The Pernkopf anatomical atlas controversy: issues of Nazi medicine and medical ethics.
Pernkopf’s anatomical atlas, Topographische Anatomie des Menschen (Atlas of Topographical and Applied Human Anatomy),is considered by anatomists and surgeons to be a true classic. The Topographische Anatomie maps the human body in exquisite detail and has been hailed as one of the most important anatomic atlases since the work of Vesalius. The New England Journal of Medicine review of the 3rd addition in 1990 praised it as an outstanding book of great value to anatomists and the Journal of the American Medical Association called it a classic among anatomical atlases. Pernkopf’s Topographische Anatomie was published between 1937 and 1960 in four volumes. It was republished several times in different variations, and was also published in several editions in English and in Spanish in 1953. The atlas contains some 800 anatomical plates. There is a fundamental flaw in this work, however. Its creators were ardent Nazis and the anatomical sources of the illustrations are shrouded in a veil of Nazi taint.
The controversy over the Topographische Anatomie began in 1996 when Dr. Howard Israel, an oral surgeon at Columbia University, and Dr. William Seidelman, Director of an AIDs clinic at the University of Toronto, wrote a letter to the Journal of the American Medical Association stating that Pernkopf was an ardent Nazi, and that human subjects used in the preparation of the atlas had been victims of Nazi terror.
Eduard Pernkopf (1888-1955) had a distinguished academic career blemished by strident Nazi sympathies. In 1926 he became an Associate Professor at the University of Vienna, then considered the leading medical center in the world, and in 1928 he was named Professor of anatomy. In 1933 Pernkopf became Director of the Institute of Anatomy, and in 1938 he was made Dean of the Medical Faculty in Vienna, and from 1943-45 served as President of the University of Vienna. Pernkopf became a fervent member of the National Socialist (Nazi) Party in 1933, and joined the storm troopers or brown shirts a year later. He regularly wore the Nazi uniform and gave the Nazi salute. As Dean of the Vienna medical school, Pernkopf led the purging of all Jews and ‘undesirables’ from the faculty. Under his direction, the Vienna Medical Faculty witnessed a virtual intellectual decapitation, with 111 of 309 faculty members being forced to emigrate, including three Nobel laureates. Others were less fortunate; six perished in concentration camps, four committed suicide, and nine more died under questionable circumstances. Although never charged with war crimes, Pernkopf spent three years in an Allied prison camp near Salzburg after the war. When released in 1948, he was a broken and dispirited man, but returned to the university, stripped of all titles, to resume work on his beloved atlas. In this effort he was rejoined by several of the artists that collaborated with him on the atlas in the period 1933-45. Pernkopf died suddenly of a stroke in 1955, while working on the first part of the fourth volume.
In his first official speech as Dean of the Vienna Medical Faculty, Eduard Pernkopf issued the following charge to his faculty in words that clearly predict both euthanasia and eventual Holocaust:
"To assume the medical care -- with all your professional skill -- of the body of the people which has been entrusted to you, not only in the positive sense of furthering the propagation of the fit, but also in the negative sense of eliminating the unfit and defective. The methods by which racial hygiene proceeds are well known to you: control of marriage, propagation of the genetically fit whose genetic, biologic constitution promises healthy descendants: discouragement of breeding by individuals who do not belong together properly, whose races clash: finally, the exclusion of the genetically inferior from future generations by sterilization and other means."
Over and above Pernkopf’s personal political persuasion, and lamentableimplementation of a Nazi-directed administration of the Medical Faculty, lies the issue of the sources of the cadavers received by the University of Vienna, and from which the illustrations in Pernkopf’s Topographische Anatomie were drawn. It is has been documented that 1377 cadavers were delivered after execution at the Vienna District Court and Gestapo execution chambers in Munich and Prague. Who were these people? Most were ‘law breakers,’ including political dissidents who opposed the Nazi regime. Their 'crimes' included disobedience towards the Nazi regime, the illegal slaughter of animals, listening to the BBC, and trading on the black market. They included non-Jewish Austrian patriots, communists, and others who had been declared “enemies of the state.” As such, they were victims of political terror. Of the 1377 corpses, 9 were Jewish. (Overall, during the period 1939-1945, the Institute of Anatomy received a total of more than 12,300 bodies for autopsy and study from Vienna’s hospitals.) Were any bodies brought from the concentration camps? Despite investigations, including a University of Vienna research project entitled “The Anatomical Sciences, 1938-1945”, no proof has been found that bodies were brought to the Vienna Institute of Anatomy from the concentration camps. It is clear, however, that bodies of Nazi victims were used for scientific purposes. It is also certain that Pernkopf was a devout Nazi, who thought that the ‘undesirables’ of society should be eliminated. While he did not carry out medical experimentation, and he evidently had no compunction about using Nazi victims’ bodies for anatomical study. Several views have been advanced regarding the disposition of Pernkopf’s Topographische Anatomie: destroy all copies, which would resemble the Nazi book burnings and is unacceptable; remove them from general circulation and put them in special collections (for use by scholars and to prevent mutilation); or allow general use.
Many opinions support the latter decision. Howard Spiro of Yale University states that the Pernkopf pictures serve a double role: “They teach anatomy and remind us of the horror ‘objective’ science can impose. Edward Hutton, the American publisher, continued to publish the work because of its scientific merit. The New England Journal of Medicine praised the Atlas “as an outstanding book of great value to anatomists and surgeons in a class of its own.” Malcolm Hast of Northwestern University Medical School said it was one of the most beautiful anatomy books published and should be used.
Many other sources agree, but some dissented. Abraham Foxman, national director of the Anti-Defamation League, said it should not be used because it would possibly justify similar acts in the future.
What are the libraries’ responsibilities? It is considered unethical for libraries and librarians to act as censors, even when the material is controversial. The American Library Association’s “Library Bill of Rights” states that materials should not be excluded because of the origin, background, or views of those contributing to their creation, and materials should not be removed because of partisan or doctrinal disapproval. Follow this link to view a list of all libraries with Ohiolink listings for 1989 and 1943 editions of the Atlas.
A code of ethics for health sciences librarianship was adopted by the Medical Library Association in 1994, stating that “conditions of freedom of inquiry, thought, and expression that facilitate informed health care decisions should be maintained. Most medical school libraries acted in accordance and did not withdraw the Pernkopf atlas. At the Cleveland Health Sciences Library we have inserted in each Topographische Anatomie volume an official cautionary note sent in 1997 by the University of Vienna to libraries holding the Pernkopf atlas. Their final report of 1998 marked the first time a German language university publicly and widely acknowledged its role in the medical abuses of Hitler’s Nazi regime.
The chief artists involved in preparing the plates for Pernkopf’s Topographische Anatomie des Menschen included Erich Lepier (1898-1974), Ludwig Schrott, Jr. (1906-1970), Karl Endtresser (1903-1978), and Franz Batke (1903-1983). They all joined the Nazi party and those that were fit served in the military. Batke and Endtresser fought on the Eastern front, and Schrott served on the Western front; Lepier was exempted from active service for health reasons, but served as an air raid warden in Vienna. Their Nazi sympathies showed in their signatures on artwork for Pernkopf’s atlas, as seen here. In spelling his name, Endtresser used the lightning bolt shaped 
, which was a double sig rune (an alphabetic letter from a pre-Christian Germanic languages). This runes design was created in 1931 when Walter Heck, a Sturmführer in the Schutzstaffel (SS), drew two reversed and inverted sig runes side by side and noticed the similarity to the initials of the SS. It subsequently became the Nazi symbol signifying the SS, Heinrich Himmler’s police forces, whose members ranged from agents of the Gestapo to soldiers of the Waffen SS to the guards at concentration and death camps. Lepier chose to feature the swastika in his signature. The swastika was an ancient religious symbol, that when shown in a counterclockwise or left-facing form represented a sign of good luck. Hitler made the Nazi swastika unique to his party by reversing the normal direction of the symbol so that it appeared to spin clockwise. And of course today it carries singularly sinister meaning, and its use is taboo and outlawed in many societies.
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The artists signatures on the left are examples without Nazi symbols and on the right with the symbols. All these signatures are from the 1943 edition of the atlas. |
