As one who has searched since 1983 for the eponymic Alzheimer case record, I congratulate Konrad Maurer and colleagues (May 14, p 1546)1
on their exciting discovery of the file on Auguste D. Their remarkable find represents another milestone in the early story of Alzheimer's disease, to which I would like to add a note on the largely forgotten role of Dr Solomon Carter Fuller (1872—1953) who, in 1912, reported the tenth of a heterogeneous early group of cases called “Alzheimer's disease”.2
In a 1912 paper that described his own patient with Alzheimer's disease and reviewed the cases published to that time, Fuller provided the first English translation of Alzheimer's original 1907 case.3
Fuller also suggested that the patient originally reported by Alzheimer was the same case as that reported in 1910 by Alzheimer's junior collaborator, Gaetano Perusini (1879—1915), as the first of four cases of “clinically and histologically peculiar illnesses of later life”. Fuller also published his own 1912 Alzheimer case in German, including clinical and neuro-pathological details.
Photograph showing seated, left to right, Alzheimer and Fuller
Recognition of the identity of Alzheimer's original case with Perusini's first case seems to have been forgotten since Torack's historical overview in 1978,2
in which he describes the first 13 published cases of Alzheimer's disease and refers to Perusini's “four cases including Alzheimer's original case and a subsequent case (actually, one of cerebral syphilis with tangles and plaques!) published by Bonfiglio (another of Alzheimer's junior collaborators) in 1908”. Bick and Amaducci rediscovered this identity in 1989 and more recently acknowledged Fuller's role.4
So Maurer and co-workers were mistaken in their assertion that the identity of Alzheimer's original case with Perusini's first case “was not completely clear until now”. As Perusini's and Fuller's papers indicate, the identity of these cases has always been clear, though temporarily forgotten, and is now happily confirmed by the discovery of the actual case record.
Fuller studied with Alzheimer in Munich in 1905 during a sabbatical from his position as pathologist at Westborough State Hospital in Massachusetts, USA. The photograph is testimony to the seminal influence of Alzheimer on Fuller (personal communication, Solomon Carter Fuller II). Alzheimer had been in Munich for only 1—2 years when they collaborated, at a time when Auguste D was in the terminal stage of her illness in the Frankfurt asylum. Even before her death in 1906, Alzheimer and his collaborators' work on tangles and plaques influenced Fuller's work on comprehensive clinicopathological examination of neurofibrils in several degenerative diseases.
I thank Solomon Carter Fuller II, Charles Pinderhughes, Doris Bunte, and Kenneth Minaker.