Neisser, Albert Ludwig Sigesmund

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NEISSER, ALBERT LUDWIG SIGESMUND

(b. Schweidnitz, Germany [now Swidnica, Poland], 22 January 1855; d. Breslau, Germany [now Wroclaw, Poland], 30 July 1916)

dermatology.

Neisser’s father was a highly respected physician; his mother died before he was a year old, and he was raised by his stepmother. Neisser attended the Volksschule in Münsterberg, then entered the St. Maria Magdalena Humanistic Gymnasium in Breslau, where Paul Ehrlich was a classmate. In 1872 he began his medical studies, which, with the exception of one semester of clinical work in Erlangen, were carried out entirely in Breslau. His studies were not outstanding—in fact, he had to repeat the chemistry test—but he passed the state examination and received the medical degree in 1877 with a thesis on echinococcosis, prepared under the direction of the internist Anton Biermer. His other teachers included Rudolf Heidenhain, Julius Cohnheim, Carl Weigert, and C. I. Salomonsen. Neisser originally planned to become a specialist in internal medicine, but there were no openings for assistants in Biermer’s clinic. It was therefore purely by chance that he turned to dermatology, becoming an assistant in Oskar Simon’s clinic, where he worked for two years. It was there that in 1879 Neisser discovered the gonococcus.

Neisser’s discovery occurred in the wake of the rapid development of the new field of bacteriology. It was made possible in large part by his close association with the botanist Ferdinand Cohn, who taught him Koch’s smear tests for the identification of bacteria, and with Cohnheim and Weigert, who taught him staining techniques, including those with methylene blue. Neisser was further able to make use of a new Zeiss microscope that incorporated Abbe’s innovative condenser and oil-immersion system. He at first called the microorganisms that he thus observed “micrococcus” they were then given the name “gonococcus” by Ehrlich. Neisser’s paper “Über eineder Gonorrhoe eigenthümliche Micrococcenform,” published in 1879, was a milestone in elucidating the etiology of venereal diseases.

Neisser made a research trip to Norway in the same year. He was able to examine more than 100 patients with leprosy in Trondheim, Molde, and Bergen, and to take secretion smears back to Germany to study. In examining the smears he found, in almost all cases, “bacilli as small, thin rods, whose length amounts to about half the diameter of a human red blood corpuscle and whose width I estimate at one-fourth the length.” These results embroiled him in a priority dispute with the Norwegian bacteriologist G. H. A. Hansen, who had found similar microorganisms in leprosy secretions as early as 1873; when Neisser published his findings in 1880, Hansen responded with a paper, published in four languages, in which he stated his earlier claim. It is clear, however, that while Hansen first discovered the leprosy bacillus, Neisser was the first to identify it as the etiological agent of the disease. The etiology, diagnosis, and prophylaxis of leprosy occupied him for much of his subsequent career.

His early publications made Neisser’s name well known. On his return to Breslau, he was able to qualify as a lecturer in dermatology on the university medical faculty, and he was named Privatdozent on 6 August 1880. In 1882 Simon died suddenly, and Neisser was appointed his successor in the chair of dermatology and as director of the clinic. His promotion at the age of twenty-seven was sponsored by Friedrich Althoff, the Prussian councillor for education and cultural affairs. In the following year Neisser married Toni Kauffmann, who assisted him in his investigations and accompanied him on research trips. At about the same time he became involved in planning a new dermatological clinic, which, built to his design, was opened in 1892 and became an internationally famous research center.

Neisser’s work with leprosy led him to study another infectious skin disease, lupus. He early suspected a connection between lupus and tuberculosis and went on to distinguish non-tubercular forms of the disease, including lupus erythematosus, lupus pernio, and sarcoidosis of the skin. His attempts to cure lupus with tuberculin came to nothing, however; he remained particularly concerned in alleviating the lot of those scarred by lupus. His servant, Hein, was so afflicted, and Neisser often used him as an object lesson in what might be done toward rehabilitation.

Neisser also devoted intensive study to syphilis, although his therapeutic suggestions are of little significance. His attempt to discover the cause of the disease through a series of inoculation experiments were unfortunate; he was accused of having “maliciously inoculated innocent children with syphilis poison,” and a scandal resulted. Neisser was misled by drawing an analogy with the serum therapy that Behring had used against diphtheria and tetanus; the supposed serum with which he inoculated young prostitutes was probably highly infectious in itself.

In 1903 Metchnikoff and Roux demonstrated that syphilis could be communicated to apes, and Neisser immediately repeated their experiments and confirmed their findings. He made two trips to Java, in 1905 and 1906, to obtain ape specimens and to continue his research toward determining the cause of the disease. On 16 May 1905, however, he heard of Schaudinn and Hoffmann’s discovery of the syphilis spirochete; the news must have been disappointing to him, and he at first was disinclined to accept that the spirochete was actually the causative agent. In a letter of June 1905, he wrote, “We are still toiling with the syphilis spirilla. Here and there we find something positive, but on the whole we are more convinced than ever that these spirilla… are not really the syphilis spirilla.” By the time of his second Java trip he was convinced, however, and he turned to the investigation of the transmission of syphilis among both apes and men—the temporary stationing of Dutch sailors in Java supplied him with the human syphilis patients formerly lacking on that island. His observations yielded valuable data concerning reinfection and superinfection.

Neisser encouraged Wassermann to study seroreaction in syphilis in 1906. With him and with Carl Bruck, he developed the serological test, now named for Wassermann. He also worked in testing therapeutically the arsenic preparations, especially arsenophenylglycine, with which Ehrlich provided him. He found these to be effective but dangerous as remedies for syphilis. He also contributed to Ehrlich’s introduction of Salvarsan (1910).

Neisser’s work with venereal diseases brought him into the field of public health. He propagandized widely for better prophylactic measures and for more public education about these diseases; he was active in founding the Deutschen Gesellschaft zur Bekämpfung der Geschlechtskrankheiten and served as its president in 1901. He strongly supported stricter regulation of prostitution, and favored increased sanitary measures rather than police action. He also supported the establishment of a central board of health but objected to the obligation to inform the police and advocated the confidentiality of the doctorpatient relationship.

In 1907 Neisser was named full-time professor of dermatology at Breslau. He trained a number of eminent dermatologists, and conducted research on lichen infestations and urticaria. He experimentally explored the emergence of weals in the latter condition, and contributed substantially to Heidenhain’s conclusion that the weal is a vasodilatory edema. As early as 1894 he described vitiligo with lichenoid eruptions, and he published a number of other findings about skin tumors, infectious diseases (including anthrax, actinomycosis, glanders, blastomycosis, and skin diphtheria), psoriasis, mycosis fungoids, and various forms of pemphigus. His work received wide official recognition.

The death of his wife, in 1913, affected Neisser deeply. His own health began to fail rapidly in 1916, and he died shortly after he was named a member of the Imperial Health Council. In 1920 his house was made a museum; in 1933 it was confiscated by the Nazis and turned into a guesthouse. Neisser’s papers were salvaged by a Schweinfurt physician named Brock and form the basis for recent works about him.

BIBLIOGRAPHY

I. Original Works. A full list of Neisser’s publications may be found in the biography by Sigrid Schmitz, cited below. His most important works include “Über eine der Gonorrboe eigenthümliche Mierococcenform,” in Centralblatt für die medizinischen Wissemchaften, 28 (1879), 497–500; “Über die Aetiologie des Aussatzes,” in Jahresbericht der Schlesischen Gesellschaft für vaterländische Kultur, 57 (1880), 65–72; “Weitere Beiträge zur Aetiologie der Lepra,” in Archiv für pathologische Anatomic und Physiologie, 84 (1881), 514–542; “Die Mikrokokken der Gonorrhoe in Deutsche medizinische Wochenschrift, 8 (1882), 279–283; “Die chronischen Infektionskrankheiten der Haut,” in H. W. von Ziemssen, ed., Handbuch der speciellen Pathologic und Therapie, XIV (Leipzig, 1883), 560–723; “Über das Leukoderma syphiliticum,” in Vierteljahrsschrift für Dermatologie und Syphilis, 15 (1883), 491–508; “Über die Mängel dcr zur Zeit üblichen Prostituiertenuntersuchungen,” in Deutsche medizinische Wochenschrift, 16 (1890), 834–837; “Pathologic des Ekzems,” in Archiv für Dermatologie und Syphilis, 1 (1892), suppl., 116–161; “Über den gegenwärtigen Stand der Lichenfrage,” ibid., 28 (1894), 75–99; and “Über Vitiligo mit lichenoiden Eruptionen,” in Verhandlungen der Deutschen Dermatologischcn Gesellschaft. IV. Kongress zu Breslau (Vienna-Leipzig, 1894), 435–439.

See also “Syphilis maligne,” in Journal des maladies cutanèes et syphilitiques, 9 (1896), 210–213; “Was wissen wir von einer Serumtherapie der Syphilis und was haben wir von ihr zu hoffen?,” in Archiv für Dermatologie und Syphilis, 44 (1898), 431–439; “Über Versuche, Syphilis auf Schweine zu übertragen,” ibid., 59 (1902), 163–170; “Meine Versuche zur Übertragung der Syphilis auf Affen,” in Deutsche medizinische Wochenschrift, 30 (1904), 1369–1373, 1431–1434; “Weitere Mitteilungen Über den Nachweis spezifischer luetischer Substanzen durch Komplementbindung,” in Zeitschrift für Hygiene und Infektionskrankheiten, 55 (1906), 451–477, written with A. Wassermann, C. Bruck, and A. Schucht; Über die Bedetttimg der Lupuskrankheit und die Notwendigkeit ihrer Bekämpfung (Leipzig, 1908); “Über das neue Ehrlich’sche Mittel,” in Deutsche medizinische Wochenschrift, 36 (1910), 1212–1213; “Beiträge zur Pathologic und Therapie der Syphilis,” in Arbeiten aus dem Kaiserlichen Gesundheitsamt, 37 (1911), 1–624; Syphilis und Salvarsan (Berlin, 1913); “Ist es wirkiich ganz unmöglich, die Prostitution gesundheitlich unsehädlich zu machen?,” in Deutsche medizinische Wochenschrift, 41 (1915), 1385–1388; “Über das urtikarielle Ekzem,” in Arehiv für Dermatoiogie und Syphilis, 121 (1916), 579–612; and Die Geschlechtskrankheiten und ihre Bekämpfung (Berlin, 1916).

II. Secondary Literature. In addition to obituary notices in a number of medical journals, see K. Bochmann, “Albert Neisser,” in Heilberufe, 7 (1955), 179; E. Czaplewski, “Albert Neisser und die Entdeckung des Leprabazillus,” in Archiv für Dermatologie und Syphilis, 124 (1917), 513–530; G. L. Flite and H. W. Wade, “The Contribution of Neisser to the Establishment of the Hansen Bacillus as the Etiologic Agent of Leprosy and the So-called Hansen-Neisser Controversy,” in International Journal of Leprosy, 23 (1955), 418–428; J. Jadassohn, “Albert Neisser,” in F. Andreae, ed., Schlesische Lebensbilder, I (Breslau, 1922), 111–115; J. Schäffer, Albert Neisser (Berlin-Vienna, 1917); W. Schönfeld, “In Memoriam Albert Neisser zum 100. Geburtstag,” in Hautarzt, 6 (1955), 94–96; A. Stühmer, “Albert Neisser,” in Dermatologische Wochenschrift, 131 (1955), 214–216; and T. M. Vogelsang, “The Hansen-Neisser Controversy, 1879–1880,” in International Journal of Leprosy, 31 (1963), 74–80, and 32 (1964), 330–331.

The best and most comprehensive biography, which draws upon Neisser’s posthumous papers and other previously unpublished sources, is Sigrid Schmitz, “Albert Neisser. Leben und Werk auf Grund neuer, unveröffentlicher Quellen,” in H. Schadewaldt, ed., Düsseldorfer Arbeiten zur Geschichte der Medizin, XXIX (Düsseldorf, 1968).

H. Schadewaldt