of the night. Upon meeting her, Alzheimer said, “This is my case,” Maurer said.
The neuropsychiatrist kept a detailed medical history of Deter, found in the 1990s by Maurer’s team, who was director of the same psychiatric hospital where Alzheimer worked.
The psychiatrist had handwritten all his questions and observations about the patient’s condition.
“I show her a pencil, a pen, a purse, some keys, a diary and a cigarette and she correctly identifies them.”
“When she has to write Dona Auguste D. she writes Dona and then we have to repeat the other words because she forgets”.
“The patient cannot progress in writing and repeats ‘I got lost'”.
Recognition
Auguste Deter ended up living another five years in the hospital. By the end, he was totally deranged. She died on April 8, 1906.
According to Maurer, shortly after her death, the woman’s brain was thoroughly analyzed by the psychiatrist.
Alzheimer created many plaques that can still be examined under a microscope today.
The most relevant thing that the psychiatrist found in Auguste’s brain was that the cerebral cortex was narrower than normal (it was atrophic). He also discovered the accumulation of plaques and neurofilaments, which explained his illness. To this day “we still believe that this is the reason for the evil,” says Maurer.
About six months after Auguste’s death, Alzheimer gave an important case presentation at the 37th Southern German Psychiatric Conference, in which he described how the patient’s cognitive decline had progressed, what her neurological symptoms were, in addition to her delusions, hallucinations, and her progressive psychosocial incompetence.
In this lecture, the psychiatrist described for the first time a type of dementia that, at the suggestion of another specialist, would come to be called Alzheimer’s disease.
The doctor died in 1915, aged 51, never suspecting that Auguste’s disease would one day affect the lives of millions of people and lead to a huge international research effort.
Scientists attribute to him not only the discovery of the neurodegenerative disease, but also the importance of his innovative method of study, as the pathological diagnosis of dementia is still based on the same research methods used in 1906.
The text was originally published here.
