Eduard Heinrich Henoch

Eduard Heinrich Henoch's father was a royal tax collector. He received his first education at the Joachimsthaler Gymnasium, and then commenced the study of medicine at the University of Berlin, where one of his teachers was his uncle Heinrich Moritz Romberg.

Henoch was a pupil of Johann Lukas Schönlein, also attending the lectures of Friedrich Schlemm (1795-1858), Jakob Henle (1809-1885) and Johann Friedrich Dieffenbach (1792-1847), all medical authorities in Germany at that time.

After graduating in doctor of medicine in 1843 with the dissertation De atrophi cerebri, Henoch went for an educational journey to Italy and Switzerland.

In 1844 he became assistant at the Berlin University Policlinic, an outpatient clinic headed by his uncle, Moritz Heinirich Romberg (1795-1873). He soon began to publish paediatric studies, and also translated books by George Budd (1808-1882), Sir Henry Holland (1788-1873), Mathéo-José-Bonaventure Orfila (1787-1853), and Bourguignon.

In addition to his duties at the Poliklinik, Henoch worked as an Armenarzt, a doctor for underprivileged persons. This position gave young doctors the chance to gain practical experience. In December 1849 he completed his postgraduate training in internal medicine, qualifying him for a lecturing license. He was habilitated as Privatdozent in 1850.

Henoch formally left the Poliklinik in 1851, but continued his university affiliation through lecturing and publishing while conducting his own practice. On September 18, 1858, in appreciation of his scientific work, Henoch was appointed ausserordentlicher Professor (associate professor).

Shortly after the birth of their daughter in 1860, Henoch’s wife (date of marriage unknown), Helene Luise Henoch, née Behrens, died from scarlet fever at the age of 25. After this shock, Henoch threw himself into his work. On January 12, 1860 he was able to open his Kinderklinik, a children’s outpatient clinic located in Henoch’s private rooms on the Wilhelmstrasse in Berlin and existing until 1871.

The opening of the Kinderklinik is a clear sign that Henoch had forsaken his thoughts of having an academic career in internal medicine, and at that times no professor ordinarius (full professor) positions in paediatrics yet existed in Germany. Still, however, he continued to publish.

Henoch had hoped to succeed Romberg as director of the Berlin University Poliklinik, but this never happened, most probably due to conflict with the minister von Mühler. Henoch was a liberal, but his minister was a strict conservative. Henoch being a converted Jew may also have provoked some anti-Semitic tendencies. Henoch therefore resigned in 1868. In 1872, however, under the minister Adalbert Falk (1827-1890), he resumed his work as assistant professor of children's diseases at the Berlin faculty, and that year was made director of the clinic and policlinic for children's diseases at the Berlin Charité, succeeding Hermann Friedrich Ludwig Ebert (1814-1872). He held this position until 1893. This was the first children’s hospital in Germany, founded in 1830.

During Henoch’s directorship the annual number of new admissions rose from 400 under Ebert, to almost 1200 in the 1880s. The number of outpatients also increased, from about 500 a year to more than 4000 per year by 1884. Throughout the years of Henoch’s directorship of the Kinderklinik, he strove to improve conditions and to reduce the high mortality, due to adverse conditions. Despite Henoch’s great efforts, his successor Johann Otto Leonhardt Heubner (1843-1926) found the situation in the Kinderklinik deplorable when he became director in 1894. Heubner, in 1913, was first to receive title of full professor of paediatrics at a German university.

In the first edition of his main work, Vorlesungen über Kinderkrankheiten, he argued against modern bacteriology, calling it Bakterienschwindel (Swindle of Bacteria). He later changed his opinion. In his text he also mentioned social factors as influential in childhood diseases.

In 1889, Henoch received a medal of high distinction, the Rothe Adlerorden. For his 70th birthday in 1890, he was presented a Festschrift (commemorative volume) with 24 articles written by colleagues and edited by Adolf Baginsky (1843-1918). The same year, Henoch wrote an article for the Klinisches Jahrbuch (Clinical Yearbook), in which he placed his scientific statement. He demanded separation of internal medicine and paediatrics, establishment of hospitals for children at the universities, and obligatory examinations for students in paediatrics.

After retiring in 1893 Henoch spent the years 1893 to 1899 in Meran with his daughter’s family and from then lived in his small villa in Dresden until his death on August 25, 1910. He was buried in Berlin at the community cemetery on Luisenstrasse.

Henoch's name is perpetuated in medical history chiefly through his description of the connection between purpura and abdominal pains - Henoch's purpura. Henoch illustrated his description of this condition with a sickness history with a 15-year-old adolescent, which Henoch had been called to see on April 16, 1868. In this work the purpura is entered as Schönlein-Henoch, the former having described it first. The single eponyms Henoch’s purpura or disease and Schönlein’s purpura are also used. The description is thus named both for each of teacher and student separately, and for the two of them - both ways.

Henoch was also the first to describe purpura fulminans, which is sometimes called Henoch’s Purpura II (misnomer). He presented a paper on this to the Berlin Medical Society on December 15, 1886.

Henoch wrote extensively on childhood illness and in 1872 published the fifth German edition Charles West's (1816-1898) work Lectures on Diseases of Infancy and Childhood, first published in London in 1848. The German title was Pathologie und Therapie der Kinderheilkunde.

Henoch was privy medical counsellor.

• De atrophia cerebri. Doctoral dissertation, Berlin, 1843.
• Vergleichende Pathologie der Bewegungs- und Nervenkrankheiten des Menschen und der Haustiere, 1845.
  (Comparative Pathology of the Diseases of the Locomotor and Nervous Systems of Man and Domestic Animals).
• Klinische Ergebnisse. Gesammelt in dem kgl. poliklinischen Institut der Universität.
  Edited by Henoch and Ernst Moritz Romberg. Berlin, 1846.
• Klinische Wahrnehmungen.
  Edited by Henoch and Ernst Moritz Romberg. 1852.
• Klinik der Unterleibskrankheiten. 3 volumes; Berlin, 1852, 1854, 1858.
• Beiträge zur Kinderheilkunde.
  Berlin, A. Hirschwald, 1861.
  In the first edition, 2. Hefte, 1861, Henoch reported 426 cases he had seen in his Kinderklinik. In a new edition, 1868, he reported on 4500 cases.
• Vorlesungen über Kinderkrankheiten. Ein Handbuch für Aerzte und Studirende.
  Berlin, Verlag von August Hirschwald, 1881. 6th edition, Berlin, 1892, XII + 888 pages.
• Ueber Purpura fulminans. Berliner klinische Wochenschrift, 1887, 24: 8-10.
  
  Biographical:
  
  
• A. Förster:
  Eduard Heinrich Henoch – ein Leben im Kampf um die Anerkennung der Pädiatrie.
  Medical dissertation, Humboldt-Universität Berlin, 1964.
• Watson, in Archives of Pediatrics, New York, 1893.
• Arthur Schlossmann (1867-1832), in Münchener medizinische Wochenschrift, 1910, 28: 1504-1505.