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The controversial Third Reich history of Hans Creutzfeldt: was he a supporter or just another adept of the “hand washing policy”?

A controversa história do terceiro reich de Hans Creutzfeldt: seria ele um apoiador ou apenas outro adepto da "política de lavagem das mãos"?

ABSTRACT

Creutzfeldt-Jakob disease (CJD) is a transmissible spongiform encephalopathy whose initial description is associated with two German authors, Alfons Maria Jakob and Hans Gerhard Creutzfeldt. As polemic as the issue about the Creutzfeldt’s merit in the first description of the disease, is his history during the Third Reich. Some evidence pointed to the idea that he was essentially against the Nazi ideology, though some did not. He was an official member of the SS, but his own wife was convicted by a Nazi court. Some authors have argued that Creutzfeldt helped save many patients during Aktion T4 operation, but, in fact, he could have done more. Even during the post-war period, he sent a letter to authorities reporting the name of a Nazi physician who worked as a medical reviewer at the euthanasia court, but he did not proceed any further when his letter initially failed to start an investigation.

Keywords:
Creutzfeldt-Jakob Syndrome; National Socialism; History

RESUMO

A doença de Creutzfeldt-Jakob (DCJ) é uma encefalopatia espongiforme transmissível, cuja descrição original está associada ao nome de dois autores alemães, Alfons Maria Jakob e Hans Gerhard Creuztfeldt. Tão polêmica quanto a questão sobre o real mérito de Creutzfeldt na primeira descrição da doença, é sua história de vida durante o Terceiro Reich. Algumas evidências apontavam para a ideia de que ele era essencialmente contra a ideologia nazista, mas outras não. Ele foi um membro oficial da SS, mas sua própria esposa foi condenada por um tribunal nazista. Alguns autores têm argumentado que Creutzfeldt ajudou a salvar muitos pacientes durante a operação Aktion T4, mas, na verdade, ele poderia ter feito muito mais. Mesmo durante o período pós-guerra, ele enviou uma carta às autoridades revelando o nome de um médico nazista que havia se empregado como revisor médico na corte sobre eutanásia, mas ele não insistiu mais quando sua carta inicialmente não desencadeou uma investigação.

Palavras-chave:
Síndrome de Creutzfeldt-Jakob; Socialismo Nacional; História

INTRODUCTION

Walther Spielmeyer first used the term Creutzfeldt-Jakob disease (CJD) because two German neuropathologists had previously described the disease11. Henry R, Murphy FA. Etymologia: Creutzfeldt-Jakob Disease. Emerg Infect Dis. 2017 Jun;23(6):956. https://doi.org/10.3201/eid2306.ET2306
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,22. Pearce JMS. Jakob-Creutzfeldt Disease. Historical Note. Eur Neurol. 2004 Nov;52(3):129-31. https://doi.org/10.1159/000081462
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. Alfons Maria Jakob described a series of six patients with spasticity and progressive dementia associated with neural degeneration in the early 1920s, as did Hans Gerhardt Creutzfeldt (Figure 1), who had independently published the case of a “not so” similar patient. Jakob credited Creutzfeldt for first describing the syndrome, without realizing he had also uncovered the new syndrome22. Pearce JMS. Jakob-Creutzfeldt Disease. Historical Note. Eur Neurol. 2004 Nov;52(3):129-31. https://doi.org/10.1159/000081462
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,33. Masters CL, Gajdusek DC. In: Smith WT, Cavanagh JB (eds.). Recent advances in neuropathology. v. 2. Edinburgh: Churchill Livingstone; 1982. p.139-63.. CJD is the usual eponym used, since Creutzfeldt certainly gave the earlier account. But, in view of Jakob’s greatest contribution, many authors reasonably argued that the correct designation should be Jakob-Creutzfeldt disease22. Pearce JMS. Jakob-Creutzfeldt Disease. Historical Note. Eur Neurol. 2004 Nov;52(3):129-31. https://doi.org/10.1159/000081462
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,44. Katscher F. It’s Jakob’s disease, not Creutzfeldt’s. Nature. 1998 May;393(6680):11. https://doi.org/10.1038/29862
https://doi.org/https://doi.org/10.1038/...
,55. Manuelidis EE. Creutzfeldt-Jakob disease. J Neuropathol Exp Neurol. 1985 Jan;44(1):1-17. https://doi.org/10.1097/00005072-198501000-00001
https://doi.org/https://doi.org/10.1097/...
. One55. Manuelidis EE. Creutzfeldt-Jakob disease. J Neuropathol Exp Neurol. 1985 Jan;44(1):1-17. https://doi.org/10.1097/00005072-198501000-00001
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had reported, in his own words, that: “Dr. Creutzfeldt after the II World War (WWII) told me that his case did not bear any resemblance to the cases described by Jakob”. Particularly in Brazil, the use of “Jakob-Creutzfeldt Disease” is common, instead of CJD. It is also probably due to the prominent figure that doctor Jakob represented for Brazil. From May to July 1928, he gave a 20-lecture course in Rio de Janeiro on nervous pathology, as well as in São Paulo and Campinas66. Triarhou LC. Alfons Maria Jakob (1884-1931), neuropathologist par excellence. Scientific endeavors in Europe and Americas. Eur Neurol. 2009 Nov;61(1):52-8. https://doi.org/10.1159/000175123
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,77. De Muñoz PFN. À luz do biológico: psiquiatria, neurologia e eugenia nas relações Brasil-Alemanha (1900-1942). Thesis (Doctorate in History of Health Sciences). Rio de Janeiro: Fundação Oswaldo Cruz; 2015..

Figure 1.
Hans Gerhardt Creutzfeldt (1920); author unknown (public domain).

Moreover, both Jakob and Creutzfeldt had studied under Alois Alzheimer’s supervision, in different units led by him. Creutzfeldt22. Pearce JMS. Jakob-Creutzfeldt Disease. Historical Note. Eur Neurol. 2004 Nov;52(3):129-31. https://doi.org/10.1159/000081462
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in Breslau and Jakob in Munich66. Triarhou LC. Alfons Maria Jakob (1884-1931), neuropathologist par excellence. Scientific endeavors in Europe and Americas. Eur Neurol. 2009 Nov;61(1):52-8. https://doi.org/10.1159/000175123
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. In 1913, Creutzfeldt studied the clinical picture and pathological brain changes of a previously unknown disease in a patient at the Breslau University’s Neurology Unit. His publication of a description of this disease in 1920 was considered by some researchers to be the first in the world’s medical literature approximately a year before Jakob published his series88. Cipriani G, Dolciotti C, Pichi L, Bonucelli U. Alzheimer and his disease: a brief history. Neurol Sci. 2011 Apr;32(2):275-9. https://doi.org/10.1007/s10072-010-0454-7
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. Putting aside the controversy of the CJD name, unequivocally, it is easy to recognize that both authors are important historical figures in Neurology.

Dr. Jakob deceased in 1931, years before the arrival of the Third Reich. Dr. Creutzfeldt, on the other hand, lived throughout the Nazi era. Some data suggest that he was against the ideology99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
,1010. Lifton RJ. The Nazi doctors: medical killing and the psychology of genocide. New York: Basic Books, Inc., Publishers; 1986.,1111. Strous RD, Edelman MC. Eponyms and the Nazi era: time to remember and time for change. Isr Med Assoc J. 2007 Mar;9(3):207-14., with clear declarations that he disliked Nazi policies99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
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. However, contradictory, he became a Patron Member of Heinrich Himmler’s SS from 1932 to 1933 and had, at least, an ambivalent posture facing Nazism ideology and the Aktion T4* euthanasia program99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
,1212. Zeidman LA. Neuroscience In Nazi Europe Part Ii. Can J Neurol Sci. 2011 Nov;38(6):826-38. https://doi.org/10.1017/s0317167100012397
https://doi.org/https://doi.org/10.1017/...
,1313. Kondziella D. Thirty neurological eponyms associated with the Nazi era. Eur Neurol. 2009 Jun;62(1):56-64. https://doi.org/10.1159/000215880
https://doi.org/https://doi.org/10.1159/...
,1414. Kondziella D, Zeidman LA. What's in a name? Neurological eponyms of the Nazi era. Front Neurol Neurosci. 2016 Apr;38:184-200. https://doi.org/10.1159/000442683
https://doi.org/https://doi.org/10.1159/...
.

CREUTZFELDT’S BRIEF HISTORY

Creutzfeldt was born into a medical family in Harburg, a city annexed to Hamburg since 1937, on June 2nd, 1885. In 1903, he was drafted into the German army and was stationed in Kiel99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
. Afterward, he attended the Medicine School of the University of Jena and the University of Rostock, receiving his doctorate in 190922. Pearce JMS. Jakob-Creutzfeldt Disease. Historical Note. Eur Neurol. 2004 Nov;52(3):129-31. https://doi.org/10.1159/000081462
https://doi.org/https://doi.org/10.1159/...
. In the following years until 1912, he sought adventure as a ship's surgeon, voyaging the Pacific Ocean, taking the opportunity to study local crafts, linguistics, and tropical plants99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
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. After returning, he worked at the Neurological Institute in Frankfurt am Main and at the psychiatric-neurological clinics in Breslau, with professor Alzheimer, and then in Kiel, after in Berlin, and finally at the Deutsche Forschungsanstalt für Psychiatrie in Munich99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
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.

During World War I (WWI), he was a German naval medical officer. He was deployed as a reserve medical officer and survived the sinking of the auxiliary cruiser SMS Greif (Figure 2). After being captured, he was repatriated and served in the Imperial Navy until the end of the war in 191899. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
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.

Figure 2.
HMS Alcantara engages the German raider Grief on 29 February 1916, in the North Sea. Both ships sank. SS Grief was Creutzfeldt’s warship in World War I (public domain).

After WWI, Creutzfeldt worked with Spielmeyer in Munich and with Siemerling in Kiel22. Pearce JMS. Jakob-Creutzfeldt Disease. Historical Note. Eur Neurol. 2004 Nov;52(3):129-31. https://doi.org/10.1159/000081462
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. He moved to the Charité Hospital in Berlin and, after 14 years, he returned to Kiel in 1938 to become Emeritus Professor and Director of the Psychiatric and Neurological Division99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
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,1010. Lifton RJ. The Nazi doctors: medical killing and the psychology of genocide. New York: Basic Books, Inc., Publishers; 1986.. Then, 1939 arrived and WWII began.

THE AMBIVALENT RELATIONSHIP WITH NAZISM

During the years spent in Berlin and his subsequent time in Kiel, Creutzfeldt adopted a reserved but not completely hostile attitude to Nazism99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
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. He was a registered candidate for the National Socialist German Doctors’ Association, a paying member of the SS and Deputy Medical Assessor at the Berlin High Court of Hereditary Health99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
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. However, he was one of just two members of Kiel’s school of medicine who did not join the Nazi Party1010. Lifton RJ. The Nazi doctors: medical killing and the psychology of genocide. New York: Basic Books, Inc., Publishers; 1986.. He was politically inconspicuous, with no emotional attachment to the ideology99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
,1313. Kondziella D. Thirty neurological eponyms associated with the Nazi era. Eur Neurol. 2009 Jun;62(1):56-64. https://doi.org/10.1159/000215880
https://doi.org/https://doi.org/10.1159/...
. He also did not categorically reject compulsory sterilization in the reports he was required to produce and accepted that chronically ill patients who were unavoidably transferred to state hospitals for long-term treatment faced the threat of being sent to death camps for Aktion T499. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
,1414. Kondziella D, Zeidman LA. What's in a name? Neurological eponyms of the Nazi era. Front Neurol Neurosci. 2016 Apr;38:184-200. https://doi.org/10.1159/000442683
https://doi.org/https://doi.org/10.1159/...
,1515. Illert M, Schmidt M. Hans Gerhardt Creutzfeldt (1885-1964) in the Third Reich. A reevaluation. Neurology 2020 Jun;95:72-76. doi:10.1212/WNL.0000000000009785
https://doi.org/10.1212/WNL.000000000000...
(Chart 1). During WWII, as a Clinic Director in Kiel, of 605 patients transferred from Kiel, 135 were deported and 65 of these are known to having been murdered (the true figure is likely to be over 100)99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
. Nevertheless, Creutzfeldt claimed that he was “a decided opponent of the murder of the psychiatrically ill”99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
,1010. Lifton RJ. The Nazi doctors: medical killing and the psychology of genocide. New York: Basic Books, Inc., Publishers; 1986.,1414. Kondziella D, Zeidman LA. What's in a name? Neurological eponyms of the Nazi era. Front Neurol Neurosci. 2016 Apr;38:184-200. https://doi.org/10.1159/000442683
https://doi.org/https://doi.org/10.1159/...
and one psychiatrist once declared that he was known to have attacked “euthanasia” during his lectures1010. Lifton RJ. The Nazi doctors: medical killing and the psychology of genocide. New York: Basic Books, Inc., Publishers; 1986., declaring that “They are murderers!” His luck was that some Nazis thought him very eccentric or even “a little mad”1010. Lifton RJ. The Nazi doctors: medical killing and the psychology of genocide. New York: Basic Books, Inc., Publishers; 1986.. However, it was not consistent with his lack of energy in the prevention of such murders99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
. Another event, which reinforced this idea, occurred when he put a great effort into reversing the conviction of a soldier in 1941/1942 who had deserted, which led to an avoidable death sentence1414. Kondziella D, Zeidman LA. What's in a name? Neurological eponyms of the Nazi era. Front Neurol Neurosci. 2016 Apr;38:184-200. https://doi.org/10.1159/000442683
https://doi.org/https://doi.org/10.1159/...
,1515. Illert M, Schmidt M. Hans Gerhardt Creutzfeldt (1885-1964) in the Third Reich. A reevaluation. Neurology 2020 Jun;95:72-76. doi:10.1212/WNL.0000000000009785
https://doi.org/10.1212/WNL.000000000000...
.

Chart 1.
Aktion T4 Nazi operation.

However, worth mentioning, is the fact that, during the war, bombing raids destroyed his home and clinic1111. Strous RD, Edelman MC. Eponyms and the Nazi era: time to remember and time for change. Isr Med Assoc J. 2007 Mar;9(3):207-14.. Besides, in 1943, a court sentenced his wife, Cläre, to four years in prison for spiteful and malicious remarks against the Third Reich1111. Strous RD, Edelman MC. Eponyms and the Nazi era: time to remember and time for change. Isr Med Assoc J. 2007 Mar;9(3):207-14.. Noteworthy, his son, Harald, defected from the German navy to join the Dutch underground resistance1212. Zeidman LA. Neuroscience In Nazi Europe Part Ii. Can J Neurol Sci. 2011 Nov;38(6):826-38. https://doi.org/10.1017/s0317167100012397
https://doi.org/https://doi.org/10.1017/...
.

Finally, another ambivalent event occurred years after WWII. In 1955, Creutzfeldt informed the President of the Court in Schleswig Holstein that the Nazi physician, Werner Heyde, was employed as a medical reviewer at the court. Interestingly, Creutzfeldt did not proceed any further when his letter initially failed to start an investigation into Heyde’s case99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
,1212. Zeidman LA. Neuroscience In Nazi Europe Part Ii. Can J Neurol Sci. 2011 Nov;38(6):826-38. https://doi.org/10.1017/s0317167100012397
https://doi.org/https://doi.org/10.1017/...
,1313. Kondziella D. Thirty neurological eponyms associated with the Nazi era. Eur Neurol. 2009 Jun;62(1):56-64. https://doi.org/10.1159/000215880
https://doi.org/https://doi.org/10.1159/...
. One year after, doctor Creutzfeldt retired and, on December 30th, 1964, he died at the age of 80, after a long-lasting disease22. Pearce JMS. Jakob-Creutzfeldt Disease. Historical Note. Eur Neurol. 2004 Nov;52(3):129-31. https://doi.org/10.1159/000081462
https://doi.org/https://doi.org/10.1159/...
,99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
.

It is difficult to consider that Creutzfedt was a clear adept of the Third Reich ideology. However, it is also nonsense to deny that some of his attitudes and passive behaviors put in check this belief. In general, his declared position seemed to be against the Third Reich, but some controversy has recently emerged, according to some authors99. Wolf JH, Foley P. Hans Gerhard Creutzfeldt (1885-1964): a life in neuropathology. J Neural Transm (Vienna). 2005 Aug;112(8):I-XCVII. https://doi.org/10.1007/s00702-005-0288-2
https://doi.org/https://doi.org/10.1007/...
,1313. Kondziella D. Thirty neurological eponyms associated with the Nazi era. Eur Neurol. 2009 Jun;62(1):56-64. https://doi.org/10.1159/000215880
https://doi.org/https://doi.org/10.1159/...
,1414. Kondziella D, Zeidman LA. What's in a name? Neurological eponyms of the Nazi era. Front Neurol Neurosci. 2016 Apr;38:184-200. https://doi.org/10.1159/000442683
https://doi.org/https://doi.org/10.1159/...
,1515. Illert M, Schmidt M. Hans Gerhardt Creutzfeldt (1885-1964) in the Third Reich. A reevaluation. Neurology 2020 Jun;95:72-76. doi:10.1212/WNL.0000000000009785
https://doi.org/10.1212/WNL.000000000000...
. Nevertheless, the actual question remains the same: Was he head-on against the Nazi ideology or was he merely another person who washed his hands? Only more historical research could shed light on this issue.

References

Publication Dates

  • Publication in this collection
    26 Feb 2021
  • Date of issue
    Jan 2021

History

  • Received
    18 June 2020
  • Accepted
    19 July 2020
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