The History of Neurosurgery in Germany

With great interest I read the historical article by Drs. Arnold and Collmann about the first German neurosurgical department in Würzburg and the role of Professor Wilhelm Tönnis.[1] Both authors are to be commended for their efforts in researching and describing this important episode, and in explaining the consequences of the political situation leading up to the Second World War and the individual choices made at that time by the main players in the neurosurgical field in their country.

The development of modern neurosurgery in the Netherlands took place in the early 1930s by the time Tönnis founded the first international neurosurgical journal, the Zentralblatt für Neurochirurgie. In their paper, Arnold and Collmann state that Verbiest (from) Leiden was on the editorial board of the new journal.[1] However, in 1936 Henk Verbiest was a resident in neurology and psychiatry in Leiden. In 1938 he started his training in neurosurgery in Paris, under the supervision of Professor Clovis Vincent, and from 1940 he was a resident of Cornelis Lenshoek in Utrecht and Amsterdam.[2] It was only in 1942 that Verbiest was registered as a certified neurosurgeon in the Netherlands and started his neurosurgical practice in Utrecht. He never worked as a neurosurgeon in Leiden, and he never was coeditor of the Zentralblatt. Today he is the most renowned Dutch neurosurgeon, due to his description of the concept of neural intermittent claudication and the stenosis of the spinal canal (also known as Verbiest syndrome).

The only Dutch neurosurgeon who served as the coeditor of the Zentralblatt für Neurochirurgie was Ferdinand A. Verbeek ([Fig. 1]). Verbeek was the first neurosurgeon in Groningen, in the northern part of the Netherlands, and the second neurosurgeon in his country. He was a pupil of Walter E. Dandy in Baltimore, where he had spend almost 3 years (between 1932 and 1935).[3] In the correspondence between Verbeek and Dandy, Dandy urged Verbeek to contact European neurosurgeons and to promote his new neurosurgical techniques. Unlike Harvey Cushing, who traveled to Europe many times, giving lectures and socializing with his continental colleagues, Dandy visited Europe only once. This was in the winter months of 1923–1924.[3] In the 1930s, most European neurosurgeons were influenced by the Cushing school, and it appeared that Dandy hoped Verbeek would serve as ambassador of the Dandy school. Indeed, Verbeek performed his type of surgeries and promoted these techniques to his colleagues in the Netherlands and the rest of Europe. Dandy wrote to Verbeek, “you are way ahead of the times in Holland” and “you have been well trained and do the best type of work.”[3] [4] In line with his strategy, Dandy encouraged Verbeek to contact renowned European neurosurgeons, writing to Verbeek in 1937, “Have you ever met Wilhelm Tönnis in Berlin? I get the impression that he is doing very good work in Germany.”[3] [4]

Fig. 1 Cover of the Zentralblatt für Neurochirurgie in 1942, listing F. Verbeek from Groningen as one of the coeditors of the journal.

That summer, Verbeek attended the British-German joint meeting in Berlin, as he already had become friends with Tönnis. At that time Verbeek became the Dutch representative on the editorial board of the Zentralblatt ([Fig. 2]), until the final edition in 1943.

Fig. 2 Dr. Ferdinand A. Verbeek, the first neurosurgeon in Groningen, the Netherlands, and the second neurosurgeon in his country, who was a member of the editorial board of the Zentralblatt für Neurochirurgie from 1936 until 1943.

Due to the political situation in the Second World War, the German neurosurgeons became isolated. The personal contacts between them and the foreign coeditors of the Zentralblatt stopped. Verbeek was one of the first Dutch colleagues who reestablished communication with German neurosurgeons after the war, especially Tönnis. He was seen at the regular meetings of the “Tönnis alumni,” at least in Köln in the years after 1951 (personal communication from Professor Loew, former senior assistant of Professor Tönnis).

• References

• 1 Arnold H, Collmann H. Neurosurgery in Wurzburg until World War II. J Neurol Surg A Cent Eur Neurosurg 2012; 73 (1) 38-45
• 2 Tulleken CAF, Dokkum ThA. In memoriam prof. dr. H. Verbiest. Ned Tijdschr Geneeskd 1997; 141: 2375-2376
• 3 Groen RJM, Koehler PJ, Kloet A. The role of Harvey Cushing and Walter Dandy in the evolution of modern neurosurgery in the Netherlands, illustrated by their correspondence. J Neurosurg 2013; 118 (3) 539-549
• 4 Dandy WE. Walter Edward Dandy Papers. The Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions. Available at: http://www.medicalarchives.jhmi.edu/papers/dandy.html