Adolpho Lutz: Education and First Works

Adolpho Lutz: Education and First

Works

 

Magali Romero Sá; Jaime Benchimol

 

Family origins

When tracing the origins of the Lutzes, one of the most established families of Bern, biographers tend to spotlight the Brazilian scientist’s grandfather, Friedrich Bernard Jacob Lutz, an important figure in Swiss medical history. The son of Abraham Jacob Lutz (1756-1817) and M. Elizabeth Barth, Friedrich was born in Lichtenfteig on January 28, 1785, and migrated with his family to Gesteid bei

Interlaken in 1794. 1 He was educated by his father, an erudite minister schooled in the ancient classics, and from an early age he displayed a propensity to study medicine, something he was unable to pursue given the lack of resources.

Friedrich Bernard grew up amid the tumultuous backdrop of the Helvetic Confederation. From 1798, the year the Napoleonic army conquered the 13 cantons and established the Helvetic Republic, until 1815, when the Congress of Vienna ratified the new confederal pact, Switzerland was stripped not only of its autonomy, but also of some territory, as the regions of Jura and Neuchatel had been ceded to France. The protectionist policy of France towards its manufacturers, with hefty duties placed upon imported goods, affected Romand cantons far more than the German cantons, which maintained tighter trade links with Prussia, Bavaria and other regions in the Austro-Hungarian Empire.

The French Revolution had rallied the support of numerous democrats who had taken part in the revolt against the Geneva bourgeoisie in 1782, many of them taking refuge in Paris before returning to Switzerland with French troops. Friedrich Bernard, who sympathized with the democrats, accompanied the French army in its flight to Baadtland after the federalist rebellion, which led Bonaparte to issue the “Act of Mediation” in 1803, restoring the confederal system, although conserving French control over the country. In 1804, the very same Lutz became a medical assistant in the Bern military hospital. He arranged to be transferred to Munich, where he attended classes in the university and visited maternity wards and hospitals. However, the environment of the era was not conducive to calm academic study; warring European armies provided ample practical opportunities for a young man to gain experience in medicine. In the fall of 1805, Friedrich Bernard enlisted as a chirurgien sous-aide-major in the Napoleonic army and, in the days following Austerlitz and Magram, he served at hospitals in Munich, Lins and Braunau. Only in 1807 did he manage to earn a doctorate in medicine and surgery from Heidelberg University.

Coats of arms of the Lutz family, whose members had been citizens

of Bern since 1559. Members of the carpenter guild, they preferred

using the second coat of arms. Wappenbuch der burgerlichen

Geschlechter der Stadt Bern. Herausgegeben von der

Burgergemeinde. Bern: 1932.

The Congress of Vienna (1815) redesigned the map of Europe, and the Helvetic Confederation regained its pre-1789 borders. The former confederal canton system was restored, although it was far weaker. Bern, Basel and Neuchâtel resisted the reforms imposed by the liberal bourgeoisie between 1827 and 1831, the years a new revolutionary surge was sweeping through Europe. Partisans of the

Mazzinian-inspired Young Switzerland,2 together with radicals, anticlerics, and democrats led the confederation from 1835 to 1845, while other European states lived under the yoke of restored monarchies. In September 1848, while barricades were being reerected in European capitals, the first Swiss constitution was ratified, installing in Bern the central government and the National Assembly of the Helvetic Confederation.

 

Map of Switzerland from:

www.wsl.ch/hazards/3rdDFHM/pictures/schweiz.jpg

Adolpho Lutz’s grandfather played a pertinent role in these developments. He headed up the smallpox vaccination program from 1811 to 1818, and in 1815 became the chief doctor of the 45,000-strong confederation army. In January 1831, just months after the popular uprising that resulted in the triumph of the democrats, he was appointed chief doctor for the troops in Bern, continuing as head of confederation army medical services for four more years. In 1859, Friedrich Bernard Jacob Lutz was elected to the Council of Bern, a prestigious appointment that gave him the right to vote and carry weapons. He ended his career as an assemblyman in the Swiss capital, “during a time in which the City Council challenged the federal government” (Delta Larousse, 1975, v.2, 9 and 14; B. Lutz, Lutziana).

In about 1812, he married Margareta Sophie Wyss (1770-1815 [1813?]), in 1814 he married Maria Stuber (1791-1819) and in 1824 he wed for a third time, with Maria Elisabeth Bitzius (1797-1857). One of his three sons, Gustav Lutz, born in Brunnengasse, in the canton of Bern, on May 31, 1818, married Mathilde Oberteuffer (7/24/1824-1/11/1893). In the same year, after their honeymoon, the couple emigrated to Brazil.

 

Friedrich Bernard Jacob Lutz (1785-1861), Adolpho Lutz’s

grandfather. Ludwig Lauterburg. Berner Taschenbuch auf das jahr

1862.Bern, Druch und Verlag der Haller’schen Buchdruckerei, 1862,

p.269-84.

The arrival of the Lutzes is linked to a wave of immigration that had been going on for three decades. The general calculation from the 19 th century is that the Swiss represented one of the smallest contingents of when compared to the Portuguese, Italians, Spanish and Germans. However, they were instrumental in the first colonization experiments in nineteenth-century Brazil, which gave

rise to Nova Friburgo, in the province of Rio de Janeiro,3 the colony of Leopoldina, in Bahia, and the colonies set up in São Paulo mid-way through the century, that were conducted by the company belonging to Senator Nicolau de Campos Vergueiro, with the objective of replacing slave labor on coffee plantations.

 

LUTZ, Bernhard Fnednch/surgeon doctor in Bern. Lecture in Burgdorf on 22 June 1825. Burgerbibliothek Bern Collection:

Mss.h.h.XXXIX 28.105-cover.

According to Bertha Lutz 4 (Lutziana) , her grandparents Gustav and Mathilde arrived in Rio de Janeiro in January of 1850. This would have been during the peak of the devastating yellow fever epidemic that, for the first time in history, swept through the Brazilian capital, killing 4,160 people according to official data, or as many as 15,000 by unofficial sources. Adolpho Lutz (1930, p. 2), however, wrote that his parents came to Rio de Janeiro before the outbreak of the disease, which would mean that they disembarked shortly before December 28, 1849, the date in which a doctor from Lubeck, Robert Christian Berthold Avé-Lallement (1812-84), diagnosed the first cases of the disease in the foreigners’ ward at Santa Casa da

Misericórdia Hospital. 5

 

Opening lecture at Surgery and Medical Society of Bern Canton,

given by Dr. Lutz. Burgerbibliothek Bern: Mss.h.h.XXXIX 28.105-titel.

Book with the registration of the emigration from Switzerland to

Brazil of Adolpho Lutz’s mother, Mathilde Lutz, born in Oberteuffer.

Registration dated 25 October 1849. The columns register her

personal data: birth place or residence (Bern); rank or profession (no

data) and “signalement” or physical characteristics. She was 25

years old and 5 feet tall. She had brown hair and eyebrows, oval

face, normal nose, mouth and chin. Bern, Staatsarchiv, Passe n.3,

147-1852, BB XIIIa55.

Nearly all the couple’s 10 children were born in the Brazilian capital, including Adolpho, on December 18, 1855.

In partnership with another Swiss named Keller, Gustav Lutz founded a business for importing “haberdashery” and exporting

agricultural produce on Rua do Sabão, 44A.6 In 1857, the Lutz’s returned to Bern, confident that their partner would take care of the business; the decision was possibly motivated by the insalubrity of Rio de Janeiro. Aside from yellow fever, which raged every summer following the 1849-50 crisis, the city also faced a devastating cholera epidemic that happened to brake out precisely on Rua do Sabão, where a street slave belonging to businessman Leon Cohn fell ill (Gerson, 1965, p. 88).

Panorama of Rio de Janeiro, lithograph by Iluchar Desmons (1803,

France – ?). This French artist came to live in Rio de Janeiro in

1840. In 1855, he had the drawings he made the year before printed

in Paris, at Lemercier lithographic workshop. Thirteen lithographs

were published with the title Panoramas de la Ville de Rio de

Janeiro. This view of Santo Antônio Hill shows Pharoux Quay (praça

XV de Novembro at present), where Adolpho Lutz’s family had

landed four years before. Biblioteca Nacional.

Map of Rio de Janeiro (1874), made by engineer J. Rocha Fragoso

and engraved by M. J. Aranha. It shows the facade of downtown

buildings. In this segment, Pharoux Quay, the market docks and the

Customs docks. Biblioteca Nacional.

New plan of the city of Rio de Janeiro (1864), organized by

publishers Eduardo and Henrique Laemmert, who came from Baden

grand duchy to settle in Brazil in 1837. The map registers squares,

roundabouts, roads, streets, churches and public buildings in the

city, whose urban area was beginning to go beyond Campo de

Santana, on one side, and Outeiro da Glória, on the other. Beyond

Glória, one can see traits of occupation reaching Botafogo beach

and spreading up to Laranjeiras and Botafogo districts. The tram system, started in the 1870’s, encouraged urban expansion towards

both directions. Museu Histórico Nacional. Mapoteca da Secretaria

de Estado das Relações Exteriores.

Rio de Janeiro, 1861engraving representing the seashore between

Outeiro da Glória, on the left, Morro do Castelo, in the middle, and

Morro de São Bento, on the right. Pharoux Quay was located

between these two hills.

www.lombardmaps.com/cat/viewsforeign/southamerica/rio.jpg

Photograph from the 1880’s. Adolpho Lutz’s family on the front stairs

of “Colégio Suisso Brazileiro”, on Princeza Imperial street, n.33, in

the district of Catete. In 1887, it was transferred to Farani street n.12, in Botafogo. Front: Adolpho Lutz’s mother, Mathilde Oberteuffer Lutz,

holds the hand of her granddaughter, Gertrude Lutz Warnstorff, born

on July 24,1880. On the right, Gustav, the scientist’s father, and on

the left, Mathilde’s second granddaughter, Paula Elisabeth Lutz

Warnstorff. Back right: Adolpho Lutz, second sister, who was named

after her mother (Mathilde). Back left:, Maria Elizabeth, his oldest sister, the mother of the two children. Beside her, one of his brothers,

Gustav or William Robert. Casa de Oswaldo Cruz/ Fiocruz,

Departamento de Arquivo e Documentação, Setor iconográfico,

Série Personalidades, Pasta IOC (P) LUTZ, A-7. Instituto Adolfo Lutz

also has a copy of this photograph.

Relations between Keller and Gustav became strained, 7 and in 1864 the Lutzes returned to the Brazilian capital, leaving their three oldest sons in Basel to attend school.

Mathilde Oberteuffer Lutz appears to have been just as enterprising as her husband. Brasil Gerson (1965) makes reference to an educated woman who founded the Swiss-Brazilian school in Botafogo, on Rua Farani, near the home of Senator Cristiano Ottoni,

the first director of D. Pedro II Railroad. 8 The first reference to the “Girl’s School run by d. Mathilde Elena Lutz”, on Rua Princeza Imperial, 33, in the neighborhood of Catete, appears in the 1880 copy of Almanak Laemmert. In the following year, it became known as the Swiss-Brazilian School. In 1887, it moved to Rua Farani, 12.

Announcements published in Almanaque Laemmert in 1881, 1882

and 1889 (http://wwwcrl.uchicago.edu/info/brazil/pindex.htm).

 

Initial studies

Adolpho Lutz traveled with his parents to Switzerland when he was just two years old; they lived together until 1864, after which they were separated for 17 years. When his parents returned to Brazil, nine-year-old Adolpho, his ten-year-old brother, Gustav, and his youngest brother, Friedrich Eugen, who was born in Switzerland and was only seven or eight years old, were taken care of by relatives in Basel and educated by local tutors.

During his childhood, Adolpho Lutz developed a special interest in natural history. Observing and collecting specimens was part of learning about nature, and constituted a social activity that combined family recreation and intellectual development, which was still in vogue during the second half of the 19th Century. Mollusks in their shells, insects, plants, fossils, rocks and minerals were integrated into collections that were admired and exchanged or purchased by amateurs and professionals alike. The wealth of the fauna and flora in the New World, already known by Europeans from the reports and specimens brought home by travelers, aroused a keen interest among collectors. In a letter sent from Basel on August 5, 1865, to his sister Helena, who had returned to Brazil with her parents a year previously, Adolpho Lutz revealed his enthusiasm as a collector and his vocation to observe the natural world:

 

Basel, bridge over the Rhine, circa 1884 (Meier, 1980, p.151, fig.

180).

Riehentor (Riehen Gate), 1864. Built in the thirteenth century, it was

the finest gate to the city of Basel (Meier, 1980, p.191, fig. 228).

The “Aeschenvorstadt” looking towards the Aeschenplatz, about

1880 (Meier, 1980, p.59, fig.56).

In c.1875, by St. Elizabeth’s Fountain, which was built in 1863 and is crowned with a granite statue made by sculptor R. H. Meili, depicting

St. Elizabeth carrying a loaf of bread and a water-jug (Meier, 1980,

p.45, fig.38).

Spring has begun with a vigor and trees are budding. This year,

there are many violets and I have discovered the best places in

which to find them.

When you have the opportunity, don’t forget to send us some

objects of natural history, mollusks, sea horses, nautilus shells

and any rare stones, if possible, any specimens that we can

exchange.

We have ordered a den for lizards and we are going to breed

them, while we have also caught butterflies and hope to obtain

many for our collection, even though Basel is not the ideal

place. I know of much better places in Bern. We also want to

start a collection of dried plants, and we need some dried leaves

and flowers from Brazil, preferentially with their names attached.

Theophil Gautier is also going to help with this. We already have

some dried plants, but we are still not very good at drying them.

The book on plants is going to be useful when we plant our

gardens.9

His interest in natural history intensified and, at 15 years of age, when he was ready to enroll in a secondary school and he was faced with the difficult decision of choosing a profession, natural history became a genuine vocation for the young Lutz. In a letter to his

mother, dated February 4, 1871, he expressed his yearning:10

Look, what I’m about to say is something I sincerely believe in,

and I hope that you will believe it to be true. I don’t even know

whether I’ll be required to work diligently, particularly if I want to

pursue a career that beckons me. I’d like to speak again of my

aspirations and intentions for the future. What I always wanted

as a child and, without due reflection, what I still want now, is to

be a researcher in natural sciences. I frequently ponder over this

aspiration. I have also often thought that I may need a

qualification to earn a living. As a general rule, medicine

occurred to me first of all, although I also feel attracted by

philosophy ... . If I could be a natural sciences teacher, that

would also suit me. I am gathering all the knowledge about

natural history that I can find, I make my own observations, I

attend lectures and, during the holidays, I study all the books on

biology that I can get my hands on. However, there are not

many of these available to me. I have considered asking

permission to buy a good natural history publication that would

also serve me later on and last all my life. I hope, with God’s

help, to become a true naturalist. As far as I am concerned, I’d

be content to live very modestly if I could be a good researcher.

The fulfillment of this aspiration does not appear at all

impossible. Mr. Massini, in Basel, with whom I have spoken on

the subject, has given me great hopes.11

In the same year, 1871, Lutz enrolled in the Gymnasium in Bern, where he would acquire a solid knowledge of Greek and Latin. According to Pyenson & Pyenson (1999, p. 57), these languages were, at the time, indispensable for students to be admitted into university, where admission was free as long students presented their Abitur, the diploma awarded after the successful conclusion of secondary school. Lutz ended up studying medicine and, on November 4, 1874, shortly before his 19 th birthday, he enrolled at Bern University.

The transformation through which universities and scientific institutions in Germanic countries were passing at this time was at its peak, and the new changes introduced were decisive for the sound education that Lutz would receive, in both medicine and subjects related to natural history. The reformist movement, which had been evolving since the first half of the 19th Century, gave precedence to scientific practice in universities and was associated with a broader educational reform in primary and secondary schools. Researchers such as Jan Purkynje (1787-1869), Karl Heinrich Schultz (1798-1871) and Julius Budge (1811-1888) drew up ambitious plans to create new experimental research institutes. Microscopy and chemistry were awarded more prominent roles in this research. Physiology was separated from anatomy and was used as a leverage for the reform of medical and biological education in Prussia and, subsequently, other German-speaking countries. The studies of Johannes Müller (1801-1858) in Berlin, and Carl Ludwig (1816-95) in Leipzig (Kremer, 1992, pp. 72-79) were an important part of this process. The principle of “knuckling down” to work became central in the education of medical and philosophy students, while the laboratory continued to acquire an increasingly more important role in science. According to Bonner (1962, pp.15-16), by 1870 universities in German-speaking countries had reached their apogee in terms of organization, productivity, and local and international prestige. Even the barriers between the institutions had been lowered: Germanic medicine, just like Germanic science and the Germanic school, expanded beyond the confines of national borders. Students, relatively uninfluenced by political geography, took courses in different countries. German, Swiss-German and Austro-German universities started to become part of the same learning community – and the reader will notice the degree of mobility that so characterized the trajectory of not only Lutz, but also his fellow students and professors. The courses attended at any of these universities were easily accepted in the curriculum.

Readers will also notice that the trajectories of Lutz’s professors were significantly influenced by the wars that preceded the unification of Germany; because of this, some mention of them is warranted.

In the mid-1800s, after its alliance with France, the Kingdom of Denmark began to decline. After its defeat in the Napoleonic wars (1814), the political and economic crisis worsened. Dissatisfied, and harboring a strong conviction that they were German and not Danish, the duchies of Schleswig and Holstein established a provisional government in 1848, which was immediately recognized by Berlin (Prussia) and Frankfurt (Germanic Confederation). As a result, war broke out over the ownership of the two duchies between 1848 and 1851. The Austrians occupied Holstein, while the Danish keept Schleswig, together with Rendsburg. On May 8, 1852, the Treaty of London granted the two duchies autonomy, although under the aegis of the Danish monarchy. The injurious outcome of the Schleswig-Holstein uprising exasperated German nationalists, who blamed both the king of Prussia and the lack of unity in the Germanic states. In 1857, Christian IX was crowned king of Denmark and declared that, in accordance with a 1481 resolution, Holstein must be reincorporated, by force if necessary, with its sister duchy. This triggered renewed armed intervention by Prussia and Austria. Denmark was defeated in 1864 and the Treaty of Vienna ceded the territory of Schleswig-Holstein to the victors. By 1866, the region had become part of the Prussian Empire. Backed by a reorganized army, Bismarck began to build Germany as a sovereign and unified State. The dissolution of the Germanic Confederation and the formation of a North German Confederation, dominated by Prussia and excluding Austria (1866-1871), which rubbed shoulders with the opposition in France, prevented the annexation of States to the south of the Main River. The ensuing victorious war against the French (1870-71) consolidated German unity and resulted in the proclamation of the II Reich: a federal monarchy made up of 25 sovereign states – including Alsace-Lorraine, taken from France – over which reigned Wilhelm I, a puppet ruler for the powerful Otto von Bismarck-Schõnhausen, who was later promoted to prince of the new empire, an appointment that combined the positions of Chancellor of Germany and Prime Minister of Prussia.

 

The Faculty of Medicine in Bern

Established in 1834, the University of Bern may be considered a remote offshoot of the seminary created in 1528 in Barfüsserkloster – Monastery of the Discalced – where theology, Hebrew, Greek and philosophy were taught. In the so-called Insular Hospital (Inselspital), founded in 1354 to take in beggars and the sick and impoverished, professors from the seminary used to give classes to the physicians and surgeons in the region. In 1797, the Institute of Medicine was founded and, in 1805, the Bern School of Higher Education was transformed into an Academy, following the French model. This was comprised of the aforementioned Institute of Medicine and faculties of law, theology and philosophy. With the foundation of the University per se in 1834, significant changes were starting to be introduced to medical education, in line with the new order that had been implemented at universities in Germanic countries, characterized by freedom of teaching and learning. Departments of clinical and surgical medicine, chemistry, and anatomy and physiology were created. “Extraordinary” professors were hired to teach other subjects: ophthalmology, obstetrics, polyclinical medicine and legal medicine. Clinics and institutes were established to supervise the teaching of subjects associated with clinical and laboratory research. The Insular Hospital was transformed into a university hospital. Medical education in Bern gained considerable international prestige, thanks to the new professors hired to lecture the recently created disciplines: Edwin Klebs (1834-1913), Bernhard Naunyn (1839-1925), Marcel Nencki (18471901), Theodor Kocher (1841-1917), Hermann Sahli (1856-1933), Wilhelm Philipp Friedrich Vogt (1786-1861), Hermann Askan Demme (1802-1867) and Gabriel Gustav Valentin (1810-1883), among others (Bickel, 1984, p. 629).

Map of Bern (Reclus, 1878, p.95, fig. 35).

Bern view from west, c. 1860 (Schwengeler, 1975, p.18).

Bear pit, c. 1857. The bear is the symbol in the coat of arms of the

city and canton of Bern. In 1891, during the 700th anniversary of

Bern’s foundation, bears were taken to parade on its streets

(Leuenberger, 1997, p.97).

Market street (Marktgasse) in 1890. In the middle, one can see

Schützenbrunnen fountain. When Lutz was at Bern Medical School,

he used to live at n° 84 on this same street. (Schwengeler, 1975,

p.54).

When Adolpho Lutz enrolled in the Faculty of Medicine, the course had a duration of six semesters, at the end of which students were submitted to an evaluation on their propaedeutic skills and to a practical examination. Physiology, separated from anatomy in 1863, was taught by Gabriel Gustav Valentin, one of the oldest professors at the university, author of important papers on physiology, anatomy and protozoology. Born in Breslau, in the former Prussia (now Wroclaw, in Poland) on July 8, 1810, Valentin graduated in medicine in 1832 from the university in his home town, having written a dissertation on muscular propulsion systems Historiete evolutionis systematis muscularis propulsio. While working with his professor, the Czech physiologist Jan Evangelista Purkynje, he discovered in

1834 the ciliary movement of the cells of vertebrates.12 In the following year, the Paris Academy of Sciences awarded Valentin the Physical Science Grand Prize for his histology manuscript Histiogenia Comparata on the evolution of animals and plants. In 1836, he was the first to describe the cell, nucleus and nucleolus of neurons. In the same year, he was hired as a full professor (Ordinarius) at the University of Bern. He ran the Institute of Anatomy from 1853 to 1863 and, after the division of anatomy and physiology in the latter year, he took responsibility for the teaching, and later for the department, of physiology, which continued to function in the building of the Institute of Anatomy. Between 1836 and 1843, he published Repertorium für Anatomie und Physiologie. In the following year, he discovered the role of pancreatic juice in the digestive process; in 1841, he described a type of Trypanosoma, that would later be known as the protozoan that causes sleeping sickness. Valentin was a member of the Bern Society of Naturalists

and regularly published articles in its periodical.13

 

The old university seen from Kirchenfeld Bridge in 1890

(Schwengeler, 1975, p.34).

Adolpho Lutz registration at Bern University on November 4, 1874.

Die Studierenden der Universität Bern 1834 bis 1914.

Universitätsarchiv: www.uniarchiv.unibe.ch.

The Anatomy Institute building on today’s Genfergasse during

demolition in the winter of 1898-1899 (Schwengeler, 1975, p.73).

The classes that Adolpho Lutz attended in human and compared anatomy and in microscopic anatomy were given by Theodor Aeby (1835-1885), a Swiss doctor and anatomist hired by the University of Bern in 1863, when anatomy and physiology were separated disciplines. Although he did not possess the scientific capacity of Valentin, Aeby did produce some very important works, such as the description of muscular and craniometric structures, including two

that carry his name: Aeby’s muscle and Aeby’s plain.14

Edwin Klebs (1834 – 1913) Photo from www.uni-

wuerzburg.de/pathologie/Virchow/pathosum/klebs.htm

Prior to 1867, pathology classes were taught in the Institute of Anatomy building. Originally associated with pathological anatomy, pathology became an independent department in 1866, headed up by Theodor Albrecht Edwin Klebs. Before moving to Bern, this doctor, who graduated at Königsberg in 1859, had been the assistant of Rudolph Virchow (1821-1902) in the Berlin Institute of Pathology

since 1861. 15 Dissatisfied with the limited space for his new department at the University of Bern, in 1867 he was given new quarters in the National Pharmacy to set up the new Institute of Pathology, where it remained until 1885, when the institute was finally permitted to have its own offices. Working as professors and researchers with Klebs at the institute were Gabriel Valentin (as deputy) and Daniel Jonquière (1821-1899), who was also a member of the Bern Natural History Society. While Klebs worked at the University of Bern (1866-1872), he founded the Correspondezblatt für Schweizer Ärtze (Correspondence Bulletin for Swiss Doctors), a

specialized periodical16 in which Adolpho Lutz would publish his first articles, between 1880 and 1883 (see later in this volume). In Bern, Klebs developed the technique of soaking tissue in paraffin, which would become so important for the progress of histological research. He was also responsible for hiring Bernhard Naunyn, a doctor who had arrived only recently at the university to head up the medical clinic. Having graduated in Berlin in 1862, Naunyn became an

assistant to Friedrich Theodor von Frerichs (1819-1885),17 in whose laboratory in the city there worked a young team extremely motivated in their research of the relationship between disease and human metabolism. In this field of metabolic pathology, Naunyn took a special interest in the liver, pancreas and diabetes. With the help of Otto Schultzen, another of Frerichs’ assistant, he published an important paper on the behavior of benzene-derived hydrocarbons in the animal organism.

 

Bernhard Naunyn (1839-1925). Photo from

www.iqb.es/HistoriaMedicina/personas/naunyn.htm

When hired by the University of Bern in 1871, Naunyn took with him

important scientific studies on both pathology and biochemistry.18 Aware of the importance of the latter in medical research, Naunyn and Klebs proposed that the university create a position as chemical assistant for the Institute of Pathology, a job that was taken in 1872 by Marcel Nencki (1847-1901), a Pole who had been another of Frerichs’ assistants in Berlin. A specialist in biological chemistry, Nencki had studied with the Berlin chemist Johann Friedrich Wilhelm Adolf von Baeyer (1835-1917) before moving to Bern, as Privatdozent. He was made “extraordinary” professor in 1876, when Chemical Medicine became independent from Pathology. In the following year, he was promoted to full professor and put in charge of the new chemical medicine laboratory, an appointment he kept until 1891, when he transferred to St. Petersburg, in Russia, to take over the control of a department of the Imperial Institute of Experimental Medicine.

 

Friedrich Theodor von Frerichs (1819-1885). Photo from www.ms-

society.ie/history/hist_fvf.html

While he lived in Bern, Nencki actively participated in the National History Society. He began to teach bacteriology in 1888 and, later on, he also founded a department purely for this subject at the

National Pharmacy. 19

The site of the National Pharmacy also housed the Eye Clinic, which

was inaugurated in November 1867 by the Swiss doctor Henri Dor, 20 who ran it until 1876, when he moved to Lyon. He was replaced by Ernst Pflüger (18461903), who managed to arrange for the clinic to

be transferred to the new Insular Hospital,21 where clinical and surgical medicine, gynecology and obstetrics were taught.

 

Marcel Nencki (1847-1901). Photo from

http://clendening.kumc.edu/dc/pc/nencki.jpg

 

Microscopy Office in Pharmacology Institute in 1894 (Bickel, 1984,

p.675).

In the years that Adolpho Lutz attended the University of Bern, Clinical Medicine was taught by Heinrich Irenaeus Quincke (1842-1922), a German doctor who studied in Berlin and another of Frerichs’ assistants at the Charité Hospital from 1867 to 1871. His research interests at this time laid with the anatomy and physiology of cerebrospinal fluid. During the five years he was a full professor (Ordinarius) and head of the Medical Clinic in Bern (1873 to 1878), he conducted important research on the reabsorbsion of inorganic iron in the treatment of anemia caused by iron deficiencies, and he was the first person to note poikilocytosis in pernicious anemia,

associating it with gastric cancer.22 The classes at the Medical Clinic were taught in the conference hall or in the wards of the Insular Hospital, where 20 to 24 beds were reserved for the professor. Quincke’s class was one of the first that Adolpho Lutz attended. A month after the classes had begun, he asked one of the university professors for advice on a diagnosis of diabetes he had made on a patient. In the written response, in Bern, on December 22, 1874, the professor stated:

At first glance, I would not say with any certainty that your case

is, in fact, a form of diabetes that occurred spontaneously –

such a weighty diagnosis is only permitted when melituria is

proven; the subjective symptoms that the anamnesis shows do

not appear to me to be sufficient.

Concerning the question of acetone, it has been proven that this

smell on patients’ breath is by no means a sure indication of

glycosuria, as this may also occur due to gastric catarrh and

febrile digestive disorders ... In addition to this, as I have been

told by Nencki, whom I have consulted on occasion, acetic acid

is just as unsafe. In order to know for sure if it is diabetes, your

report would be necessary. If you wish to pursue this, I’d ask

you to consult Nencki, as I am not familiar with this type of

diagnosis.23

At the Insular Hospital, Lutz also attended classes on surgical

medicine given by Professor Theodor Kocher. 24 Born in Bern on August 23, 1841, into a long-established family in the region (his father was Chief-Engineer for the Bern Canton). Kocher studied medicine in his home city and, once he had completed the course, he traveled to Berlin, Paris and London. In 1866, he was hired by the University of Bern as an assistant professor of surgery.

 

Theodor Kocher (1841-1917). Bern, Staatsarchiv.

 

Insular hospital seen from the northern side of Bern (Leuenberger

and Erne, 1997).

The surgical and obstetrics clinic, established with the founding of the university in 1834, was run, to begin with, by Professor Hermann Askan Demme (1802-1867), who had at his disposal two wards with 20 beds at the Insular Hospital. In 1838, the clinic was granted one of the hospital’s outbuildings to perform autopsies. There, medical and surgical students practiced the dissection of corpses. Demme left the university in 1865. His successor, Georg Albert Lücke (1829-1894), a privat-docent in Berlin, only remained in Bern until 1872, handing over the position to his assistant, Kocher. As the new director, he became a full professor and ran the clinic for the next 40 years. Under Kocher, the surgical clinic enjoyed a growing prestige. He transformed the ‘Bern surgical school’ into an appealing center for young doctors and doctorate students who wanted to pursue the revolutionary antiseptic method of treatment proposed by Lister and perfected by the Bern doctor. Kocher would determine that it was not so much the air as the instruments and the surgeon’s hands that jeopardize the health of patients undergoing surgery. In addition, he managed to significantly reduce post-surgical mortality rates with the use of antiseptic ligatures, taking the first step towards pure asepsis. To begin with, the Insular Hospital did not posses its own room for surgical operations; these were performed in the auditorium. But by 1884, the surgical clinic consisted of three buildings: the clinic itself, with a classroom and six consulting rooms; a two-story wing; and a singlestory surgical wing, for post-surgery patients. The operating theater built in 1890 possessed a steam device to sterilize the instruments and the surgical environment itself. Kocher was the first surgeon to be awarded the Nobel Prize, in 1909, for his work on the thyroid gland. He died on July 27, 1917.

During the years in which Adolpho Lutz was his pupil, gynecology and obstetrics were taught by Peter Müller (1836-1922), a full professor from 1874 to 1910. When the university was founded, obstetrics was part of surgery, and taught by Demme. Gynecology was awarded the status as an ‘extraordinary’ department, taught by Johann Jakob Hermann (1790-1861). In 1867, obstetrics became an independent faculty, and the Czech doctor August Breisky (1832-1889) was hired to teach it. He arranged for the construction of a maternity ward beside the gynecology clinic, although he moved to Prague (1874) before it was completed. It now fell to Peter Müller, his successor, two years later, to inaugurate the new clinic and maternity ward, which he would run for the following 36 years.

 

The Maternity Hospital was at 28 Brunngasse (Well Street), in Bern,

until 1876. Photo by Q. Reichen (Bickel, 1984, p.662).

 

Studies in Leipzig, Prague and Strasbourg

Lutz took courses at the University of Bern until the end of the summer of 1877, after which he continued his studies at in Leipzig. He enrolled in the city’s faculty of medicine on October 22, 1877, and attended classes for two semesters. At the University of Leipzig, Adolpho Lutz rubbed shoulders with some of the great names in the

history of medicine and natural sciences. 25 During the winter of 1877-88, he took classes in surgical and specialized medicine with

Karl Thiersch (1822-1895);26 in surgical propaedeutics with Helferich; in clinical medicine with Ernest Leberecht Wagner (1829-

1888);27 and in gynecology with Carl Siegmund Franz Credé (1819-1892). He also specialized in ophthalmology with Schoen. In the summer of 1878, he took courses in clinical medicine and gynecology, and also frequented classes on pathological anatomy, histology, microscopy and pathology, taught by Julius Cohnheim (1839-1884) and his assistant Carl Weigert (1845-1904). The latter also gave a course on surgical operations (autopsies). Lectures on ophthalmology were given by Küster; on adduction by von Lesser; and on polyclinical medicine, with an emphasis on pediatrics, by

Johann Otto Leonhard Heubner (1843-1926).28

 

Leipzig University building at Augustplatz. Postcard made by Louis

Glaser, 1906 (Sohl, 1989, p. 32).

Plan of Lepzig University (Festschrift, 1909).

Among Lutz’s experiences during this period, what particularly impressed him were the lectures on pathology and autopsy and the memorable visit made by Robert Koch to Cohnheim and Weigert. In 1936 (p. 852), the Brazilian physician recalled:

From 1877 to 1878, I spent my second and third clinical

semesters in Leipzig, where I witnessed cases and autopsies of

typhoid fever. There was already some doubt that this illness

was caused by a specific bacillus, even though it had not yet

been detected in the sections seen in the course given by

Cohnheim and his assistant, Weigert. In 1878, Koch visited

Cohnheim and unveiled the first preparations of Bacillus

anthracis, colored with methylene blue, contrasting with the

colorless tissue. I had the privilege to see these preparations,

which marked an important step in microscope technique. At

that time, histologic sections were stained with vesuvin

(Bismarck brown) 29 or by aniline violet, very tolerant to glycerin.

At the end of those semesters, I took several courses during

vacations, including one on autopsy, given by Weigert, which

proved to be extremely worthwhile given the fewer number of

students.

During the time in which Lutz studied at Leipzig, Julius Cohnheim had recently replaced Wagner as head of the pathology

department. 30 Born in Demmin on July 20, 1839, Cohnheim studied medicine in Würzburg, Greifswald and Berlin, where he defended his thesis in 1861. He worked as Rudolph Virchow’s assistant in the Institute of Pathology, and it was here that he discovered a dyeing method with gold chloride, which helped make the thinnest nerve ends visible. In 1869, he became a full professor of Pathological Anatomy and General Pathology at Kiel University, although he often visited Leipzig to study at the Institute of Pathology under Carl Ludwig, who was considered one of the best physiologists of his generation. In 1872, Cohnheim, who pursued an interest in what today we call pathological physiology, transferred to the University of Breslau, replacing Heinrich Wilhelm Gottfried von Waldeyer-Hartz (1836-1921), who was leaving the city he had lived in for eight years to lecture in Strasbourg. Carl Weigert, cousin of the bacteriologist Paul Ehrlich, had worked with Waldeyer-Hartz since 1866. He stayed on at Breslau, where he now collaborated with Cohnheim. When the

latter moved to Leipzig, with him went his assistant, Weigert. 31

Julius Cohnheim (1839-1884). Photo from

 

www.umanitoba.ca/faculties/medicine/units/history/lesion/lesion11.ht

ml

 

Carl Weigert (1845-1904). Photo from

www.uic.edu/depts/mcne/founders/page0100.html

Carl Ludwig (1816-1895). Photo published in Festschrift (1909,

 

p.53).

In Breslau, they had the opportunity to attend Koch’s first demonstration on the life cycle of the anthrax bacillus, on April 30, 1876. According to Mazumdar (1995, p. 60), they were so impressed that Cohnheim, on returning to his laboratory, told his assistants: “stop whatever you’re doing and go and see Koch. This man has made a great discovery”. That still relatively unknown physician from the rural district of Wollstein had known the botanist Ferdinand Cohn (1828-1898), one of the few people to have worked on the

classification of bacteria. 32 Koch became friendly with Cohnheim and Weigert and, in the days he spent in Breslau, he had the opportunity to observe the new methods for staining tissue that the latter had developed using aniline dyes.

Weigert had studied medicine in Breslau under Ferdinand Cohn, Rudolf Heidenhain (1834-1897) and Wilhelm von Waldeyer-Hartz (1836-1921), and he had continued his studies in Berlin, where he worked with Virchow. He had also spent time in Vienna before receiving his medical degree from the University of Berlin in 1866 for his thesis entitled De nervorum laesionibus telorum ictu effectis. Two years later, he returned to Breslau to work with Waldeyer-Hartz. He saw active service in the Franco-Prussian war in 187071 and, once discharged, became clinical assistant to Hermann Lebert (18131878).

During this period, Weigert started to make revolutionary advances in histologic techniques, by demonstrating the selective action of staining in biological material. Although he was not the first to stain

bacteria, 33 he did introduce the use of aniline dyes in microscope techniques, and these would be of great use to Koch in his future research.

In April 1878, in between the two semesters he studied at Leipzig, Adolpho Lutz went to Prague to take practical courses in gynecology under Johannowsky, Nérat and August Breisky (1832-1889) in the city’s Gynecology Hospital. He received certificates for having

completed the courses on April 27 and 28, 1874. 34 Back in Leipzig, he attended the aforementioned disciplines in the summer of 1878, but towards the end he fell ill with typhoid fever.

During this vacation” – recounts Lutz (1936, p. 852) – I began to

feel ill, completely losing my appetite, sleep and tolerance of

noise, and I became tired very quickly. After spending a week

and a half in this state, I was confined to bed. The teacher who

treated the students diagnosed my condition as febrile gastric

catarrh, but an older colleague told me, and rightly so, that I was

suffering from typhoid fever and that there had been another

case among our colleagues. My fever worsened and a few days

passed about which I have no recollection. After 10 or 12 days

the fever subsided and I was able to get up and organize my

return trip. I had lost a lot of weight and was still very weak.

Although my condition could be classified as both ambulatory

and abortive, I had been a lot sicker than I realized, and my

recovery took time. I had thrombosis of the superficial veins in

my legs, furunculosis and hair loss, which was very typical,

although short-lived, and after another five weeks I considered

myself to be fit.

Once this sickness had passed, Adolpho Lutz traveled again, this time with the intention of attending classes at the University of Strasbourg, particularly at the General Clinic, that had been run by Adolf Kussmaul (18221902) since 1876. A graduate of Heidelberg and having also studied at Vienna, Kussmaul was considered an authority in his field in virtue of the innovative diagnostic procedures he had developed. Among his most prominent works, one that stands out is a book he published in 1877 on aphasia, considered a

landmark in clinical medicine in its time.35

Kärlsbrucke Bridge in Prague. Drawing by H. Clerget based on photo

by M. M. Lévy e Cia (Reclus, 1878, p.56).

After Prussia annexed Alsace, French professors were forced to resign from the University of Strasbourg and their positions were filled by professors recruited from German universities. Waldeyer-Hartz came to Strasbourg in 1872, taking over as head of the anatomy department. Other recent arrivals were Friedrich Leopold

Goltz (1834-1902), professor of physiology; 36 Friedrich Daniel von Recklinghausen (1833-1910), pathologist and rector of the university

when Lutz studied there; 37 and Kussmaul, all striving to transform that university, now named Kaiser-Wilhelms-Universitãt, into a more appealing center of learning for students from German-speaking nations.

Lutz enrolled there on November 6, 1878, and in the winter semester attended classes in clinical medicine; surgical and polyclinical medicine; ophthalmology and psychiatric medicine. He also

frequented the pharmacy and toxicology laboratories. 38 In December 1878, he received a letter from a colleague in Leipzig, who expressed surprise about the fact that he had not taken his final exam in Bonn, as planned.

I received news of you from Ewald. Tell me, for goodness sake,

what are you doing in Strasbourg? I thought you were in the

middle of your examinations in Bonn. What will you do about

your exam, will you take it in Strasbourg? Here in Leipzig it’s

business as usual, things at the clinic seem to be terribly

stagnant. You wouldn’t believe it, miraculously Credé this winter

hasn’t stopped arousing our curiosity. In class, each lecture the

man delivers is more interesting than the last, so much so that

he is practically unrecognizable! On the other hand, Wagner and

Thiersch are so tedious it’s beyond belief. Every day Wagner

cuts down to size at least two licentiate students in front of the

entire clinic.39

In fact, it was in the Bern of his ancestors, where he would return in March 1879, that Adolpho Lutz took the final exams for his medical degree.

Graduation diploma from Kaiser-Wilhelms-Universität, issued at 20

March 1879, after Lutz finished the courses he started on 6

November 1878. BR. MN. Fundo Adolpho Lutz. Diplomas.

 

Natural History

During these years, Lutz never lost interest in natural history. His talent as a naturalist and a collector motivated him to keep on good terms with the professors and attend their lectures at the Bern Faculty of Philosophy and other schools of higher education he frequented, enabling him to stay on top of new developments in the field. Among the natural history professors that Lutz knew was Joseph Anton Maximilian Perty (1804-1884), one of the University of Bern’s oldest docents, who started lecturing in 1833, when it was still the Academy. Perty graduated in medicine from Munich and was hired by that university’s Faculty of Sciences. He began to look after the Munich Academy of Science’s zoological collections, including the specimens contributed by the naturalists Johann Baptist von Spix and Karl Friedrich Philipp von Martius during their three and a half

year expedition in Brazil (1817-1820).40 Perty studied the entomological collection gathered by Spix, the expedition’s zoologist, and between 1830 and 1833 published an important contribution to the knowledge of Brazilian insects. During the half century he lived in Bern, he wrote several other papers on zoology, anthropology and psychology. He was particularly interested in observing microscopic animals, and he even devised a classification for bacteria (Papavero, 1971, vol. 1, pp. 110-1). Rector of the p.394). University of Bern between 1837-1856, Perty was at the peak of his career when Lutz met him.

Theophil Studer (1845-1922) (Attinger, Godet, Turler, 1930, p.394).

The catalogue of naturalists that influenced the Brazilian doctor should also include Theophil Studer (1845-1922), professor of zoology and curator of zoological collections at the Bern Museum of National History between 1871 and 1922. From 1874 to 1876, he took part in an expedition to circumnavigate the globe in the German frigate S. M. S. Gazelle, under the command of Captain Georg