My first ever scientific paper, a spin-off from my MD thesis, was published exactly 40 years ago. Since then, I have written many more articles. Readers of this blog might think that they are all on alternative medicine, but that is not the case. My most cited paper is (I think) one which combined my research in haemorheology with that in epidemiology. Yet, I would not consider it to be my most important article.

So, what is my most important publication?

It is one that relates to the history of medicine.

How come?

In 1990, I was appointed as chair of Rehabilitation Medicine at the University of Vienna. On the occasion of the official opening of the new 2000-bed university hospital in Vienna, I was asked to say a few words and thought that a review of the history of my department might be a fitting subject. But I was wrong. What I discovered while researching it turned out to be totally unfitting for the event; in fact, it contributed to my decision to leave Vienna in 1993. I did, however, summarize my findings in an article – and it is this paper that I consider my most important publication. Here is its abstract:

Misguided by the notion that the decline of the German race would be prevented by purifying “Aryan blood” and eliminating foreign, particularly Jewish, influences, the Nazis evicted all Jews from universities within their growing empire during the Third Reich. The Medical Faculty of Vienna suffered more than any other European faculty from “race hygiene.” Within weeks of the Nazi annexation of Austria in 1938, 153 of the Faculty’s 197 members were dismissed. By far the most frequent reason for dismissal was Jewish origin. Most victims managed to emigrate, many died in concentration camps, and others committed suicide. The “cleansing” process encountered little resistance, and the vacant posts were quickly filled with persons known not for their medical expertise but for their political trustworthiness. It was in this climate that medical atrocities could be committed. After the collapse of the Third Reich, most members of the Faculty were burdened with a Nazi past. Most remained in office, and those who had to leave were reinstituted swiftly. The Jews evicted in 1938 were discouraged from returning. These events have significantly–and with long-lasting effects–damaged the quality of a once-leading medical school. This story needs to be told to honor its victims and to fortify us so that history does not repeat itself.

As I pointed out in my memoir, it “was not published until 1995, by which time I was no longer at the University of Vienna but had left Austria and gone joyfully back to the U.K. to take up my post at the University of Exeter. When the paper was published, it had a considerable impact and important consequences. On the one hand, I received a torrent of hate-mail and threats, and was even accused by the more sensationalistic elements of the Austrian press of having stolen considerable amounts of money from my department at the University of Vienna – an entirely fabricated story, of course, and so ridiculous that I couldn’t even take it seriously enough to instigate legal action.”

So, what else happened as a consequence of the paper?

The answer is ‘lots’.

The Nazi-dean of the medical faculty in 1938, Eduard Pernkopf,  became the author of one of the world’s best anatomical atlas. Here is a short excerpt from a website on Pernkopf and his work which outlines some of the consequences of my paper:


Following Dr. Edzard Ernst’s, revelations in the Annals of Internal Medicine (1995) about the source of Pernkopf’s “models,” Yad Vashem (the Holocaust Authority in Israel) requested that the Universities of Vienna and Insbruck conduct an independent inquiry to determine who the subjects in Pernkopf’s Atlas were and how they died. The request from Yad Vashem was initially denied; but the issue did not end. The following year, a letter by Dr. Seidelman and Dr. Howard Israel, an oral surgeon at Columbia University published in JAMA (November, 1996) in which they stated: “The abuses of medicine perpetrated during the Hitler regime pervaded the entire medical profession of the Third Reich including the academic elite. One legacy of the tragic era endures today through the continued publication of a critically acclaimed atlas, Pernkopf Anatomy…” Their letter prompted a report by the New York Times (1996).

In 1997, Alfred Ebenbauer, the rector of the University of Vienna, wrote to JAMA indicating that an investigation had been initiated and that preliminary findings indicated that the anatomy department had indeed, routinely received corpses of executed persons, among them renowned dissidents, and “brain preparations derived from children under the euthanasia program in psychiatric institutes were still stored there…” For the first time, he acknowledged publicly systematic suppression and even denial of the university’s Nazi past and its failure to conduct relevant investigations. Ebenbauer explained that this attitude had changed because of ‘‘increasing pressure from abroad’’ and a new political atmosphere in Austria (Ethics and Access…Pernkopf atlas, Bulletin of the Medical Library Association 2001; Hildebrandt, 2006).

Penkopf_Atlas Human Anatomy_neck-shoulderThe final report of University of Vienna investigation found that at least 1,377 bodies of executed victims (guillotined or shot by the Gestapo at a rifle range); about 7,000 bodies of fetuses and children; and “8 victims of Jewish origin” had been received by the Anatomy Institute. A statement for users of Pernkop’s Atlas sent out by the U of V to all libraries states: “it is therefore within the individual user’s ethical responsibility to decide whether and in which way he wishes to use this book.” (Hildebrandt, 2006). Hildebrandt states: “the influx of bodies from executions increased so much during the NS [Nazi] regime that the rooms of the anatomy institute were sometimes overfilled and executions had to be postponed because of this.” However, she notes that the true numbers are not known because of incomplete documentation.

Howard M. Spiro, M.D., director of Yale’s Program for Humanities in Medicine and professor of internal medicine, was among the noted speakers at the convocation in Vienna marking (1998) the 60th anniversary of the dismissal of Jewish faculty members from the Vienna Medical School. In his address The Silence of Words, Dr. Spiro said, “the things that we avoid and don’t talk about are the matters that mean the most to us. The shame that has no vent in words makes other organs weep.” Dr. Spiro acknowledged that current officials of the University of Vienna are attempting to recover information that has either been hidden or destroyed and trying to locate former faculty who were interned and exiled. “There is a new generation that has taken over, and they are not afraid to look into these atrocities.”

It is now understood that many of the incredibly detailed illustrations in Pernkopf’s atlas depicted the bodies of victims of Nazi terror.


Why do I bring this up again today?

For two reasons: firstly, I have been invited to give two lecture about these events in recent weeks. Secondly and much more importantly, we seem to live in times when the threat of fascism in several countries has again become worrisomely acute, and I think reminding people of my conclusion drawn in 1995 might not be a bad idea:

This story needs to be told to honor its victims and to fortify us so that history does not repeat itself.

18 Responses to The most important paper I ever published

  • How many times has this paper been cited? That would be a measure of how seriously its message is taken.

    “All that is necessary for evil to triumph, is that good men do nothing”. Edmund Burke

  • A disturbing reminder of how easy it is to slide into atrocities when people are dehumanised. Les, it has been cited 60 times but I think its impact is perhaps better seen in the response it has had in the “real world”. My congratulations to Prof. Ernst on uncovering and disclosing this horrific story.

  • yes, indeed, there are ominous signs that the world wants to forget….

  • ‘Those who cannot remember the past are condemned to repeat it.’

  • Important indeed. And courageous.

    It also reminds me of what Prof. Sebruyns told us when he was teaching histology at Gent University (Belgium) some 35 years ago, namely that modern medicine had a ‘dirty secret’ most people did not want to talk about, the fact that much of our then-current knowledge was directly based on what the nazis had discovered during their cruel experiments on people. I am not, and have never been, in a position to study this claim, but it has continued to haunt me to this day. The day that stops, will indicate that my brain has stopped functioning properly. I hope that will be the day I die.

    Humanity has a lot of unnamed cruelty on its record. Belgium may not have had Adolf Hitler, but it certainly has had Leopold II, still largely a verboten subject in the country. I do not condone the hypocrisy that surrounds these horrendous deeds, and less horrendous deeds as well. It is my opinion that these cases must be investigated and documented as full as humanly possible. Not to accuse people, not exact revenge on hapless descendants who had/have nothing to do with it all, but because truth is better than lies, helps us understand how and why atrocities were committed and – hopefully – avoid them in the future.

    It should also remind us that people who ‘say it like it is’ are often ruthless manipulators who mainly ‘say it like it is not‘.

  • @Professor Ernst

    Thank you for sharing this important recounting of past horrible policies, as well as your contribution to the truth about Pernkopf’s models. We should all pray that such racially motivated purgatory is never again repeated.

  • Thank you, Professor Ernst, your story does indeed need to be told and re-told to honour the victims. Whilst I knew nothing about this, it struck a chord because very recently I had the privilege to pay my respects at Auschwitz-Birkenau: it was humbling and moving; I was especially moved by the “corridor ” of photos of the “inmates” where I tried, unsuccessfully, because of time pressure, to read and look at the photo of every one – there were professors, teachers, musicians amongst others, and I felt saddened that our world was poorer for their loss.

    We must never forget what man can do to fellow man. I left with hope because that lies within our young people. I observed many coaches of children from all over the world. I spoke to two young Scandinavian school girls and they lifted my spirits. Our guide was a very young Ukranian woman whose knowledge of the atrocities was second to none: I learnt so much from this young woman, and with tears in her eyes she finished our tour by saying ‘we have choices, please ensure we make the right ones”. A timely reminder, Professor Ernst, thank you once again.

  • Particularly poignant in that today, Time magazine has announced Nigel Farage as their man of the year, in 1938 it was …

  • Your courage and persistence to uncover the collaboration of UWIen with the NS and the Medical University’s lead in committing atrocities was the start of a critical revolution of thinking both at the University and the country. I have been documenting the various activities at UWien and MediUni that have ensued after your revelations: none of this would have happened without you. My mother and her father were student and professor respectively in the Medical School and were expelled. Their lives were ruined.

    • thank you

    • My father Ludwig Selzer MD was removed March 1938. I’m not sure what his position was. He made his way to the US via UK. I am interested in finding out more. N. Hillyer, I realize you posted this some years ago, but if you read my reply, could you email me? [email protected]. Also, anyone else, I would like to connect with other relatives of physicians who were removed in 1938 for being Jewish. I had no idea there were so many until I read Dr. Ernst’s article. Thanks to Dr Ernst.

  • Well done Edzard. It comes as no surprise to me, that you would have wanted to shine a light into a shameful darkness.

  • I have just finished an excellent book by Philippe Sands entitled, “The Ratline: Love, Lies and Justice on the Trail of a Nazi Fugitive” Why do I mention this? Because the Nazi in question was Otto Freiherr von Wachter, an Austrian member of the SS and the man tasked with the ethnic cleansing of Jews from the professions in Vienna after the Anschluss. The book goes into quite a lot of detail as to how efficiently Wachter pursued his role in removing Jews from the legal, medical and teaching professions in Austria. It is he who was most likely to be responsible for the cleansing in the Medical Faculty at the University of Vienna. The book sheds much light on his activities in Austria and elsewhere and I would recommend it to anyone interested in delving deeper into this subject.

  • Fairly recently I read that there was some question of whether Pernkopf’s Atlas should be reprinted. I had not previously heard of it (I used a number of different textbooks when I studied anatomy in the 1980’s, but not this one). One view was that the very detailed illustrations made this a uniquely valuable tool for teaching and should remain available to anatomists. The other view was that it was unethical to use it because of the way the source material had been obtained. More generally the question can be extended to whether any good can ever come from evil (or indeed whether good and evil is a valid way of looking at history, as opposed to considering actions and their consequences).

    My position is that it is never right to bury atrocities from the past, but to understand how they could have happened and to learn from them. The current debate about historical slavery is a case in point, though both sides seem to be ignoring the fact that the Western democracy in its present form is founded upon the the civilisations of the Romans and the Greeks, both of which were in turn dependent on institutionalised slavery.

    • these are very complex issues. if they reprint it, I think they should make sure all the revenue goes to an appropriate Jewish charity in Vienna.

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