gms | German Medical Science

Objective: Historical review the developmental state of neurosurgery in Germany in 1937.

Methods: Comprehensive search for biographical data and publications of German physicians focusing on surgery of the central nervous system. Review of documents from diverse archives and available literature dealing with political and social conditions.

Results: In 1937, neurosurgery as a recognized medical specialty did not exist in Germany. Nor was there any organization of those physicians interested in brain surgery. In this year, 17 institutions focused on brain surgery. Of these, 10 were general surgical departments, while 6 were affiliated to neurological departments. Only one was exclusively dedicated to neurosurgery: Just in 1937, this first and single German department of neurosurgery had been established in Berlin, chaired by Wilhelm Tönnis. In 1936, he had founded the “Zentralblatt für Neurochirurgie”, the first journal worldwide dedicated to neurosurgery, in order to foster the young subspecialty. His call for the constitution of a scientific society could not be realized because Nazi Germany launched World War II.

In other countries the development of the neurosurgical specialty had already reached an advanced stage: In the United States, at the same time several dozens of neurosurgeons were already working. They were organized in two scientific societies, founded in 1920 and 1931. In the United Kingdom a neurosurgical society was established in 1926. The developmental delay of Germany is remarkable in view of the fact that during the first decades of the century German science played a major role in the world. The analysis of political and social conditions as well as academic structures revealed three major contributing factors: 1) World War I, the treaty of Versailles and the hyperinflation resulted in low income and widespread unemployment of physicians, and, hence, resentment. 2) The hierarchic order at the universities, reflecting the militaristic German social structure, put the medical chairholders in the rank of absolutistic rulers, who successfully opposed an additional surgical subspecialty. 3) The Nazi regime affected the development of neurosurgery in an opposing manner: First they displaced several of the most important and promising neurosurgeons because of their Jewish descent. Some of them had already tried to establish neurosurgery as a new academic subspecialty – they failed. A few years later, having recognized the importance of neurosurgery for the already plotted war, the regime vigorously fostered the young specialty.

Conclusion: In Germany, the emergence of modern neurosurgery as a specialty, was a result of conflicting interests and was influenced to a large extent by the political turmoil caused by the Nazi regime.