Albert Ludwig Sigesmund Neisser

The most significant advances in the diagnosis and treatment of venereal diseases were made in the late nineteenth and early twentieth century. One of the greatest names in this pioneering work was Albert Neisser. Neisser is remembered for his discovery of the gonococcus, the bacterium that causes gonorrhoea, for his work on lepra and the contagion of syphilis in man and animals.

Albert Ludwig Sigesmund Neisser was born in the Silesian town of Schweidnitz near Breslau, the son of a well known Jewish physician, Moritz Neisser (1820-1896). His mother died before he was a year old, and he was raised by his stepmother. Neisser attended the Volksschule in Münsterberg, then entered the St. Maria Magdalena Gymnasium in Breslau, where Paul Ehrlich (1854-1915) was a classmate.

Neisser began his medical studies in Breslau in 1872. Except for one semester of clinical work in Erlangen, his studies were carried out in Breslau. His studies were not outstanding – in fact he had to repeat the chemistry test – but he passed the state examination and received the medical degree in Breslau in 1877 with a thesis on echinococcosis, prepared under the direction of the internist Michael Anton Biermer (1827-1892). His other teachers included Rudolf Peter Heinrich Heidenhain (1834-1897), Julius Friedrich Cohnheim (1839-1884), Carl Weigert (1845-1904), and Carl Julius Salomonsen (1847-1924). Neisser originally planned to become a specialist in internal medicine, but there was no opening for assistants in Biermer's clinic. It was therefore purely by chance that he turned to dermatology and became an assistant physician to Oskar Simon (1845-1892) in the dermatology clinic originally founded by Heinrich Koebner (1838-1904). He worked here for two years, and it was here, in 1879, Neisser discovered the gonococcus.

Neisser's discovery occurred in the wake of the rapid development of the new field of bacteriology. It was made possible in large part by his close association with Ferdinand Cohn (1828-1898), the botanist who also gave invaulable help to Robert Koch (1843-1910). Cohn taught him Koch's smear tests for the identification of bacteria., while Cohnheim and Weigert taught him staining techniques, including those with methylene blue. Neisser was further able to make use of a new Zeiss microscope that incorporated Ernst Abbe's (1840-1905) innovative condenser and oil-immersion system. He at first called the microorganism that he thus observed "micrococcus"; they were then given the name "gonococcus" by Paul Ehrlich. Neisser's paper Über eine der Gonorrhoe eigenthümliche Micrococcenfork, published in 1879, was a milestone in elucidating the aetiology of venereal diseases. Neisser was then 24 years of age. Althoug his discovery was extremely important, it was not until the advent of penicillin that this widespread disease could be controlled. His students affectionately called him the "father of gonococcus".

A journey to Norway
Neisser in 1879 made a research trip to Norway. He was able to examine more than 100 patients with leprosy in Trondheim, Molde, and Bergen, and to take secretion smears back to Germany to study. In examining the smears he found, in almost all cases, "bacilli as small, thin rods, whose length amounts to about half the diameter of a human red blodd-corpuscle and whose width I estimate at one-fourth the length."

These results embroiled him in a priority dispute with the Norwegian bacteriologist Gerhard Armauer Hansen, who had found similar microorganisms in leprosy secretions as early a 1873. When Neisser published his findings in 1880, Hansen responded with a paper, published in four languages, in which he stated his earlier claim. It is clear, however, that while Hansen first discovered the leprosy bacillus, Neisser was the first to identify it as the etiological agent of the disease. The etiology, diagnosis, and prophylaxiss of leprosy occupied him for much of his subsequent career. He also studied lepra in Spain.

A brilliant career
Neisser was habilitated as a lecturer in dermatology in Leipzig in 1880, and on August 6 that year was named Privatdozent. Two years later, in 1882, he was called to Breslau to become extraordinary professor of skin- and venereal diseases, succeeding Simon, who had died of cancer, and also became director of the dermatology department. His promotion at the age of twenty-seven was sponsored by Friedrich Althoff (1839–1908), the allmight Prussian councellor for education and cultural affairs. In the following year Neisser married Toni Kauffmann, who assisted him in his investigations and accompanied him on research trips. At about the same time he became involved in planning a new dermatological clinic, which, built to his designs, was opened in 1892 and became an internationally famous research center.

Neisser in 1894 was appointed Geheimer Medicinal-Rat. In 1896 he rejected an invitation to Berlin.

Syphilis
Neisser subsequently undertook investigations on lupus, but syphilis was to become his next major research area.

Following the demonstration in 1903 by Elie Metchnikoff (1845-1916) and Pierre-Paul-Émile Roux (1853-1933), that syphilis could be communicated to apes, Neisser in 1905 and 1906 went to Java – on an expedition he personally financed – to obtain ape specimens and to continue his research toward determining the the cause of the disease. It was on May 16, 1905, that he received the news that Fritz Richard Schaudinn (1871-1906) and Erich Hoffmann (1868-1959) had succeeded in discovering and isolating the syphilis spirochaete. During his second Java trip he studied the transmission of syphilis among both apes and men. The temporary stationing of Dutch soldiers in Java supplied him an ample material of human syphilis patients.

Neisser also worked with August Paul von Wassermann (1866-1925) in developing the Wassermann test for syphilis. In 1906 he encouraged Wassermann to study seroreaction in syphilis. With him and with Carl Bruck (1879–), he developed the serological test, now named for Wassermann. Neissser also contributed to Ehrlich's introduction of Salvarsan in 1910.

Neisser's was also active in the field of public health, propagandizing better prophylactic measures and more public education about venereal diseases. He was active founding the Deutsche Gesellschaft zur Bekämpfung der Geschlechtskrankheiten in 1902. He organized continuous diagnostic supervision of prostitutes and strongly supported stricter regulation of prostitution, and favoured increased sanitary measures rather than police action.

His attempts to discover the cause of syphilis through a series of inoculation experiments were unfortunate. He was accused of having "maliciously inoculated innocent children with syphilis poison," and a scandal resulted. In 1910 he was publicly sensored and fined for injecting syphilitic serum into four healthy people. No useful observations were apparently obtained from this venture. Ironocally, Gerhard Armauer Hansen had caused a similar scandal when he, in 1880, inoculated the eye of a woman suffering from a neural form of the lepra with material drawn from a leprous nodule of a patient suffering from the cutaneous form. Hansen's venture, too, was futile.

In 1907 Neisser became the first clinical dermatologist to be named full-time professor of dermatology at Breslau.

Neisser was also known for his organisational talent, not only for scientific congresses, but also for popular science, arranging exhibitions. In 1988, with Pick, he founded the Deutsche Dermatologische Gesellschaft.

The death of his wife, in 1913, affected Neisser deeply. He was a diabetic and fell and broke his femur a few years before his death, never recovering his health completely. His health began to fail rapidly in 1916. He suffered with renal calculi and after having colic and cystitis had the stone removed from his bladder in Berlin and returned to Breslau, but developed septicaemia and died shortly after he was named a member of the Imperial Health Council.

In 1920 his house was made a museum; in 1933 it was confiscated by the Nazis and turned into a Gasthaus. Neisser's papers were salvaged by a Schweinfurt physician named Brock and form the basis for recent works about him.

• Ueber eine der Gonorrhoe eigentümliche Micrcoccenform.
  Centralblatt für die medicinischen Wissenschaften, Berlin, 1879, 17: 497-500.
  Discovery of the gonococcus – causal organism in gonorrhoea.
• Ueber die Aetiologie des Aussatzes. Jahresberichte der schlesischen Gesellschaft für vaterländische Cultur, Breslau, 1880, 57: 65-72.
  Neisser obtained leprosy tissue form Hansen and, using aniline dyes for staining Mycobacterium leprae, was able to demonstrate it more convincingly than Hansen.
• Weitere Beiträge zur Aetiologie der Lepra.
  [Virchows] Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, Berlin, 1881, 84: 514-542.
• Die Mikrokokken der Gonorrhoe.
  Deutsche Medizinische Wochenschrift, Berlin, 1882, 8: 279-283.
• Die chronischen Infektionskrankheiten der Haut.
  In: Hugo Wilhelm von Ziemssen (1829-1902), editor: Handbuch der speciellen Pathologie und Therapie. Leipzig, 1880, IV: 560-723.
• Über das Leykoderma syphiliticum.
  Vierteljahrsschrift für Dermatologie und Syphilis, 1883, 15: 491-508.
• Ueber die Mängerl der zur Zeit üblichen Prostituiertenuntersuchungen.
  Deutsche medicinische Wochenschrift, Berlin, 1890, 16: 834-837.
• Pathologie des Ekzems.
  Archiv für Dermatologie und Syphilis, Berlin, 1892. Supplement 1: 116-161.
• Über den gegenwartigen Stand der Lichenfrage.
  Archiv für Dermatologie und Syphilis, Berlin, 1894, 28: 75-99.
• Über Vitiligo mit lichenoiden Eruptionen.
  Verhandlungen der deutschen dermatologischen Gesellschaft. IV. Kongress zu Breslau. Wien, Leipzig, 1894: 435-439.
• Syphilis maligne. Journal des maladies cutanées et syphilitiques, 1896, 9: 210-213.
• Die Einreibungskur.
  [Volkmanns] Sammlung klinisher Vorträge, Leipzig, 1897, 199: 1083-1114.
• Was wissen wir von einer Serumtherapie der Syphilis und was haben wir von ihn zu Hoffen?
  Archiv für Dermatologie und Syphilis, Berlin, 1898, 44: 431-439.
• Über Versuche, Syphilis auf Schweine zu übertragen.
  Archiv für Dermatologie und Syphilis, Berlin, 1902, 59: 163-170.
• Zur Erinnerung an den 25 jährigen Bestand der Breslauer Hautklinik 1877 bis 1902. Archiv für Dermatologie und Syphilis, 1902, 60: 1-36.
• Meine Versuche zur Übertragung der Syphilis auf Affen.
  Deutsche medicinische Wochenschrift, Berlin, 1904, 30: 1369-1373, 1431-1434.
• Weitere Mitteilungen über den Nachweis spezifischer luetischer Substanzen durch Komplementbindung. With August Wassermann, Carl Bruck and A. Schucht.
  Zeitschrift für Hygiene und Infektionskrankheiten, 1906, 55: 451-477.
• Über die Bedeutung der Lupuskrankheit und die Notwendigkeit ihrer Bekämpfung. Leipzig, 1908.
• Über das neue Ehrlich'sche Mittel.
  Deutsche medicinische Wochenschrift, Berlin, 1910, 36: 1212-1213.
• Beiträge zur Pathologie und Therapie der Syphilis.
  Arbeiten aus dem Kaiserlichen Gesundheitsamte, 1911, 37: 1-624.
• Syfilis und Salvarsan. Berlin, 1913.
• Ist es wirklich ganz unmöglich, die Prostitution gesundheitlich unschädlich zu machen? Deutsche medicinische Wochenschrift, Berlin, 1915, 41: 1385-1388.
• Über das urtikarielle Ekzem.
  Archiv für Dermatologie und Syphilis, Berlin, 1916, 121: 579-612.
• Geschlechtskrankheiten und ihre Bekämpfung. Berlin, 1916.
• Scholz, G. Sebastian:
  Albert Neisser und seine Schüler. In: J. J. Herzberg and G. W. Korting, editors: Zur Geschichte der deutschen Dermatologie. Grosse, 65-75, Berlin 1987.
• G. Sebastian and A. Scholz:
  Albert Neisser (1855-1916) und die Moulagensammlung in Breslau.
  Der Deutsche Dermatologe, 1993, 7, 771-773.
• Neisser, Albert.
  In: J. Pagel, publisher: Biographisches Lexikon hervorragender Ärzte des neunzehnten Jahrhunderts. Urban & Schwarzenberg, Berlin and Vienna, 1901: 1193-1196.
• H. Schadewaldt:
  Neisser, Albert Ludwig Sigesmund.
  In: Charles Coulston Gillispie. Editor in chief: Dictionary of Scientific Biographies. Charles Scribner’s Sons. New York, 1970. © 1970. American council of learned societies.
• A. L. S. Neisser. In: B. G. Firkin and J. A. Whitehead: Dictionary of Medical Eponyms. Parthenon Publishing Group. 1989.