Otfrid Foerster

Otfrid Foerster

Zülch KJ. Otfrid Foerster · Physician and Naturalist: November 9, 1873 – June 15, 1941. Springer Berlin Heidelberg, 2012 page 97.

 

Professor Otfrid Foerster (1877-1941) was one of the most “distinguished neuroscientists of his time” and had mapped the cerebral cortex and the dermatomes of the human body (1). His map of the dermatomes published in 1933 was based on work from cases, which he had compiled for over 20 years and is credited as the source of the schematic dermatomes illustrated in the International Neurological Standards Classification for Spinal Cord Injury (ISNCSCI) (2). This classification system provides baseline data for neurological severity in virtually all acute Spinal Cord Injury (SCI) trials today. He was regarded as the foremost neurosurgeon in Europe and his counterpart in the United Sated was Harvey Cushing in the 1930s (3).

Foerster was a careful observer, well trained in neurology by Wernicke in Breslau, Germany and Dejerine and Babinski in Paris. He sought practical application of neurophysiology to clinical problems. In Germany he pioneered the use of physical therapy in the specialty of neurology as an important adjunct to the treatment of diseases of the nervous system prior to and during WW I (3). His interest in physical medicine and  rehabilitation had been stimulated by his early association for two summers (1897-1899) with Dr. Heinrich S. Frenkel at the famous spa in Heiden, Switzerland where he published a joint paper on exercise therapy (ebungstherapie) for locomotor ataxia (tabes dorsalis).(3; 4). During WW I he acquired skill as a neurosurgeon and he developed operations to control pain (antero-lateral cordotomy) and spasticity (ventral rhizotomy) in patients with SCI and improved their mobility further by ambulation training (5). He was known to exercise patients himself and train his spinal cord injured (SCI) patients in walking (6) (see Photo p 97). He was particularly interested in the categorical care of peripheral nerve injuries from the initial surgery to the post operative physical restoration of function. Foerster was mentor to his young neurosurgical assistant, Ludwig Guttmann in Breslau, Germany from 1929-1933. before Guttmann fled to England in 1939.

John Silver, credits Foerster training of Guttmann in the management of peripheral nerve injuries as the basis for Guttmann’s development of the SCI center at Stoke-Mandeville in 1944. “Foerster trained Ludwig Guttmann in the management of peripheral nerve injuries and it was this rigorous Prussian training that influenced Guttmann in the founding of the only successful spinal unit in the United Kingdom at Stoke Mandeville Hospital”. (7)

 Sources:

1.Sarikcioglu L. Otfrid Foerster (1873-1941): one of the distinguished neuroscientists of his time. J Neurol Neurosurg Psychiatry 2007; 78: 650. DOI: 10.1136/jnnp.2006.112680.

2. Foerster O. The Dermatomes in Man. Brain 1933; 56: 1-39.

3. Obituary: OTFRID FOERSTER, 1873–1941: AN APPRECIATION. Journal of neurophysiology 1942;

4. Zwecker M, Zeilig G and Ohry A. Professor Heinrich Sebastian Frenkel: a forgotten founder of rehabilitation medicine. Spinal Cord 2004; 42: 55-56. 2004/01/10. DOI: 10.1038/sj.sc.3101515.

5. Foerster O. Resection of the Posterior Spinal Nerve-roots in the Treatment of Gastric Crises and Spastic Paralysis. Proc R Soc Med 1911; 4(Surg Sect): 226-246.

6. Zülch KJ. Otfrid Foerster · Physician and Naturalist: November 9, 1873 – June 15, 1941. Springer Berlin Heidelberg, 2012. p 97.

7. Weiner MF and Silver JR. The origins of the treatment of traumatic spinal injuries. Eur Neurol 2014; 72:363-369. DOI: 10.1159/000365287.

 Profile written by John Ditunno

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