Max Hirsch (1875–1941): His Forgotten Fate and His Contributions to the Founding of Modern Rheumatology Wolfgang Keitel1, Leif Olsson2, Eric L

DOI: 10.5152/eurjrheum.2016.15101 Original Investigation Max Hirsch (1875–1941): His forgotten fate and his contributions to the founding of modern rheumatology Wolfgang Keitel1, Leif Olsson2, Eric L. Matteson3 Abstract Objective: To elucidate the connections between balneology and rheumatology in the founding period of the discipline of rheumatology, and describe the contributions of Max Hirsch, MD in the formation of professional rheumatology societies. Material and Methods: Historical documents from the medical history collection of Vogelsang –Gommern, Germany, and original personal documents of the Hirsch family and information from the medical and historical period literature were used in developing this report. Results: The first efforts at organizing rheumatology as a recognized clinical and academic discipline took place in the 1920s. Many of the first proponents were balneologists who cared for patients with chronic arthritic conditions without the benefit of effective medications. Max Hirsch, MD was a major figure in the development of modern rheumatology as it emerged from the provenance of balneology and orthopedics as a recognized organized medical discipline, contributing to the founding of the German Society for Rheumatology and the International League Against Rheumatism. Conclusion: Max Hirsch made significant contributions to scientific and organized rheumatology in the early days of the discipline. His contributions to the field and his fate as a Jewish physician have only recently come to light. Keywords: Max Hirsch, history of rheumatology, balneology Introduction The leaders and founders of rheumatology as a formal academic discipline and the initiators of national and international professional rheumatology societies and organizations are well known and appreciated in the rheumatology and wider medical communities. These include historical figures such as William Heberden, Alfred Garrod, Vladimer Bechterew, Jacques Forestier, and Philip Hench, to name just a few. Others who have made important contributions are less widely known. Important contributions can be largely unknown because of the social and political circumstances during and after the careers of the contributors. This is the case for Max Hirsch, a leading figure in the early development of the specialty of rheumatology in Germany and across the world. His contributions and his fate have only recently come to light, having been virtually unknown outside of a limited circle of specialists in Germany. Material and Methods 1 Emeritus Chief of Rheumatology, In preparing this article, historical documents from the medical history collection of Vogelsang –Gommern Fachkrankenhaus Vogelsang; Director, Medical History Collection, housed at the Specialty Hospital in Vogelsang, Germany, were accessed, as well as available documents Gommern-Vogelsang, Germany from state and private archives and sources in Germany, including original personal documents of the de- 2 Stockholm, Sweden cendents of the Hirsch family in Stockholm, Sweden. As well, information from the medical and historical 3 Division of Epidemiology, period literature were used in developing this report. Department of Heath Sciences Research, Division of Rheumatology, Mayo Clinic College of Medicine, Results Rochester, USA Max Hirsch (Figure 1) was a leading figure and founding father of rheumatology in Germany who also had Address for Correspondence: an important influence on the early organization of the International League against Rheumatism (1, 2). Eric L. Matteson, Division of Epidemiology, Department of Yet, when the founders of the German Society for Rheumatology, including Max Hirsch as their real guiding Heath Sciences Research, Division of spirit, were recognized on the occasion of the 75th anniversary of the society’s inception in 2002, nothing Rheumatology, Mayo Clinic College of Medicine, Rochester, USA was known about his fate after 1933 (2). E-mail: [email protected] Submitted: 31.12.2015 Indeed, in the first paper from the postwar period that dealt with the history of the German Society against Accepted: 05.02.2016 Rheumatism, he is mentioned only in a single sentence, which states, “After the resignation of Prof. Diet- ©Copyright by 2016 Medical Research and Education Association - Available online at www.eurjrheumatol.org. rich, M.D., Ph.D. and Dr. Hirsch, Prof. H. Vogt, M.D. assumed leadership of the Society” (3). Also, “Hirsch suf- 101 Keitel et al. Max Hirsch, balneologist and rheumatologist Eur J Rheumatol 2016; 3: 101-5 of mechanical devices in the treatment of joint disorders is well known…. But also in the treatment of medical diseases … mechanical devices aiding physiotherapy have acquired a dominant role” (9). In 1913, Hirsch appeared as a speaker at the memorable IV. International Congress of Physical Therapy, which took place from March 26 to 30 in Berlin and at which Jan van Breemen of Amsterdam proposed the cre- ation of an international rheumatology society (10). Hirsch also discussed his own results at the 35th Meeting of the Society for Balneology, which met from March 11 to 16, 1914, in Ham- burg (11). Among the more than 50 lectures, “Mr. Hirsch (Salzschlirf): Associations of gout and arteriosclerosis” is announced as No. 31. Hirsch was not able to devote himself to his research or to his family for long. At the beginning of World War I, he began service as an Army phy- Figure 1. Portrait of Max Hirsch (Courtesy W. Figure 2. Prof. Eduard Dietrich, M.D. (Courtesy sician. At age 39 and with a family, it is unlike- Keitel) W. Keitel) ly that he would have been drafted. Given his nationalistic attitude, as reflected in many of his fered greatly from the loss of his position. He was established as early as 1847. A “Section for writings, it is highly probable that he was infect- emigrated in 1933 to Russia. Nothing further Balneology” was created in the Society of Med- ed by the prevailing patriotic mood and volun- is known about his fate” (2). Recently, contact icine in July 1878, and it held its first general teered, as did many of his fellow Jews. with his descendants has succeeded, in part, scientific congress in 1879. The section later in establishing the tragic events that led to his became independent, calling itself the Society The first postwar congress of balneologists was death. This contact provides an opportunity to for Balneology. Two of the prime movers in the held in 1920 and was led by interim president review his meritorious service to balneology field, Eduard Dietrich and Max Hirsch, reported Hermann Strauss (1864–1944) from Berlin. and rheumatology. on the history of the Society for Balneology on Eduard Dietrich (Figure 2), who was to become th the occasion of the 40 Congress of the society Hirsch’s friend and mentor, was elected as the Max Hirsch was born on April 28, 1875 in (5, 6). At that congress, Hirsch gave his report next chairman. Hirsch served as interim Secre- Blütenau, West Poland (former province of as secretary-general and took on the role of tary-General of the Society for Balneology and Posen). Blütenau, known in the past as Kwie- historian (6). then assumed the full-time role in 1922. ciszewo, Poland, was then located in the Ger- man province of Poland as a result of the first The diversity of journals in the field grew during With the assumption of their duties in 1920, the partition of Poland in 1772 after it fell to Prussia. this period. The journals established by Dietrich new president and secretary-general pursued Hirsch studied medicine from 1895 to 1900 in and Hirsch together and by Max Hirsch alone the kindling and preservation of national unity Berlin. In March 1900, he submitted his doc- include the Archives of Balneology, Journal of among the members of the Society for Balne- toral thesis titled “On the Causation of Scarlet Scientific Balneology, and Journal of Health Re- ology. This purpose was also served by the pro- Fever” (4). On the title page of his dissertation, sort Science. grams of the “Society for Medical Study Tours.” he describes himself as a “General practitioner The purpose of selecting venues and destina- from Kwieciszewo/Poland,” using the Polish In 1905, Hirsch took up practice as a spa physi- tions in the former imperial German territories name of his birthplace; he was probably then cian in Bad Kudowa (known today as Kudowa that had become separated by the Versailles working as an assistant to another physician in Zdrój, Poland) (7). In 1906, he married Emma Treaty was to demonstrate and strengthen the Erkelenz, in the Rheinland. Weissbein. On January 16, 1907, a son, Rudolf bond and sense of unity with the medical pro- Ernst, called Rudi, was born in Berlin-Charlot- fession in the area that had been cut off from The science of spa treatment undoubtedly tenburg. A second son, Otto, was born in 1910. Germany. played the most important role in the professional life of Max Hirsch, although later, rheu- Even as he pursued day–to-day work at the In this role, which accounted for the major matology would also dominate his attention. Kudowa spa, Hirsch took time out from his ac- share of Hirsch’s professional activities, he per- He devoted himself not only to his medical tivities at the resort in order to pursue scientific formed a variety of functions, ranging from practice and scientific endeavors but also to endeavors in Berlin. An example is a publica- organizational work to the resolution of civil journalistic and organizational work critical to tion from March 4, 1912, titled “On the effect of matters. As far as is known, he planned and the professional standing of his field. alkaline saline waters on uric acid metabolism conducted the Annual Meeting of the Society in sufferers of gout” (8). of Balneology for the first time in 1921 and for Earlier than in other medical disciplines, there the last time in 1932 (12, 13).

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