Abstract
On 4 March 1905 in the Journal de Genève 1 a note (Figure 1) appears inviting a German doctor to chair the Department of Pathology at the University of Geneva (Figures 2–4).
Askanazy is invited to join the staff of the Faculty of Medicine, Geneva. Journal de Genève, 4 March 1905
Announcement of Askanazy's death. Journal de Genève, 23 January 1940
Young Dr Askanazy
Professor Askanazy
Max Askanazy was a Jew, a German Physician born at Stallupönen, East Prussia on 24 February 1865 to Joseph-Samuel and Stephanie Elisabeth Maria Gerstel. According to the Jewish Encyclopaedia 2 he received his high school education in Königsberg, Prussia and studied medicine there, graduating in 1890 when he became Assistant at the Pathological Institute. In 1893 he was promoted to Lecturer. Askanazy worked in the Pathological Institute until 1895 under Ernst Neumann (1834–1918) who, in 1898 described the presence of nucleated red blood cells in the bone marrow of humans and rabbits, was the first to conclude erythropoiesis continues in the bone marrow.
From 1894 Askanazy concentrated on general pathology, pathological mycology and pathological anatomy, becoming titular Professor in 1903. In 1905 he accepted an invitation to become Professor of General Pathology in Geneva, succeeding Friedrich Wilhelm Zahn (1845–1904). He worked and taught there until 1939 and became a Citizen of Honour of Geneva in 1935.
While still in Germany Askanazy observed that some diseases had been brought from abroad, for example leprosy and other parasitic diseases. When he came to Switzerland he found goitre and a high incidence of cirrhosis of the liver. In 1928 he founded the Société Internationale de Pathologie Géographique. 3, 4 The First International Conference was held in Geneva in 1931 and was devoted to cirrhosis of the liver and was attended by delegates from 24 countries. A second conference took place at Utrecht in 1934 on gastric ulcer and, at a third conference in 1937 in Stockholm, anaemias were discussed. Askanazy had planned originally that the geographical analysis of the causes of a disease must include the investigation of ‘climate, soil, food, customs, general civilization, economic status and hygiene’. However, instead the society consisted primarily of specialists in pathology and pathological anatomy who certainly did not have the experience to develop debate on the geography of diseases and geographical pathology, a subject that requires the close co-operation of workers from many different fields.
Max was the author of more than 170 articles on clinical and pathological–anatomical subjects. 5–10 The faculty recruited famous international experts to teach there, including Max Askanazy 11 whose numerous publications on pathological anatomy, haematology, parasitology, oncology and endocrinology made him a well-known scientist. His interest in biochemistry prompted him to create a specialized laboratory within the University Institute of Pathology 12–14 and here he investigated the correlation between copper and liver cirrhosis, following his observation about the frequency of this condition in the Geneva region (it is not clear whether this was hepatolenticular degeneration, Wilson's disease).
In 1903 Askanazy was the first to note the association of amyloidosis with multiple myeloma. His works on blood formation, animal parasites, the pathology of bones, and experimental and spontaneous formation of tumours in man are still quoted in current literature.
In agreement with the Will of its founder, a French lawyer who resided in Lausanne and who died in 1918, the Marcel Benoist Prize has been awarded every year since 1920 to scientists working in Switzerland who have made, as formulated in the founder's testament, ‘the most useful scientific discovery or study, in particular in disciplines which are of significance for human life’. With its administration linked tightly to the Federal Government, the Marcel Benoist Prize, the oldest scientific award in Switzerland, has come to be regarded as the Swiss Confederation's highest recognition for outstanding achievements in the sciences and the humanities. Max Askanazy received the prize in 1934.
The high esteem in which his pupils and friends held him was shown on the occasion of his 60th birthday in 1925 when they dedicated to him a Festschrift that formed part of the 254th volume of Virchow's Archiv. 15 Askanazy died on 23 October 1940 in Geneva (Figure 2). 16
Several eponyms remind us of Askanazy. The Askanazy and Maurice Roch syndrome consists of oedematous cachexia or aquosa, due to ancylostomiasis (Ancylostoma duodenale infection of humans or animals with hookworms of the genus ancylostoma). Characteristics include anaemia, dyspepsia, eosinophilia and abdominal swelling.
Hürthle-Askanazy cells (B Karl Hurthle cells or M Askanazy's cells) are large granular eosinophil-staining epithelial cells with acidophilic cytoplasm occasionally present in the thyroid gland. Max Askanazy first described them in 1898. 17
Jurgen Nilsen Schaumann's bodies are inclusion bodies composed of calcium and proteins in the giant cells (Langhans' giant cells) seen in granulomatous conditions including sarcoidosis and berylliosis. The cells are rounded, with a diameter of 8–300 µm, made up of concentrically layered lamella. They are easily recognized in infrared light. These bodies were first described by the German physician Oscar von Schoppel (1837–81) in 1871 and again by Max Askanazy in 1921 as Kalkdrusen. Theodor Langhans (1839–1915), German pathologist, is remembered for his discovery of multinucleated giant cells that are found in granulomatous conditions and are now referred to as Langhans giant cells. His name is also associated with ‘Langhans layer’, a cytotrophoblastic layer in the chorionic villi.