(b. Berlin, German, 9 September 1865; d. New York City, 5 February 1955)
Magnus-Levy pioneered the study of human me tabolism and its relation to such disease as diabetes, goiter, and multiple myeloma, and applied studies of energy exchange to clinical medicine. An early interest in history was abandoned in order to pursue medical studies at Berlin, Tübigen, Leipzig, Hei delberg, and Freiburg, but he was disappointed at the heavy emphasis on morphology and pathology at these schools. He ultimately concluded that anatomy dealt only with the sites of physiological pro cesses, without seeking an understanding of the role of those processes in health and disease. Only the physiology lectures of Carl Ludwig at Leipzig from 1886 to 1888 stimulated Magnus-Levy to realize that he sought enlightenment through the understanding of physiological processes.
After receiving the M.D. at Heidelberg in 1890, Magnus-Levy sought to study analytical methods, first with Nathan Zuntz at Berlin, where he gained experience in gas analysis and the study of energy exchange. At Freiburg, with Eugen Baumann, he participated in the chemical analysis of thyroid ex tract. He completed his studies at Erlangen, where he was awarded the Ph.D. in 1893.
Magnus-Levy spent most of the next decade as a clinical assistant, first at the Urban Hospital in Berlin, where he worked in association with Albert Fränkel, who by 1884 had discovered the peneu mococcus (Diplococcus pneumoniae). Here he gained valuable clinical experience while focusing on metabolic problems. After two years he moved to Frankfurt-am-Main to join Carl von Noorden, who investigated nutritional problems, particularly those connected with diabetes. At this time Magnus Levy equipped a personal laboratory and initiated studies on energy relationships in patients with diabetes, with myxedema, and with obesity problems. Pursuing suggestions made by others in connection with exophthalmic goiter, he showed that to treat goiter, metabolism must be increased, and that the weight reduction produced in obese patients when they were given thyroid extract was attributable to the increased use of energy. A paper on respiratory metabolism under the influence of the thyroid and in various pathological conditions, published in 1895, brought him an offer to further his studies at the Strassburg Clinic.
The clinic, under the leadership of Bernard Naunyn, was doing important studies on diabetes and gallstones, It was there, in 1889, that Oscar Min kowski and Joseph von Mering had demonstrated the importance of the pancreas in carbohydrate metabolism.
At Strassburg, Magnus-Levy focused on the ex treme diabetic condition known as acidosis and associated with acetone on the breath an almost acidic reaction of the blood. He was successful in isolating beta-hydroxybutyric acid as a principal component of diabetic blood under conditions of acidosis. Along with a number of investigators he concluded that fatty acid oxidation is incomplete in diabetes, stop ping with the formation of modified butyric acids instead of continuing to conversion into carbon dioxide and water. His Habilitationsschrift, “Oxybutyric Acid and Its Relation to the Diabetic Coma,” led to his promotion to Privatdozent in 1899.
In 1901 Magnus-Levy returned to Berlin, where he established a limited private practice that sup ported the continuation of his metabolic studies. He was granted a titular professorship at the Uni versity of Berlin Medical School in 1905; this involved no time-consuming obligations, however, so he was able to restrict his activities primarily to research in his private laboratory. In 1910 he was made chief of medical service of Urban Hospital in Berlin. In 1921 he was married; soon after his marriage, he resigned the hospital post in order to have more time for private practice and research and for his wife and two daughters.
Magnus-Levy’s research included a broad spec trum of metabolic problems. In his early work he used the concept of basal metabolic rate (BMR) to deal with fundamental metabolic conditions free of extraordinary stress conditions. This was extended to metabolic changes in normal health and in various disease states.
Magnus-Levy was one of the first physiologists to give careful attention to the metabolism of electrolytes present in human organs; carbonate, chloride sodium, potassium, magnesium, calcium, and ironions. Attention was also given to the metabolic role of water and proteins. He had a strong interest in the behavior of Bence-Jones proteins, especially in connection with multiple myeloma, a form of cancer of the bone marrow.
Except for the period with Naunyn at Strassburg, Magnus-Levy’s research was carried out independ ently, without university support and without col laborators. In Berlin his friend Wilhelm His, Jr., director of the Charité Clinic, provided space in a small laboratory where he continued metabolic studies into the 1930’s.
Magnus-Levy prized his independence and was critical of the departure of younger medical inves tigators from the traditions of earlier physiologists who had worked in what he considered to be the heroic age of medical research. He was an uncom promising critic of physicians who were content to ignore the emerging science of medicine, continuing to look upon medicine as an art.
Because the family was Jewish, their lives were placed in serious jeopardy as a result of the rise to power of the Nazis in Germany. Magnus-Levy lost the use of the hospital laboratory and his titular professorship at the university. Although he con tinued his research privately, he was denied the right to publish in German medical journals. His classical research on multiple myeloma was published in Acta medica scandinavica in 1938. In 1940 he and his family went to America. John Fulton provided a position for him in the Physiology and History of Medicine Departments at Yale University. After five years he retired to New York City, where he pursued his lifelong interest in German literature until his death in his ninetieth year. He was survived by his two daughters.
I. Original Works. The limited numbers of Magnus Levy’s published papers are well-crafted descriptions of his laboratory and clinical research. His first paper, written with his teacher Nathan Zuntz, was “Beiträge zur Kennt niss der Verdaulichkeit und des Nährwerthes des Brodes,” in Archiv für die gesamte Physiologie des Menschen und der Tiere, 49 (1891), 438–459. Other early papers were “Über die Grösse des respiratorischen Gaswechsels unter dem Einfluss der Nahrungsaufnahme,” ibid., 52 (1892), 475–479; 55 (1893), 1–126. His interest in the thyroid gland and goiter developed early; principal papers were “Uuml;ber den respiratorischen Gaswechsel unter dem Einfluss der Thyroiden sowie unter verschiedenen physiologischen Zuständen,” in Berliner klinische Wochenschrift, 32 (1895), 650–652; “Gaswechsel und Fettumsatz bei Myxödem und Schilddrüsenfüterung,” in Verhandlungen des Kongresses für innere Medizin (Wiesbaden), 14 (1896), 137–165; “Versuche mit Thyreoantitoxin und Thyrojodin,” in “Deutsche medizinische Wochenschrift,” 22 (1896), 393– 396; “Über Organtherapie beim endemischen Kretismus,” in Berliner Klinische Wochenschrift, 40 (1903), 733–735; “Über Myxödem,” in Zeitschrift für klinische Medizin, 52 (1904), 201–256. Gout was investigated in “Beiträge zum Stoffwechsel bei Gicht,” in Berliner klinische Woch enschrift, 33 (189), 416–418; “Über Aufgaben und Be deutung von Respirationsversuchen für die Pathologie des Stoffwechsels,” in Zeitschrift für klinische Medizin, 33 (1897), 258–268; “Über Gicht, klinische Beobachtungen chemische Blutuntersuchungen und Stoffwechselver suche,” ibid., 36 (1898–1899), 353–416; “Harnsäuregehalt und Alkaleszenz des Blutes in der Gicht,” in Verhand lungen des Kongresses für innere Medizin, (Wiesbaden), 16 (1898), 266–270. In 1910 Magnus-Levy was invited to the United States to deliver the Harvey Lecture, which was subsequently published by the Harvey Society, “Uric Acid in Gout,” The Harvey Lectures 5th series (Phila delphia, 1910), 251–276.
His early interst in energy and mineral metabolism and composition of body fluids led him to pursue investigations relevant to diseases associated with hormone-related ill ness. Among these are “Untersuchungen zur Schilddruü senfrage und Stoffwechseluntersuchungenfrage bei Schilddrüsenfütterung,” ibid., 33 (1897), 269–314; “Uuml;ber den Stoffwechsel bei akuter und chronischer Leukämie,” in Archiv für pathologische Anatomie und Physiologie und für klinische Medizin, 152 (1898), 107–130; “Der Einfluss von Krankheiten auf den Energiehaushalt im Ruhestand,” in Zeitschrift für klinische Medizin, 60 (1906), 177–224; “Uuml;ber Paarung der Glukuronsäure mit optischen Antipoden,” in Biochemische Zeitschrift, 2 (1907), 319– 331; “Der Mineralstoffwechsel in der klinischen Path ologie,” in Verhandlung des Kongresses für innere Medizin (Wiesbaden) (1909), 15–42; “Über den Gehalt normaler menschlicher Organe an Chlor, Calcium, Magnesium, und Eisen sowie an Wasser, Eiweiss und Fett,” in Bio chemische Zeitschrift24 (1910), 363–380; “Über den Mineralstoffgehalt einiger Exsudate und Transsudate,” in Zeitschrift für klinische Medizin, 88 (1919), 1–8.
An early interest in proteins, particularly in their mod ification in multiple myeloma (a tumor of bone marrow), led him to pursue specific studies. Noteworthy is “Uuml;ber den Bence-Jones’ schern Eiweisskörper,” in Zeitschrift für physiologische Chemie, 30 (1900), 200–240; slightly peripheral were his studies on the role of amino acids in the elimination of benzoic acid in the urine as hippuric acid: “Über die Herkunft des Glykokols in der Hippur säure; ein Beitrag zur Frage des Eiweissabbaues im Or ganismus,” in Münchner medizinische Wochenschrift, 52 (1905), 2168–2170; “Über das Auftreten einer Benzoesäure Glukuronsäureverbindung im Hammelharn nach Ben zoesäure-Fütterung,” ’in Biochemische Zeitschrift, 6 (1907), 502–522; “Über die Neubildung von Glykokoll. Studien zur Hippursäurefrage,” ibid., 523–540; “Über das Ver halten benzoylierter Aminosäuren im Organismus,” ibid., 541–554; “Über das Verhalten formulierter Aminosäuren im Organismus,” ibid., 555–558.
Magnus-Levy’s interests in diabetes spanned much of his career. Among his publications on this topic are “Un tersuchungen über die Acidosis im Diabetes mellitus und die Säureintoxication im Coma diabeticum,” in Archiv für experimentelle Pathologie and Pharmakologie and Pharmakologie, 45 (1901), 389–434; “Uuml;ber ätherlösliche Säuren im normalen Urin,” in Beiträge zur wissenschaftlichen Medizin und Chemie, Festschrift. . . Ernst Salkowski (Berlin, 1904), 253–262; “Respirationsversuche an diabetischen Menschen,” in Zeitschrift für klinische Medizin, 56 (1905), 89–99; “Chylurie und Diabetes,” in Zeitschrift für klinische Medizin, 66 (1908–1909), 524–526; “Über Diabetiken Gebäcke des Handles. Zusammensetzung und Anwen dung,” in Berliner klinische Wochenschrift, 47 (1910), 233–238; “On Diabetic Acidosis, “Johns Hopkins Medical Bulletin”, 22 (1911), 46–52; “Über den Diabetes im Krieg,” ibid., 1150; “Über Haferkuren bei Diabetes mellitus.: ibid., 48 (1911), 213–217; “Das Insulinproblem und die Theorie des Diabetes,” Deutsche medizinische Woch enschrift, 50 (1924), 494–496. Much of his later career focused on body fluids and multiple myeloma; see “Von Basen und Säuren beim kranken Menschen,” in Deutsche medizinische Wochenschrift, 56 (1930), 571, 609; “Ein neuer Typus der der Phosphaturie mit hoher Ammoniakaus treibung,” in Zeitschrift für klinische Medizin, 115 (1930) 1–12; “Bence-Jones-Eiweiss und Amyloid,” ibid., 116 (1931), 501–531; “Über die Myelomkrankheit, vom Stoff wechsel der Bence-Jones-Proteinurie,” in Zeitschrift fürklinische Medizin, 119 (1932), 307-362 : “Multiple Myeloma, der Stoffwechsel ausserhalb der Proteinurie,” ibid., 120 (1932), 313-320 :“Über die Myelomkrankheit : Beiträge zur Klinik and Pathologie,” ibid., 121 (1932), 533-562 :“Multiple Myeloma,” Acta medica Scandinavica, 95 (1938), 217-280.
While Magnus-Levy was at Yale he prepared a historical study, “Energy Metabolism in Health and Disease,” in Journal of the History of Medicine and Allied Sciences, 2 (1947), 307-320.
II. Secondary Literature. The principal obituaries are Martin G. Goldner, “Adolf Magnus-Levy, 1865-1955,” in Diabetes, 4 (1955), 422-424 :G. Haller, Deutsche med-izinische Wochenschrift, 80 (1955), 729 : 1. Zadek, Münchener mediz inische Wochenschrift, 79 (1955), 834-835.
Aaron J. Ihde