German psychiatrist Alois Alzheimer is widely credited with having identified the eponymous disease. However, a lesser-known Czech scientist, Oskar Fischer, separately identified the disease in a 1907 publication, the same year that Alzheimer’s findings were published. Why was Fischer not recognized for the discovery along with Alzheimer?
Geopolitical factors in Europe between World War I and World War II led to Fischer’s marginalization because he was Jewish. Despite groundbreaking achievements in dementia research, he was fired from his position at the German University of Prague and cut off from the university’s laboratory resources. After the Nazi invasion of Czechoslovakia in 1939, he was arrested by the Gestapo, imprisoned, and eventually murdered.
In addition to the tragedy that befell Fischer personally, the rise of authoritarianism stymied crucial scientific research that could have brought us closer to treating this disease.
Alois Alzheimer
Alzheimer, the eccentric German psychiatrist, had a fencing scar on the left side of his face and kept a pet monkey (Karlawish, 2021). In 1907, he published a case report of a patient, Augusta D. She was a previously healthy woman who was hospitalized in 1901 when her husband, a railway clerk, could no longer care for her. Although only in her early 50s, she exhibited severe memory impairment, a decline in her ability to communicate, and the inability to care for her basic needs.
Alzheimer took a strong interest in her case and treated her until she died in 1906 from the mysterious illness. When her husband was planning to transfer her to a state asylum, Alzheimer personally paid for her to remain at the hospital. Having married the widow of a diamond merchant, Alzheimer was wealthy, and at times even paid for staff salaries and equipment (Karlawish, 2021).
Alzheimer wrote that Auguste D. exhibited, “as one of her first disease symptoms, a strong feeling of jealousy towards her husband. Very soon, she showed rapidly increasing memory impairments; she was disoriented, carrying objects to and fro in her flat, and hiding them. Sometimes she felt that someone wanted to kill her and began to scream loudly” (Maurer et al, 1997). She had insomnia with bouts of agitation and incoherence. She eventually became incontinent and regressed into a vegetative state.
Upon postmortem examination of her brain, Alzheimer identified abnormal clumps of a substance later confirmed to be amyloid plaques. In addition, he described twisted, thick fibrous inclusions in brain cells known as neurofibrillary tangles, and markedly diminished brain volume (Maurer et al, 1997). These findings are considered key pathological features of Alzheimer’s disease.
Emil Kraepelin, a highly influential German psychiatrist and author of leading textbooks, wrote in 1910, in the 8th edition of his textbook, Psychiatry, about Alois Alzheimer’s findings and named the illness “Alzheimer’s disease.”
Oskar Fischer
A contemporary of Alois Alzheimer, the brilliant Czech psychiatrist Oskar Fischer was born April 12, 1876, into a German-speaking Jewish family. Fisher and his wife, Franziska, a nurse, had twins, Lotte and Heinz. In 1907, while on staff at the German University of Prague, he published the results of pathologic findings from 16 patients with dementia.
Fischer described, in meticulous detail, the presence of tiny, dark plaque-like structures and fibrous tangles. He concluded that these plaques, known as Fischer’s plaques, were the cause of dementia (Karlawish, 2021; Goedert, 2009). Based on microscopic studies, he developed an eight-stage classification system of plaque formation (Sanchez et al, 2026). According to Fischer, as the plaques matured, they caused progressive damage to the brain, leading to worsening clinical symptoms of the illness (Sanchez et al, 2026).
Although Alzheimer’s findings were quite similar to Fischer’s, Alzheimer suggested that the disease was rare, affecting younger people, while Fischer more accurately postulated that it was a primary cause of dementia in the elderly (Sanchez et al, 2026). Alzheimer was aware of Fischer’s research and, in 1911, described abundant Fischer plaques in another patient, Johann F. (Karlawish, 2021).
Despite his seminal research on dementia and promotion to associate professor, in 1919, Fischer was forced out of his position at the German University in Prague. This occurred because he was Jewish. He opened a private practice in Prague, and although he was permitted to lecture, he was denied access to the university’s laboratory, rendering him unable to continue his research (Karlawish, 2021).
Fischer became politically active, and in 1923, while campaigning for office on behalf of the German Democratic Liberal Party, he was beaten up by antisemitic students (Goedert, 2009). In January 1939, shortly before the German invasion, a Nazi party member became chair of the German University Department of Psychiatry and revoked Fischer’s lectureship. In 1941, during the Nazi occupation of Czechoslovakia, Fischer was arrested by the Gestapo because he was Jewish. He was imprisoned in Theresienstadt, where, at the age of 65, on February 28, 1942, he was beaten to death.
Geopolitical factors and authoritarianism impact scientific research
After Germany lost World War I in 1918, the country experienced economic and political devastation. Funds for scientific research dried up as Germany’s economy plunged into a massive depression with hyperinflation and food shortages. The minimal available resources went towards addressing the hundreds of thousands of soldiers left with shellshock and traumatic brain injuries (Karlawish, 2021).
Post World War I, Germany gave rise to virulent antisemitism as the Nazi party rose to power and blamed the Jews for Germany’s loss of the war. Hitler took power in 1933 and mandated that medical institutions purge Jewish scientists from academic positions. After the mass firing of Jewish physicians and scholars, positions were filled by members of the Nazi party (Deichmann, 2020). Nazi doctrine was widely known to be anti-science. They promoted racist ideologies and supported eugenics, the pseudoscience of breeding a superior population. The Nazis developed programs to either sterilize or euthanize patients with chronic mental and neurological illnesses, including those with dementia (Karlawish, 2021).
Modern rise of anti-science political ideology and conspiracy theories
Recent decades have seen a rise in governments leaning towards authoritarianism around the world. In tandem with this trend, medical science has become politicized.
When political agendas supersede scientific veracity, a dark and dangerous trajectory unfolds. Had Oskar Fischer not been marginalized and subsequently murdered by the Nazi regime, perhaps our knowledge of Alzheimer’s disease would have led to better treatments by this point. Instead of building on his remarkable scientific contributions, much of his achievements have been buried and lost to posterity.