On November 3, 1906, a psychiatrist from Munich, Alois Alzheimer, reported a strange case at the conference of psychiatrists in southwest Germany in Tübingen. After the report was over, the audience was silent. What he had hoped for was a heated discussion. After all, nearly 100 people sat down at the audience, but the audience seemed not interested in his report.
The case reported by Alois was a German woman named Auguste Deter. About five years ago, her husband Karl took her to Alois’s clinic. Karl is a railway worker who has lived a happy life for twenty-eight years while he married Auguste. However, his wife was alarmed by a series of abnormal behaviors eight months ago.
Auguste was initially suspicious and often suspected that Karl had an improper relationship with their female neighbor. After Auguste’s memory began to severely decline. Although she has already entered the middle age and is very familiar with domestic chores, she often forgets to do household chores and often even makes mistakes in cooking.
In the next few months she began to walk around home without a destination, trying to conceal her family’s property. She began to have a variety of illusions, always afraid that the truck would enter her home at any time, and her life was in endless fear and suffering.
Karl feels more and more confused, and although he knows very well that older people are forgetful like Auguste, her mental illness-like illness makes him incredible. Karl took his wife to Frankfurt and went to Asylum for the Insane and Epileptic, the world’s most famous psychiatric clinic.
Alois warmly welcomed them. After a brief contact with Auguste, Alois had a strong interest in her because he had never seen such a patient. Auguste was quiet and anomalous the previous minute, and she became terribly frightened and screaming for a minute later, constantly reaching for the other patients’ faces.
In the next few months, Auguste gradually lost his sense of direction and became more forgetful and insane. She often looked at Alois’s eyes and repeated a word: Probably, I have lost myself.
Alois observed Auguste from day to day. As the condition worsened, she had to stay in bed all day. Alois thinks her condition is too bad and it has been difficult to get some valuable information from her.
In 1902 Alois left Frankfurt to work at Emil Kraepelin in Munich. Alois asked his colleague to replace him for Auguste. After Auguste’s death in 1906, Alois requested that the brain of Auguste be sent to his laboratory in Munich.
When Alois first saw Auguste’s brain sample, he was surprised by the petite volume of the brain. In addition, there is a large number of tissue defects in the cerebral cortex of Auguste that may be caused by the death of neurons.
When Alois looked at the brain under the microscope, he was even more shocked. Dark neurons were scattered throughout the brain’s neurons, which were very different from the surrounding brain cells. Then Alois discovered another phenomenon that puzzled him. There was another dark color in the dead neuron. The appearance was similar to linearity, and it could form various entangled substances.
Alois knew very well that although Auguste’s disease was symptomatic as a type of dementia, he was very confident that he had discovered a completely new disease from the pathological features of the disease. So Alois began collecting data to prepare for the report of the conference of psychiatrists in southwestern Germany that took place a few months later.
The silence at the end of the report caused Alois to feel a little lost. But perhaps he should not be surprised. At that time, neuroscience was still in its infancy, and Freudian theory was still highly respected in the field of psychiatry. Therefore, people’s indifference to the Alois report is almost inevitable.
In the field of scientific research, we always imagine that we are an objective and calm group with no prejudice against facts. However, countless facts tell us that scientists can be irrational when faced with new theories and new evidence.
In the following years, Alois did not stop his scientific work, and he discovered four other cases similar to Auguste’s condition. In 1910, Kraepelin used the term Alzheimer’s disease for the first time in the new book Handbook of Psychiatry.
However, some discoveries over the next few decades made people feel puzzled: The researchers found similar features to those of Alzheimer’s disease in some people without Alzheimer’s disease. Brain anatomy experiments found that a quarter of people over 60 years old had plaque and tangles in their brains.
Isn’t Auguste’s brain just accelerating aging? What does this have to do with psychotic symptoms? So some people began to peel off the plaque and tangles in the brain from the definition of the disease. Others think that there is no difference between Alzheimer’s disease and dementia, but it is only an early onset. Those who advocate Freud’s theory are also at this time. In the following decades, the field fell into endless debates.
In 1966 Martin Roth of the University of Newcastle in the UK resolved this dispute through clever experimental design. He believes that the failure of the association between brain plaque and tangles and dementia was caused by a too ambiguous definition of dementia at the time.
He and his colleagues then designed dementia scores to assess the patient’s cognitive level. His conclusion is very convincing: there is a strong correlation between the score of dementia and the number of plaques.
With the deepening of research, people have become more aware of the disease and have begun to think about how to solve the problems caused by Alzheimer’s disease. For example, how do we treat Alzheimer’s disease?