Ever heard of Fischer's disease? No? Maybe that is not surprising, because it doesn't exist. But it could have. In fact, the disease we now know as Alzheimer's disease might just as easily have been called Fischer's disease or Alzheimer-Fischer disease.
Author
- Michael Hornberger
Professor of Applied Dementia Research, University of East Anglia
Back in 1907, Dr Oskar Fischer published detailed research on what we now recognise as Alzheimer's disease. Fischer described cases of older people who had cognitive symptoms in their lifetime and noted tiny plaque-like structures and fibrous tangles in their brains after their death.
These changes were the same as those observed by Alzheimer's at around the same time. But unlike Alzheimer's brief two-page publication highlighting this new disease in one person, Fischer's work, published in 1910 , was a meticulous and wide-ranging study - spanning more than 100 pages - including several people he investigated. So why have we never heard of him?
In my new book, Tangled Up : The Science and History of Alzheimer's disease, I attempt to answer this question.
A promising mind from Prague
But before we get to why Fischer was forgotten, let's look at who he was.
Oskar Fischer was born in 1876 in a small town near Prague, part of the German-speaking minority in what is now the Czech Republic. After studying medicine in Strasbourg and Prague, he began working at the German University of Prague's Department of Psychiatry.
Fischer's career flourished under the leadership of Professor Arnold Pick - another lesser-known scientific giant. Pick was the first to describe a different kind of dementia, now called frontotemporal dementia. It was in this forward-thinking academic environment that Fischer began his research into dementia.
Fischer wasn't working in isolation. At the time, other doctors had also noticed unusual plaques in the brains of people with dementia. Researchers like Paul Blocq and Georges Marinesco in Paris , Emil Redlich in Vienna and Koichi Miyake in Tokyo had all seen similar features.
But Fischer, like Alzheimer, went a step further: he identified not only plaques but also twisted protein fibres - now known as tau tangles - that disrupt the brain's function. This combination is still central to how we define Alzheimer's disease today.
But if both men made this important discovery, why is only one name remembered?
There are two theories as to why Fischer has been forgotten. One is that Fischer believed these brain changes were specific to a type of dementia called presbyophrenia , which was thought to affect people who showed unusual cheerfulness and confusion in old age.
He may have limited his own findings by tying them to this narrow diagnosis. Indeed, in the 1920s it was realised that presbyophrenia was not a separate disease but simply how certain people with dementia presented - and the term was not used anymore.
Another factor might be politics and influence. Alzheimer had a powerful supporter: Emil Kraepelin, one of the most influential psychiatrists of the time, who Alzheimer worked for. Kraepelin included Alzheimer's work in his bestselling textbook and named the condition after him, helping to cement Alzheimer's name in medical history.
There's no record showing whether Kraepelin knew of Fischer's similar discoveries. If he did, he never acknowledged them in his textbook.
Despite his scientific achievements, Fischer's academic career stalled. In 1919, he was denied a permanent university position, despite his groundbreaking work. He opened a private practice in Prague and continued to teach, but without the recognition he deserved.
A tragic end
Then came the darkest chapter of his life. In 1941, during the Nazi occupation, Fischer was arrested by the Gestapo. He was imprisoned at Theresienstadt (now Terezín), a ghetto and transit camp for Jews and political prisoners. It's unclear why he was targeted - perhaps for his Jewish ancestry or his earlier communist activism. He died there in 1942.
Oskar Fischer's story is a reminder that scientific discovery is rarely the work of one lone genius. It's built on shared ideas, collaboration, and often forgotten contributors.
It's somewhat similar to Charles Darwin and Alfred Russell Wallace describing the theory of evolution at the same time but most only remember Darwin now. While Alois Alzheimer certainly made important observations, Fischer's role in defining this devastating disease was just as significant.
Maybe it's time we remembered Oskar Fischer and gave him the credit he so rightly deserves.
Michael Hornberger is the author of Tangled Up: The History and Science of Alzheimer's Disease, published by Canbury Press.
