Edward Flatau
Edward Flatau was a Polish neurologist and psychiatrist. He was a co-founder of the modern Polish neurology, an authority on the physiology and pathology of meningitis, co-founder of medical journals Neurologia Polska and Warszawskie Czasopismo Lekarskie, and member of the Polish Academy of Learning. His name in medicine is linked to Redlich-Flatau syndrome, Flatau-Sterling torsion dystonia, Flatau-Schilder disease, and Flatau's law. His publications greatly influenced the developing field of neurology. He published a human brain atlas, wrote a fundamental book on migraine, established the localization principle of long fibers in the spinal cord, and with Sterling published an early paper on progressive torsion spasm in children and suggested that the disease has a genetic component.
File:Flatau Berlin1.jpg| thumb | Left Siegfried Kalischer, Edward Flatau, Louis Jacobsohn-Lask, Bernhard Pollack, around 1900 in Berlin
Life
He was born in 1868 in Płock, the son of Anna and Ludwik Flatau of an assimilated Jewish family. In 1886, he graduated from high school in Płock. From 1886, Flatau attended medical school at the University of Moscow, where he graduated eximia cum laude. In Moscow, he was greatly influenced by the psychiatrist Sergei Sergeievich Korsakoff and the neurologist Alexis Jakovlevich Kozhevnikof. Flatau became a medical doctor in 1892.He spent the years 1893–1899 in Berlin in the laboratories of Emanuel Mendel and at the University of Berlin under Wilhelm von Waldeyer-Hartz. During that time, he worked together with Alfred Goldscheider, Ernst Viktor von Leyden, Hermann Oppenheim, Louis Jacobsohn, Ernst Remak, and Hugo Liepmann.
Though he was offered a position of professorship of neurology in Buenos Aires, he returned to Poland and in 1899 settled in Warsaw.
He was married twice. He had two daughters, Anna and Joanna Flatau. His first wife Zofia and daughter Anna are described in a book by Antoni Marianowicz. Some stories about his personal life are printed in reminiscences of Wacław Solski and Ludwik Krzywicki.
Scientific accomplishments
Flatau dealt with the diagnosis and treatment of diseases of the brain, treatment of muscle diseases, child neurology, peripheral nerve surgery, anatomy of the nervous system, histopathology of the nerve tissue, experimental oncology, neurophysiology, and nervous system pathophysiology.His scientific career is described in number of works. The most comprehensive are biographies written in Polish by his pupil and subsequent professor of neurology in the postwar Poland, Eugeniusz Herman.
Other Polish publications include
Besides these contributions there are several written in English and German
A good source of information is the Jubilee Book of Edward Flatau, published during his lifetime, which contains contributions from his scientific collaborators as well as a bibliography and biography written by his student Maurycy Bornsztajn.
In 1937 Warszawskie Czasopismo Lekarskie published special edition devoted to Flatau contributed mostly by his pupils.
Brain atlas and spinal cord
In 1894 at the age of 26, he published the influential Atlas of the Human Brain and the Course of the Nerve-Fibres, which was published in German, English, French, Russian, and in 1896 in Polish. The Polish edition was dedicated "To the memory of a noble man and an eminent physician Profesor Tytus Chałubiński author dedicates this work." The atlas was based on long-exposure photographs of fresh brain sections. These studies were done in Berlin under Professor Emanuel Mendel. In a review, Sigmund Freud wrote: "The plates with their clarity deserve to be called excellent educational material, suitable as an utterly reliable reference. A schematic plate in the beginning gives an overview of our knowledge on the fibre pathways in the CNS, incorporating the accounts of Mendel, Bechterew and Edinger and continuing with the differing views on the structure of nervous tissue of Camillio Golgi and Santiago Ramón y Cajal. The price of the work is minimal if one considers its completeness and beauty. The author and publisher deserve thanks from the medical community for this valuable work."In 1899, he published the second edition, which was extended and composed of two parts: an atlas and supplement. The preface to the second edition and supplement was written by Edward Flatau in Warsaw. In the second edition, Flatau added the description of his discovery on Das Gesetz der excentrischen Lagerung der langen Bahnen im Ruckenmark. Flatau's brain atlas was published two years before the work
Das Menschenhirn of Gustaf Retzius, but the first publication of images of the brain was work of Jules Bernard Luys in 1873. Sigmund Freud and Edward Flatau were together editors of the magazine Annual report on progress in neurology and psychiatry in 1897. Both were at the time neurologists.
Flatau's Law
His law played an important role in the initial studies of the spinal cord. With the Berlin neurobiologist Johannes Gad, Flatau performed experiments on dogs and criticized the Bastian-Bruns law concerning the loss of function following spinal cord injury. On the basis of numerous clinical spinal cord surgeries, experiments, and subsequent observations, he discovered that the "greater the length of the fibres in the spinal cord the closer they are situated to the periphery". He provided evidence for the laminar arrangement of spinal pathways.He also described the fifth, seventh, and eighth cranial nerves, and carefully outlined their nuclei. The paper on this topic, Das Gesetz der excentrischen Lagerung der langen Bahnen im Rückenmark, was published in 1897. For this work he received a PhD in medical sciences in Moscow in 1899.
This work was presented in 1949, next to a portrait of the author, on display at the IV International Congress of Neurologists in Paris.
The neuron theory
Flatau began working at the Center for Anatomy of the Charité in Humboldt University of Berlin two years after the Wilhelm Waldeyer introduced the term neuron. Thus, in 1895, Flatau became interested in neuron theory recently developed by Ramón y Cajal and Heinrich Waldeyer, and became one of its proponents. In several publications, he attempted to establish a unity between the physiology and anatomy of the neuron. Together with Alfred Goldscheider, he worked on the structure of nerve cells and their changes under mechanical, thermal, and toxic influences. They published results of their experiments in 1897 and 1898 in Fortschritte der Medizin and Polish Gazeta Lekarska, which were subsequently published as a special monograph. They state that the character of changes in neuron cells could provide information about the type of influences acting on them. This work, in which the normal and pathologic anatomy of the V, VII, and VIII cranial nerves was included, created much discussion and was adversely criticized by Franz Nissl, who opposed the neuron theory.He modified Golgi's method of tissue staining
and on the basis of studies of physiological effects of transverse intersection of the spinal cord in dogs carried out together with Johannes Gad, he provided criticism of the Bastian–Bruns sign of disappearance Patellar reflex as a result of this treatment.
Together with his friend Louis Jacobsohn-Lask, he continued anatomy work. In 1895 and 1896, Flatau and Jacobsohn received 1500 marks from duchess Louise von Bose, probably to develop presentation for an international medical congress in Moscow in 1897. Along with Jacobsohn, Flatau wrote a well-known textbook of comparative anatomy of the nervous system of mammals.
In 1906, he visited the Munich psychiatric clinic of Emil Kraepelin.
In 1910 and 1911, he wrote three chapters on tumors of the brain and spinal cord for the two volumes of the handbook edited by the Berlin neurologist Max Lewandowsky.
Together with the Warsaw surgeon Bronislaw Sawicki, he published a work on surgery of the spinal-cord cysts and treatment of tumors of the spine, in which he pointed out histopathological issues important for the surgical procedure. This publication was the culmination of several years of cooperation between the two doctors.
Flatau was the first in Poland to describe the cases of encephalitis lethargica and on occasion the name "Economo-Flatau disease" was used to identify this disease in Polish medical literature.
Neurology and early human genetics
In 1911, Flatau and Wladyslaw Sterling published an article on progressive torsion spasm in children.The authors pointed out that the disease was associated with genetic factors. In the same year, Theodor Ziehen and Hermann Oppenheim published a paper claiming that dystonia is related to a disease of the muscles. However, Flatau and Sterling noted that the intellectual capacity of these patients was higher than average. In 1976, Eldridge suggested that the publication of Flatau and Sterling was one of the first to describe the genetic factors of neurological diseases.
In 1927, Flatau, independently of Emil Redlich in Vienna, described the first cases of encephalomyelitis epidemica disseminata. Flatau was convinced that this illness is caused by a virus which was later confirmed by Mergulis. In 1925, Flatau described in detail Schilder disease
and suggested new name "encephaloleukopathia scleroticans progressive".
Between 1921 and 1923, he described the meningeal symptoms characteristic during tuberculosis-related inflammation of meningitis: namely, the pupil extension when bending head and erection of the penis during repeated bending of the torso forward.
Migraine and headaches
In 1912, he published in German and Polish one of the first modern monographs in the 20th century about migraine headacheswhich is still referenced in scientific literature. It was the first Polish textbook devoted to migraine. In a review of the historical background of general aspects of the headaches, Isler and Rose say, "His unique monograph of 1912, Die Migrane, contains a thoroughly structured survey of most earlier authors, precise clinical observations, a critical evaluation of pathophysiology, and uncritical opinions on treatment, including arsenic cures."
In his monograph, Flatau presented the full clinical picture of migraine and described the disease as an innate disposition to pathological metabolic processes in the nervous system and described its distinguished characters – ocular, epileptic, mental and facial. The book was based on observations of himself and about 500 cases from his own practice.
In the introduction to the monograph, he wrote,"Migraine, as such, is not an independent or autonomous disease; it is just one set of symptoms in the great chain of changed neurometabolism, whose crucial aspect are chemical changes and endocrine glands. Migraine attack is the expression of brain disorders; however, an exact mechanism which may be responsible is currently just a matter of conjecture and supposition. Today we cannot describe mechanisms that come to play and express them in well defined anatomical and physiological aspects. The forces that govern such mechanisms are also not known to us. We can only guess and make assumptions as to their operation. Nevertheless, great progress characterizing the development of neurology in the second half of the nineteenth century is visible in the field of research into migraine as well. As a result, one can describe some of the ideas on more reliable anatomical and physiological grounds."
File:Pieczatka1.jpg| thumb | left | Dr. med. E. Flatau. Nervous and mental diseases. Chmielna 60 Street . Hours 5 pm and 1/2 till 7 pm and 1/2. This is medical doctor seal from a medical prescription issued on 27 August 1920.