
==== Front
Rom J Morphol Embryol
Rom J Morphol Embryol
RJME
Romanian Journal of Morphology and Embryology
1220-0522
2066-8279
Academy of Medical Sciences, Romanian Academy Publishing House, Bucharest

39020552
650224353363
10.47162/RJME.65.2.24
Short Historical Review
From morphology of human body to reshaping a morphology of the society: heritage in the field of pathology of infectious diseases of Wilhelm Ebstein and work of councilman Sigismund Asch. A story how to counteract epidemics and to transform feudal system into civil democracy
Wincewicz Andrzej 1
Woltanowski Piotr 2
1 Specialist Medical Practice – Pathologist, Warsaw–Marymont, Poland (https://orcid.org/0000-0003-0836-2199)
2 Department of Public Finances and Financial Law, Faculty of Law, University of Białystok, Poland (https://orcid.org/0000-0002-2154-3587)
Corresponding Author: Andrzej Wincewicz, Associate Professor, MD, PhD, Fellow of European Board of Pathology (FEBP), Specialist Medical Practice – Pathologist Non Public Health Care Unit – Department of Pathology (NZOZ Zakład Patologii Spółka z o.o 70 Jagiellońska Street 25–734 Kielce Poland + 48 41 368 47 87 ruahpolin@yahoo.com
Apr-Jun 2024
30 6 2024
65 2 353363
17 11 2024
12 7 2024
Copyright © 2024, Academy of Medical Sciences, Romanian Academy Publishing House, Bucharest
2024
https://creativecommons.org/licenses/by-nc-sa/4.0/ This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
Collected, primary resources enabled us to extract data that are scarcely present in medical literature of the two Breslauer morphologists of both the human body and – metaphorically – the society: Wilhelm Ebstein (1836–1912) and Sigismund Asch (1825–1901), particularly the latter, who described morphology of melanosis in his doctoral dissertation in 1846, to switch on reshaping social morphology of Wrocław (Breslau) in Virchow-like manner. In contrast to the main perspective of Ebstein’s anomaly that has been finely described in past biographical papers, a primary aspect of infectious diseases is highlighted here in Ebstein’s heritage. In 1869, his habilitation on recurrent typhus provided professional support for Asch. As Ebstein cared for the poor in shelters of Wrocław, Asch admitted poor patients from early morning hours to gain such a great esteem to be elected alderman. Asch’s mentality corresponded to Ferdinand Lassalle’s philosophy of the social democratic movement. In front of cholera epidemics, Asch contributed to medical control of meat, development of city canalization, establishment of green areas as well he deeply got involved in charity institutions for widows and orphans and was a model medical doctor to follow for much more famous Janusz Korczak who perished together with children from his orphanage in Nazi Concentration Camp in Treblinka. Asch was immortalized as “Doctor Klaus” in the popular play by Adolf L’Arronge and united people in progress from feudal discrimination to democracy and in fight for civil rights in industrial society to gradually replace aristocracy with meritocracy in the mainstream of development of modern society.

morphology
infectious diseases
cholera epidemics
typhus
meat control
civil rights
==== Body
pmcIntroduction

In XIXth century, in Wrocław (Breslau) there was a group of medical morphologists whose merits like alderman Leopold Auerbach gained them high esteem so that they also focused on so-called social morphology aimed at description of the structure of society according to Emile Durkheim [1, 2]. They were so sensitized to notice and properly define microscopic details that they easily had a profound insight into the problems of society, and they sincerely wanted to cure their communities from illnesses of social injustice and discrimination. One of them, Wilhelm Ebstein is rightfully remembered in the first place as the anatomopathologist who discovered cardiac tricuspid valve defect and a brilliant histopathologist who described diabetes related cellular changes of renal tubules [independently from Luciano Armanni (1839–1903)], while his clinical diligence is considered in aspect of Hodgkin’s lymphoma (HL) associated intermittent fever [3, 4, 5, 6]. In our point of view, all of them, Ebstein encountered while combating infectious diseases that took the first place in healthcare in XIXth century as coronavirus disease 2019 (COVID-19) pandemia lately. Therefore, we aimed at highlighting perspective of infectious diseases in Ebstein’s heritage as this aspect was rarely mentioned in the background of papers about him at occasions of recalling his great achievements among over 200 of his publications [3]. Our paper also shows that infectious diseases were the mainstream of his professional activity, and he was of great support for other medical doctor Sigismund Asch [1, 7]. Thus, we decided to present silhouettes of two medical doctors: Wilhelm Ebstein, world’s famous morphologist with great merits for health of society and Sigismund Asch who started his professional activity from morphology of melanosis to switch on social morphology, which refers to structure of the society and Asch perfectly dealt with the society of Breslau on the way of its transformation from feudal mentality into civil democracy [1, 7, 8]. Indeed, different colors of the tissues were not destined to be at the core of his scientific explorations, but his fate was to fight against racism and discrimination. Breslau was exceptional because of magnitude of its Jewish genuine citizens in almost all branches of the life of the society in complete disproportion to relatively small number of all Jews in Breslau, e.g., there were 13 916 Jews to total 208 000 citizens in 1871, while there were 20 212 Jews to total 512 000 inhabitants in 1910 [9]. Thus, such a demography of Jews is incomparable to Warsaw community [210 500 Jews (33.7% of total city population) among 625 000 citizens in 1897 in Warsaw] and 337 000 (38.1%) among 885 000 people by 1914 [10]. That is why the structure of municipal society is fascinatingly different so is social morphology in comparison of Wrocław to Warsaw [9, 10]. However, Jewish community of Warsaw might have been affected by Asch heritage under impression of the theatre play about this Breslauer physician which was shown in Warsaw first in 1882 and later in 1908, the latter, when another social activist and medical doctor Janusz Korczak (1878 or 1879–1942) was old enough to go to watch the show by his own [11].

Materials and Methods

Actually, the aim of the paper was to present a silhouette of two medical doctors who complemented each other in close cooperation and support during their work in Wrocław (Breslau). Professor Wilhelm Ebstein gained proficiency at the position of clinical hospital physician in anatomical pathology. Sigismund Asch, who from his primary interests in morphological issues as melanosis, turned into an influential social activist, aimed at changing the morphology of society from a feudal relation to a modern democracy. These two medical doctors can be compared to Rudolf Virchow: Ebstein as prominent university professor of pathology and Asch as popular politician, alderman and social activist. However, while there are plenty of papers about both scientific and political output of Virchow, there is sparse published information about overall heritage of Ebstein, who is almost exclusively known for Ebstein’s anomaly as well as Asch, whose great impact is recalled in family memories and few papers, which are not oriented on healing medical nature of Asch’s work. Our paper is grounded on the primary original resources. Basic primary resources constitute own publications by Asch and Ebstein. The commemorative papers about Asch and Ebstein that were published shortly after their deaths, could be categorized as in situ resources [3, 7]. As cardiac Ebstein’s anomaly was a topic of numerous papers, there is little sense in constant repeating the same information. Thus, we rather focused on the field of infectious disease which is mentioned only as a background and the most neglected part of the scientific heritage of Ebstein. Moreover, it is worth to propagate a history of Sigismund Asch in this first paper about him in PubMed repository. Secondary resources are publications which deal with the heritage of them decades of years after their death. In the case of the scientific heritage of Asch and Ebstein, we put their inquiries in the field of morphology in perspective of infectious diseases, which constituted the main problems of public health.

Results

Wilhelm Ebstein’s heritage

Wilhelm Ebstein was a purely German scientist of Jewish origin. He was born on November 27, 1836, in Jauer (now Jawor in Poland) in Lower Silesia (Niederschlesien) in the Kingdom of Prussia, and died on October 22, 1912, Göttingen in Lower Saxony (Niedersachsen), in German Empire [3, 12, 13] (Figure 1).

Figure 1 Wilhelm Ebstein

The scientific heritage of Wilhelm Ebstein remained so huge that it would have been difficult to retrieve it unless the son of Wilhelm Ebstein, Doctor of Medicine, Erich Ebstein had not provided a list of his father’s publications from 1859 to 1906 [12]. During Wilhelm’s medical studies, his tutors were Friedrich Theodor von Frerichs in Breslau and Rudolf Virchow and Moritz Heinrich Romberg in Berlin [3]. He graduated medicine in Berlin and defended a doctoral thesis about saliva-induced microscopic changes on starch at the University of Berlin in 1859 [14]. Being a physician, he remained a prolific writer. His primary interests focused on functions of alimentary tract, proper nutrition and in this way enhancement of human immunity [3, 15]. He returned to Breslau and started to work as medical doctor at the in Breslau in position of prosector at All Saints’ Municipal Hospital (Allerheiligen Hospital) in Breslau [3, 12, 13]. He defended his habilitation on the recurrences of typhus in 1869, in Breslau, as infectious diseases took the first place in problems of public health at the time [16]. From 1874, he worked as a professor at the Medical Clinic of the University of Göttingen, where he subsequently served as director of the University Hospital since 1877 [3, 12, 13]. He died in Göttingen due to apoplexy on October 22, 1912 [3, 12, 13]. Wilhem Ebstein is the best example of translation of clinical scrutiny into great achievements in the field of pathology in the whole history of medicine. Therefore, recalling the heritage of Ebstein is of great merit for education and training of further morphologists who are to be clinical pathologists. However, in the first place he is not remembered as a fighter against infectious diseases but as a discoverer of cardiac tricuspid valve defect, diabetes related cellular changes of renal tubules and HL-associated intermittent fever [4, 5, 6]. In our point of view, all of them, Ebstein encountered while combating infectious diseases. Heritage of Wilhelm Ebstein (1836–1912) comprises world’s famous eponymic discoveries: Ebstein anomaly (1866) (regurgitation causing tricuspid valve defect), Ebstein’s disease (1881) and Pel–Ebstein fever (1887) [3, 4, 5]. Indeed, Wilhelm Ebstein was essentially a meticulous clinician in the first place and expert of infectious diseases of the highest priority at the time and only secondarily he performed autopsies of their patients to check initial diagnoses and hospital treatment in era when no radiological imaging was available. Ebstein’s anomaly was an unexpected finding during autopsy of the 19-year-old man in 1864 (published in 1866) who was initially suspected to suffer from infectious disease as he got easily tired and cyanotic in the position of labor worker [4]. To our knowledge, for instance, his clinical studies on diet and diet-related conditions and illnesses as obesity and diabetes led him to another great discovery in the field of pathology, this time precisely in the field of histopathology. Namely, in microscopic observation, he found hyaline degeneration with necrotic change of the epithelial cells of the renal tubules to be occurring in diabetes mellitus, which along with glycogen overload and resultant vacuolization of cells of the terminal portion of the proximal convoluted tubules are known as Armanni–Ebstein lesions that are encountered also nowadays in diabetic ketoacidosis, particularly in course of poorly controlled diabetes [5]. In result, he gained such an authority in the field of nephrology that professor of pathology and therapy in Erlangen, Hugo von Ziemssen (1829–1902) invited him to write the whole chapter about kidneys in his “Handbuch der speciellen Pathologie und Therapie”, the well-known textbook that had numerous editions since 1877 [17]. Actually, he contributed to at least a few handbooks of practical medicine including “Handbuch der praktischen Medizin”, in 1899, with Gustav Schwalbe (1844–1916) in 1901 [18]. Another of his great discoveries was the description of intermittent fever, which bears a an eponymic name Pel–Ebstein fever (rarely Ebstein–Cardarelli fever) [6]. He noticed the coincidence of the intermittent 3–10 days long fever with cyclical increases and decreases over in one to two weeks, night sweats and enlargement of lymph nodes, which later was strictly associated with clinical picture of patients with HL as their fevers [6]. In his studies of diabetes, gout and what now is called metabolic syndrome, to treat obesity he recommended a low-carbohydrate high-fat diet that included variety of meat excluded potatoes, sugar, and sweets [3]. Looking for therapeutical success, Ebstein referred to individualized response and resistance to diseases [15]. In his scientific output, which comprises numerous publications, is much more [19]. Namely, in a sort of prophylaxis and preventive approach, Ebstein wrote about habits that may contribute to prolongation of human life and healthy style of life regarding it as challenging art [20]. His work “Die Fettleibigkeit (Korpulenz)” had quite a broad readership at the time [21]. His alcohol preferences were “two or three glasses of light wine” daily but he was a great opponent of beer drinking [21]. Following Hippocratic manner, Ebstein was focused on diet to notice that improper nutrition can lead to dehydration and strenuous muscle movements and in this aspect, he was an expert on dehydration of human organism [22]. He also recommended protein rich flour in everyday diet [23]. Ebstein thought that oil and proteins that derive from vegetables were usually better for people with diabetes than food of animal origin [24]. He highly prized proteins from maturing seeds in a healthy diet [25]. His diet oriented scientific explorations resembled later publications issued by Janusz Korczak and Julian Kramsztyk [26]. He spent much of his time and efforts to charity to be employed in position of chief medical doctor at the “Findelhaus” Municipal Poorhouse in 1868 to became later an ideal medical doctor to follow his example by such people as Janusz Korczak [26]. His erudition was expressed in numerous other publications mainly in history of medicine about medicine in Bible and biblical commentaries like Talmud, diseases experienced on a campaign to Russia, etc. [27, 28, 29]. On the basis of inquiries from the historical perspective, he wanted for sure to improve his skills as a medical doctor of infectious diseases, which constituted the most frequent sort of illnesses at his time. Ebstein emerged also as one of the first thus pioneer biographers of Rudolf Virchow [30, 31], whose eminent figure is always a popular subject of endlessly repeated compilations. Humanistic interests of Ebstein also covered medical illnesses of Great Germans in history as Martin Luther (1483–1546) or Emperor Sigismund of Luxembourg (1368–1437) [32, 33, 34]. Ebstein unmasked charlatanry and quacks in medical profession in the German Empire [35]. However, being a notable historian of medicine, he referred mainly to epidemics in history of human civilization with splendid papers about the plague, which according to Thucydides killed tens of thousands of people in Athens in 430 BC during the Peloponnesian War [36, 37, 38, 39]. Ebstein also studied a history of recurrent epidemics of so-called “English sweat” (Latin: sudor anglicus), which devastated population of Britain since 1485 to affect also continental Europe [40]. As tuberculosis emerged as a great public health problem in XIXth century, he wrote about occurrence of rickets in ancient times [41]. He also dealt with the history of chickenpox and its relationship to smallpox [42]. However, first of all, his habilitation dissertation about recurrences of typhus was of great support for medical doctors, who aimed at improvement of public health by social activism like Sigismund Asch (Figure 2). In concordance with the public health policy of Asch, Ebstein also addressed issues of hygiene in urban and rural environments [43].

Figure 2 Title page of Wilhelm Ebstein’s habilitation dissertation about typhus

Sigismund Asch’s influence on morphology of the society

“A great doctor, sensitive to other people, discreet and venerable benefactor of the poor.”

From Asch’s obituary (1901)

Sigismund Asch (1825–1901) was born in Schweidnitz (Polish: Świdnica) on January 5, 1825, in the Jewish family of Julia Beate, née Prinz (1799–1876), and a printer from Gleiwitz (Polish: Gliwice), Joseph Asch (1792–1857), who ran a pottery and antiques shop [7, 44] (in his obituary written by his son Robert but printed by some else in 1901 there is a forename: Siegismund Asch but at his tombstone is Sigismund Asch). He was remembered as a talented pupil during his education at gymnasium. Teachers soon noticed he emanated with eager passion for knowledge, and they praised his intellectual diligence that was associated with his great enthusiasm, so he graduated secondary school with high grades shortly before his 18th birthday [7]. His parents were highly respected in society, but they were too poor to afford university studies for their only son. From 1843, Sigismund Asch studied mathematics and then medicine in Wrocław, but due to lack of money he had to earn them to make a living by giving lessons and by writing articles for newspapers. Cooperation with daily press made him interested in functioning of social welfare institutions [7]. Anyway, he devoted himself with the greatest zeal to medical studies which were enlightened by splendid lecturers, e.g., Barkov, Remer, Wendt, Benedict, and Purkinje. Asch got profoundly engaged in liberal social movement since the start of his medical studies, which he found corresponding with his enthusiastic conviction about equality of all the people and fresh belief that meritocracy is far better than aristocracy in progress of the modern society [7]. He belonged to the academic fraternity “Die Alte Breslauer Burschenschaft der Raczeks”, which was association of so liberal and open-minded students still having continuity in Bonn that even elected Jews to be leaders of the organization, which took their name of the inn (German: Gastwirt “Raczek” – a surname of Polish etymology meaning crayfish, which often appeared in menu), where they met at Klosterstraße (English: Cloister Street) [7, 44, 45] He graduated medicine in 1846 [7, 44]. He obtained medical doctor on grounds of the thesis about melanosis (De melanosi: dissertatio inauguralis medica) on November 24, 1846, which was published a year later [7, 8].

His political career flourished in the meantime [7]. Actually, the main initiator and philosopher of socialistic activism in Prussia, and the father of the first socialist party (Allgemeine Deutsche Arbeiterverein, ADAV) in Leipzig, in 1863, Ferdinand Johann Gottlieb Lassalle (Lassal) (April 11, 1825–August 31, 1864) was born in the same year Breslau as his fellow, Sigismund Asch. From the diary of childhood and adolescent period, Lassalle’s philosophy focused on equality of all the people in startups of their life careers. According to him, such equality was one of expressions of true freedom as he characterized Kingdom of Prussia as enormous prison governed by tyrants. The ideas of Lassalle were similar to Asch’s thoughts. However, Asch wanted all social issues to be more compromised on different sides as Asch got lots of empathy for each of his patients regardless of social status. Lassalle was born in Jewish family of silk merchant and Jewish minority was this part of society that got emancipated thanks to their work and talents and not because of aristocratic heritage of wealth and honors. Thus, it may be said that the main constructor of the social democratic movement was Ferdinand but one of highly active practitioners of Lassalle thoughts was Asch, who perfectly joined his society oriented mentality with profession of medical doctor. In 1846, Asch became officially involved in the movement of democratic liberals. On July 15, 1848, he elected a president of Breslauer Arbeiterverein (Labor Party: Party of Workers) on first regional provincial congress of Silesian democrats in Breslau, which was organized on initiative of first German Democratic Congress which was held in Frankfurt am Main from July 14–17, 1848 [46]. His reelection to this post (German: Kongresspräsident) was on the second provincial congress which took place from 21 to 23 October 1848 [46]. In 1848, he was elected to the Prussian People’s Assembly on behalf of the democrats [7]. At the same time, from 1847 he belonged to the Democratic Union and in October of the following year he was vice-president of the second Democratic Congress in Berlin, but he left the Union at the end of 1848 [7]. Thus, in 1848, he was a board member of the Wrocław Workers’ Union and joined the General German Workers’ Congress in Berlin, which contributed to abolish indirect taxes and introduce a 10-hour working day [7, 47, 48]. In the same year, he participated in two large rallies. Namely, on the first one, on August 6, in Scheitniger Park (Fürsten Garten; Polish: Szczytnicki Park), he organized a fundraising for the poor, which was a great success. He delivered his famous speech to the inhabitants of Wrocław, which he ended with a call to the crowds not to forget about the suffering weavers from the Owl Mountains [7, 44]. In another one, on September 21, 12 000 people gathered at square Exerzierplatz (Schloßplatz), which was used as military training square for Prussian soldiers (now Polish: Plac Wolności; English: Freedom Square) [7, 44]. Asch noticed that the crowd was close to radicalization, so he moved from the audience to the stage and successfully called for peace [7, 44]. He propagated the ideal of empathy, which was illustrated best by his own influential words, which prevented bloodshed, to crowds of protesters who demonstrated for civil rights for working class in 1848 at Exerzierplatz. Namely, he called to calm down to be reasonable: “It would be an injustice, if You would do any harm to these men who are bond with patriotic oath of these soldiers on the Fatherland Flag. These guards are the same children of nation as You are...” With his really strong voice, he appealed to respect those mercenaries for their loyalty and devotion to honor. This way none was shot or killed at both sides of soldiers and protesters thanks to his oratory talent [44]. However, Asch gained such a popularity that he was enviously charged with the responsibility for rioting and sentenced to imprisonment in the Glatz (Polish: Kłodzko) fortress. Namely, he was unfortunately accused of insult to His Majesty of the King of Prussia, Frederick William IV (1795–1861) [7, 44]. The Court did not recognize Asch as the “defender of the oppressed” but as a “sower of anxiety” and peacemaker but one of chiefs of the revolt [7, 44]. In May of the following year, for participating in this demonstration, he was sentenced to a year in prison in the Glatz (Kłodzko) fortress [7, 44]. His relative Dagmar Nick remarked on this fact in a bitter style, as from 1743 this fortress was extended and actually built up in majority under rule of King of Prussia, Federic II (Federic the Great) (Friedrich II: Friedrich der Große) [January 24, 1712 (Berlin)–August 17, 1786 (Potsdam)] [44, 47]. She wrote it could not have excluded that the Festung Glatz (Kłodzko Fortress), where Sigismund was imprisoned, was built for the money of her common ancestor of older generation banker Bendix Ruben Goldschmidt (1726–May 19, 1805) who borrowed money to king while living in Potsdam, Brandenburg, Germany [44, 48]. The Goldschmidts were well established Jewish Banker family, who operated in German Holy Roman Empire whose progenitor, Mosche Goldschmidt set up a bank in Haus Goldener Schwan at Judengasse im Frankfurt am Main, in 1521. After Frankfurter Fettmilch-Aufstand in 1614, his family left Frankfurt and his descendant Benedikt Moses Baruch Goldschmidt [1575 (Frankfurt am Main)–1642 (Kassel)] was court banker of three following landgraves of Hessen [May 25, 1572 (Moritz)–March 15, 1632], Wilhelm V (February 14, 1602–September 21, 1637) and Wilhelm VI (May 23, 1629–July 16, 1663). Bendix Ruben Goldschmidt was the father of Bella Betty Bauer (Goldschmidt) (1771–1851) who married Wolfrath Hieronymus Wilhelm Bauer (1763–1822) whose son Albert Abraham Bauer [July 4, 1800 (Berlin)–June 5, 1875] was the father of Jenny wife of Sigismund. Therefore, Sigismund might have been kept in a prison which was very likely built for money of his wife’s ancestor [44]. After serving his sentence, he practiced as a medical doctor in Wrocław from 1850 [7, 44]. On May 22, 1851, once again he was tried at court along with two other democrats for insult of majesty, disseminating false information and inciting disobedience to the authorities over the hanging of illegal posters in 1849, but the case was dropped due to the statute of limitations and he was released [7, 44]. From 1861, he was a member of the German Progressive Party (Deutsche Fortschrittspartei, DFP) [7]. Sigismund Asch fall in love with Jenny Bauer (1832–1907), a painter, philanthropist, tutor of children in preschool period in system of Friedrich Fröbel, a daughter of rich a Jewish furniture manufacturer [44, 48]. Actually, her father was a wealthy industrialist who also ran together with his brother Wilhelm a brickyard parquet factory and retail store with antiques in Breslau. Being a social activist attracted Jenny to Sigismund very much [44]. Actually, at the age of 23-year-old, Asch emerged as a leader of the Breslau liberal socialists to candidate for the first Prussian Volksvertretung (Representative Assembly) and to consult a Prussian prime minister Rudolf Ludwig Cäsar von Auerswald (September 1, 1795–January 15, 1866) in Berlin to adopt a conciliatory attitude to rioting of Spring of the Nations [7]. He often visited her at the saloon of the Bauers’ family, which was a meeting place for medical doctors, architects, scientists, artists as well as other sorts of prominent or wealthy people at Breslau at the time. During one such visit, he was cordially invited by Professor Wilhelm Hermann Georg Remer (1775–1850) to join the staff of Orthopedics Institute in Breslau [7, 44]. Thus, he started training to be an orthopedist and worked in this institute until 1857 [7]. However, being diligent at management of bone fractures and minor surgeries, Asch practiced all his life as Doctor of General Medicine (German: Allgemeinmediziner) an equivalent of family medicine specialist, nowadays. The Asches were modest but respected people who belonged to the lower middle class of society, while the Bauers were a wealthy family of generations of influential bankers and industrialists, who were quite sensitive to social needs [44, 48]. Albert Bauer financed the settlement of flats of workers of their furniture factory. Mother of Jenny, Fanny, née Adler, was active in at least two charity organizations and helped particularly orphaned children and financed education of poor girls [44]. However, both of her parents were skeptical about her marriage to social activist and medical doctor Asch whose family had no wealth nor social prominence in comparison to the Bauers. Therefore, Sigismund married Jenny Bauer (1832–1907) not until 1855. Their happiest imaginable relationship is documented by their letters of their beautiful, spiritual family life in which they shared interests in charity, the arts and science [6]. It developed into a 46-year-long marriage [7]. Besides son Robert, Sigismund and Jenny Asch (Bauer) (July 18, 1832–April 1, 1907) had two daughters. Their husbands’ professions reflected activities and shared similar interests. Namely, Julia Bettina (Betty) Jaenicke who married Stadtrat Karl Jaenicke (November 13, 1849–October 11, 1903) who was really long term councilman of Breslau from November 14, 1879–January 29, 1903. Antonia (Toni) Stern (Asch) (August 25, 1866–November 27, 1913) who married Breslauer Professor of internal medicine Richard Stern (September 3, 1865–February 10, 1911) – the grandfather of American historian Fritz Richard Stern (February 2, 1926–May 18, 2016), who published memories about restless philanthropist, Sigismund Asch [8]. From 1850, Asch worked as a medical doctor in Wrocław [44]. In his work at Klosterstrasse (now Romuald Traugutt Street), he helped the poor patients, whom he admitted every day from five to seven in the morning, without paying for medical service and consultation and giving the patients money to buy medicines [7, 44]. Later during the day, he led his normal medical practice [2]. Asch propagated a pioneer complimentary medical care of the poor that were also postulated by Rudolf Virchow in projects of social reforms during chancellor Otto Bismarck’s terms [9, 10]. In the year of massive protests of 1848, typhus epidemics broke out in Silesia to attract most of attention of medical doctors [49]. Typhoid fever was one of main topics of interest of Asch and Ebstein in Wrocław (Breslau) [7, 16]. In the following years, Asch cooperated with another colleague from medical studies and expert on management of cholera epidemics, Immanuel Levy (1820–1864), who worked as “Sanitätsrat” and was also curator of Jewish Theologian Seminary in Breslau [7, 50]. Asch and Levy collected experiences of the medical community of such an epidemics of 1854 year in London and did everything to unite society of Wrocław in combating cholera [7, 50]. In 1866, they significantly reduced epidemics. Asch with medical doctor Julius von Pastau (1813–1889) worked in the All Saints’ Hospital (German: Allerheiligen Hospital), which provided 600 beds for patients during the Prussian–Austrian war [7, 47, 48, 51] (Figure 3A, 3B, 3C, 3D, 3E, 3F).

Figure 3 Allerheiligen Hospital (All Saints’ Hospital): (a) Hospital buildings erected thanks to funds of Johann Heinrich Lösch (mainly built in years 1835–1836) (Löschhaus) and Pulvermacher-Ries Stiftung Pulvermacherhaus (1870); (b) Neogothic wing built by Foundation of Friebe-Agath (Auguste Friebe Agath (1900); (c and d) Later addition with external wall painting to Pulvermacher’s wing; (e and f) Pulvermacher’s wing of the hospital

During XIXth century, this hospital functioned as the main municipal hospital that hosted university clinics until 1891 [52]. In XIXth century, infectious diseases were the most frequent group of illnesses, while in the end of XXth century they were outnumbered by oncological and cardiac disorders with higher morbidity rate, nowadays to experience return of epidemics on global scale. Nevertheless, infectious diseases were the major problem of public health at the time of Asch, whose actions were strengthened by his Jewish cooperators some of them of eponymous significance in world medicine as Wilhelm Ebstein (1836–1912) and his immense influence on Asch. Ebstein was a deputy director of ward at All Saints’ Hospital (Secundärarzt), prosector, privatdocent of Breslau University and subsequent professor of medicine at Gottingen, whose main core of medical activity were infectious diseases to such extend that even his habilitation dealt on recurrence of typhus [16]. Thanks to diligent confrontation of clinical picture with both macroscopic and microscopic morphology of his autopsied patients Ebstein made world famous observations of eponymous significance in world medicine. Thus, he has been mostly remembered in eponym coined in 1927 long after his death: anomaly of Ebstein which refers to cardiac tricuspid valve defect [4]. Sigismund Asch’s son, the gynecologist Joseph Friedrich Robert Asch [December 8, 1859 (Breslau)–March 11, 1929 (Berlin)] arranged and headed the ward of women’s diseases in the same Allerheiligen Hospital (All Saints Hospital) in Wrocław, at today’s Saint John Paul II’s Square, which after the Second World War was renamed the Józef Babinski Memorial Provincial Hospital and was closed down in the summer of 2007 due to oldness of the building whose main preserved part was projected and erected by Carl Gottfried Geissler in years 1799–1801. His son resigned to be called with two first forenames which were given to future emperors at the Berliner and Vienna courts and simply limited his names to Robert Asch. Robert was also the author of his biographical obituary [7]. Sigismund ’s dynamism could hardly be reflected fully with our narration. Thus, it is worth repeating after his son Robert Asch that his father endangered his own life thousand times in his service as a general practitioner and military doctor in the trenches [1]. His son remarked that during that terrible cholera epidemic once his father managed the patients continuously for 48 hours without break. His service to the wounded and infected people was regarded as a great act of patriotism and sacrifice and also honored by the authorities. Then, for decades he was employed as the “General Doctor of Silesia” [7]. Such a position required such a large amount of daily written work that he did it only in the early morning hours, “before five o’clock in the morning in summer and before 6 am in winter” [7]. At the time, this directorial function limited his admittance of poor patients which was his everyday custom in his primary medical practice [7]. He was also a member of the board of the Medical Chamber of the Breslau District and the chairman of the Association of Breslauer Doctors [7, 44]. He was also socially active as a doctor of a Catholic orphanage and founded a fund for doctors-invalids as well as widows and orphans of doctors. He was a curator of Paulinen-Stiftung as well [7]. His silhouette as ideal for medical doctor–social activist was immortalized as “Doctor Klaus” in the play of the same title by composer, Adolf L’Arronge (1838–1908) [2, 6, 7, 44, 47, 48]. L’Arronge was a wealthy Berlin’s theater director, for whom a magnificent Villa Goldschmidt was built in 1883 at Virchowstraße 43 in Neubabelsberg. This villa was later bought in 1921 by the German–American banker Jacob Goldschmidt (December 31, 1882–September 23, 1955), who was their very far relative. Anyway, this dramatist and theater director was privately the father of Käthe [Catharina Johanna Asch (L’Arronge) born 1872], a wife of gynecologist Robert Asch, son of Sigismund. In Breslau, it was staged for the first time at the magnificent Lobe-Theater at Lessingstraße 8 (now Dobrzyńskiej 21/23), which was completely destroyed during fights in Festung Breslau in 1945 [7, 44]. But it was translated also to Polish and played also, e.g., Cracow, Lvov and Warsaw, so Asch less or more apparently became an ideal example to follow for such medical doctors of the poor as Janusz Korczak, who was fond of theater [26]. In the years 1863–1879, Asch was a member of the city council of Wrocław. His scientific diligence and medical experience were so highly appreciated that he worked there until his son-in-law replaced him in the position of councilor [7]. It was due to the city ordinance that stated that close relatives ought to have not been members of the city council [7]. Sanitary facilities and all sorts of hygienic tasks were the main area of his professional expertise during the 16 years of municipal work [7, 44]. He cared for hygiene issues in schools by actions of the Pedagogical Section, which was a commission of medical doctors and teachers. In 1863, on the first day a trichinosis case was reported, Asch immediately requested an inspection of the meat, and the city council issued such a legal obligation in Breslau [7]. Most of the projects he participated in were aimed at counteraction of any epidemics in future. It was his realized initiative to establish a commission to examine drinking water during the cholera epidemic in 1866 [44]. In his times, riverbed of Schwarze Ohle or Schwarzohlau (Black Olawa; Polish: Czarna Oława) that was a town moat in the medieval past, turned into canal full of filthy rubbish as potential source of infection and infestation, so city council ordered to dry it and fill it with ground on the impression of the latest cholera epidemics in 1866 (Figure 4) [7, 44].

Councilman Asch (Figure 5) got engaged politically in realization of the extension of municipal network of the water supply with a filter system for water conditioning in order to provide safe drinking water to the citizens [7, 44, 51]. Enlargement of water supply network was carried out by engineer John Moor and municipal architect Carl Zimmermann [November 8, 1831 (Elbing)–March 18, 1911 (Hamburg)], who acted in a new water supply company from 1864 that was expected to turn 26.5 km of Wrocław’s waterworks of the mid-XIXth century into larger modern system of water pipes [51]. At the time, English engineer John Moor from Berlin was a praised author of the concept of the Posen gas plant and water filtering plant, or the Stettin (Szczecin) water supply. Moor projected construction of water installations and Carl Zimmermann built one of the still preserved, monumental architectural relics of this great venture is a water tower Wasserturm am Weidendamm, in 1870, in Morgenau district of the city (Figure 6). The whole project was implemented after town planning counselor Carl Zimmermann introduced corrections in the years 1867–1871 for a total sum of almost three million marks [7, 51]. The newly constructed waterworks started functioning on August 1, 1871, and enabled production of 60 000 cubic meters of water per day as the total length of the water supply system approximated 200 km at the turn of the century [51]. However, in 1904, the water intake from the Oder was replaced with the use of deep wells [51].

Figure 4 Plan of Vratislavia from 1562 (Barthel and Georg Weihner) according to copy dated in 1826 by Partsch. Dark thin line highlights basic (inner) medieval moat of Breslau, called Schwarze Ohle or Schwarzohlau (Black Olawa; Polish: Czarna Oława), that was filled with soil and leveled to streets (after epidemics of the year 1866). Grey thick highlights portion of moat that was called Weiße Ohle (White Olawa; Polish: Biała Oława), which was turned into streets Weiße Ohle and Münzstraße (now Janickiego and Kraińskiego streets) earlier in the first half of XIXth century after demolition of municipal fortification in 1807. The remaining outer moat still exists along the Podwale street [am Stadtgraben (at the municipal moat, English translation)] and it has encompassed by the end XVth century fortified suburb of Breslau (Wrocław), so it was regarded simply as the moat while inner moat was called Olhau

Figure 5 Medical Doctor Sigismund Asch

Figure 6 Water tower Wasserturm am Weidendamm projected, modified and built in 1870 by John Moore and Carl Zimmermann

In the next step, Asch contributed to construction urban sewerage infrastructure in the city, with the act of city council in 1874, when the city sewage system was planned in detail to be built north of Wrocław, outside the city outskirts, downstream of the Odra River [7, 44, 51]. There sewage was discharged to the special irrigation fields in Oswitz [51]. Asch together with his wife Jenny inspired her close friend Johanna Pulvermacher, formerly Riess (called caressingly “Hännchen”) (1789) to fund an additional wing to hospital building (Pulvermacherhaus), erected in the years 1869–1870 according to the design of Carl Johann Christian Zimmermann, which housed the clinics and the surgical ward on the west side of All Saints’ Hospital, which had a long tradition as it was initiated by pastor Johann Hess in 1526 and gradually modernized and extended on the banks of Oder river (Figure 7).

Figure 7

Johanna Pulvermacher was a widowed wife of a medical advisor and a member of the Hospital Directory Management Board Christian Leopold Julius “Joel” Pulvermacher (1797–1866). She was so motivated by the Asches that she also precisely defined the building assumptions (e.g., the location of staircases), while the architect’s own contribution was limited to shaping the façade. The Pulvermachers were Breslauer Jews that were greatly devoted to medical social care and various sorts of charity. Being son of Jewish Breslauer medical doctor Joseph Pulvermacher, Christian Leopold Julius Pulvermacher also wrote a book in which he addressed on contemporary medical issues of the time that was primarily published by Friedländer in 1837 [52]. Sigismund Asch was also a member of the presidium of the medical and hygiene section of the Silesian Society of Patriotic Culture (Schlesische Gesellschaft für vaterländische Cultur) for 44 years and served as its secretary [7, 44]. He was also active on the board of the shelter for homeless people as its co-founder [7, 44]. He presided and co-founded a medical aid fund. He belonged to the management of the city hospital, board of the Silesian Medical Association. His merits for pediatric health care were very similar to Janusz Korczak involvement [7, 44]. Namely, he cared for a generation of children at the Catholic Saint Hedwig Stift until his death [7]. Nuns of that charity institution respected this physician and medical adviser so highly that he soon become their loyal and close friend [7]. He suffered from diabetes and was getting older but seemed not to slow down the speed of his strenuous work. During early spring, the period of particularly life-threatening flu infections, he continued to treat his patients in 1901. During one of his visits on March 12, 1901, Asch acquired infection from the patient: “Asch got weakened, started to suffer from fever and attended a friend’s funeral” [44, 51]. Afterwards pneumonia developed. In result, he died on March 17, 1901. He was buried on March 20 in the Jewish cemetery in Breslau at Lohestrasse (Ślężna Street) in presence of crowds of people who gathered despite unfavorable weather [44, 51]. As nowadays lots of medical academicians still reflect on how to support equity and fight against racism, the life story of Dr Asch provides an answer that altruistic medical practice can be the pathway for representatives of exact social groups to help their human rights to be recognized [53]. As immunity of society and health sociology are pivotal challenges in every health system, they were also deeply concerned by such eminent figures in history of medicine as Iuliu Moldovan (1882–1966) and Constantin Stanca (1889–1969) [54, 55]. The examples of mentioned inspiring figures are particularly pronounced in context of pandemics, which should usually evoke strong reactions of public health and public relation services for the sake of endangered integrity of society. Tireless involvement of Asch and Ebstein in health services struck against ostracism of German elites to enable Jewish community full emancipation in the society. In almost every international conflict there usually is an education of hatred for the enemy for both sides of the border which gets accelerated to final war. Thus, in narration against racism, it is important to quote persons like Ebstein, Asch and Korczak instead of historical narration that easily assumes a form of hate speech that anticipates war conflict. Taking this all into account, the context of narration is essential in opening minds of the society in course of pandemics and war around the globe. Asch did not anything in single-handed manner but had a reasonable support of professionals like Ebstein who belonged to Jewish community in his social environment [2, 7, 16]. From Middle Ages, Jews suffered severe persecutions as they were ridiculously accused to cause plagues [56]. Thus, on the way of emancipation Breslauer Jews did all their best to be medical doctors that cure effectively during epidemics to prevent such life-threatening rumors [2, 7]. One of the memento material traces, that were destined to link with such persecutions, is the medieval treasure of the town Środa (Neumarkt in Schlesien): a collection of crown jewels, which were pawned by Charles IV to Jewish banker Muscho (Moshe), who was probably murdered on the way of his escape, shortly after he walled his gold and silver in basement of his tenement house at the time of the Black Death Plague, in 1348, in Lower Silesia [57].

In further perspective, we are deeply convinced that a proper narration about Holocaust should not focus on shocking with descriptions of sadistic cruelties and immortalization of criminals but should center on those victims who shine as heroes of humanity, such as Janusz Korczak, who as a young medical doctor saw a play titled “Doctor Klaus” in Warsaw at the beginning of XXth century and got inspired. This theatre plays about charities of Dr Asch, impressed Korczak so much that he started to follow Asch in his own life. As this information is much less popular than descriptions of appliance of electricity in evoking of convulsions of prisoners of concentration camps, we decided to write a paper about Ebstein, Asch with highlights how they inspired Korczak. As some ideological narration can turn former victims into persecutors, it is always important not to provide an unhealthy sensation, to “electroshock” attention of readers but to immortalize the forgotten heroes of humanity at the time when European community is endangered by war causing totalitarianism that is aimed at total destruction of freedom of western democracy.

Conclusions

The conclusion of our paper is that the real treasures for anti-war narration for society are such Promethean medical doctors like Wilhelm Ebstein and Sigismund Asch and their followers like Janusz Korczak [2, 7, 26]. Considering that the most venerable and tragic victims of war are children, let us pray to heal the ‘eyes of mind’ to look without hate in the Holy Land and all over the globe.

Conflict of interests

The authors declare that they have no conflict of interests.

Acknowledgments

The more this paper is oriented on medical and legal professional issues within roles of the medical doctor and councilman in very formal aspects, the more we would like to dedicate this paper to Dagmar Nick who has presented the life of Sigismund Asch in an anecdotal way in landscape of her colorful family in fascinating book titled “Judisches Wirken in Breslau: Eingeholte Erinnerung. Der Alte Asch und die Bauers” (Würzburg, 1998). Her publication dealt sentimentally with Sigismund Asch, her great grandfather as Dagmar’s mother, Käte Nick-Jaenicke had the same surname as Dagmar’s grandmother (Asch’s daughter) Julia Bettina (Betty) Jaenicke who married her grandfather, jurist Karl Jänicke (1849–1903) who held a post of second mayor (Bürgermeister) of Breslau in 1902, while both her parents devoted their lives to music: her mother Käte was a professional singer who married Dr. jur. (Doctor of Laws) Edmund Josef Nick, a composer, pianist, Breslauer radio artistic music director and conductor of orchestras of Breslauer theaters, e.g., Lobetheater, where “Dr Klaus” was played. The story of this family is an model example of career of Jewish family through generations in XIXth and XXth centuries from low classes of the society via gaining financial wealth by posts of merchants, manufacturers and bankers, to social service and charity as medical doctors and lawyers in roles of municipal councilmen and further to devotion to art and culture particularly theatre and opera, which is somehow shown in an another example of the Bloch-Bauers family from Vienna in popular movie “Woman in Gold”.
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