Hello, and welcome back to This Week in History! One of the most curious areas of history — which somehow I have hardly covered in this column — is the history of medicine. The history of human experience is defined by the ability to harness physical strength and energy, but of course, bodies fail. This week, I want to zoom in on one terrifying yet fascinating medical contribution and a glimpse into the mind of a renowned scientist faced with breaking down a belief in the medical field for millennia.
To cast ourselves back in time, let’s consider a time before the history we’re looking at took place. To do so, I will refrain from labeling the disease or scientist, as that would clue you in on what’s to come, but consider this: What happens as you get older?
Plato and other classical Greek thinkers laid out human life in cycles, in essence describing categories such as infancy (ages 0–6), adolescence (7–21), adulthood (22–49), middle age (50–62), senescence (63–79), and ultimately, old age (age 80 or older). These early thinkers used logic to determine age groups. The body is youthful in its infancy up until an individual reaches their 20s, which, until 50, is their bodily peak. Of course, the peak does not stay forever, and as one enters senescence and old age, one declines both physically and mentally.
It was logical: old age naturally produces a memory decline. If you have an older family member, you understand they may forget things. As one’s physical strength peaks, so does their mental capacity, and vice versa. How else could that decline happen?
That question was ultimately answered in the life of Auguste Hochmann (married name, Deter).
Deter was born in May 1850 in Kassel, in the then-independent Electorate of Hesse, Germany. She was not of noble status, and she worked as a seamstress from a young age and married at 23 — a very typical life for a mid-19th century young German woman. The couple moved to Frankfurt and lived in an apartment on Morfelder Landstrasse, a dense city street close to her husband’s work and nestled near the river Main.
Her husband, Karl August Wilhelm Deter, worked as a railway clerk and proved to be a loving and caring partner. The two then had a daughter, Thekla. In research conducted by scholars Sean Page and Tracey Fletcher, Karl Deter “states they were ‘happy and harmonious’ that she [Auguste] was ‘rather amicable’ and ‘constantly hard-working and orderly.’”
In theory, that’s the end of “This Week in History,” but only a decade later, in 1901, Deter screamed incoherent sentences as her memory failed in the halls of the Städtische Anstalt für Irre und Epileptische — or the State Asylum for Lunatics and Epileptics in Frankfurt, Germany. There, Deter would spend the last five years of her life.
Deter ate meals such as meat and cauliflower. When a doctor asked what she was eating, with a mouthful of meat, she would reply, “Spinach.”
Next, Deter lost her object permanence — if she saw an object and looked away, it was gone. Even still, if asked a question about her symptoms, she simply stated, “So to speak, I lost myself.”
Deter had lost more than herself; Karl Deter had been increasingly concerned about his once loving and strong housewife. She stopped cooking, accused him of violating the marriage, and largely declined into an incoherent state.
Doctors were observant — though also frightened — at what Deter had become. “I don’t stab myself. I will not stab myself,” the poor lady shouted while running out of her room. To Plato and the early Greeks, such a state came with old age — Deter was 51.
Karl Deter couldn’t afford her prolonged care at the facility, so he agreed to give the hospital the right to keep her medical records and brain after her death in exchange for continued treatment.
Doctors couldn’t save Deter, but in a groundbreaking effort, they described and categorized her symptoms, behaviors and decline. Dr. Alzheimer led the work.
That name will no doubt cue many readers into the disease that was being examined in Deter; after all, it bears his name. However, Alzheimer did not write down his own likeness when describing the symptoms he observed (wouldn’t that be a bit egotistical?) instead, he considered the case to be “presenile dementia” — much to the destruction of long-held beliefs on the natural course of old age.
Alzheimer observed and cared for Deter between 1901 and 1903, keeping detailed notes:
“In speaking, she [Deter] uses gap-fills and a few paraphrased expressions (“milk-pourer” instead of cup); sometimes it is obvious she cannot go on. Plainly, she does not understand certain questions. She does not remember the use of some objects.”
However, after Alzheimer’s departure, Deter’s health failed. She died due to infected bedsores this week in history, on April 8, 1906. She was the first to be diagnosed with Alzheimer’s disease.
Alzheimer examined neuritic plaques and tangles in the structures of the brain. Through his close observations and Deter’s strength to live through her illness, what we now know as Alzheimer’s disease became diagnosable. While still in need of a cure, defining the illness and breaking down long-held views on old age were all thanks to the life of Auguste Deter.