Discussions of dementia have quite a storied history. None other than Cicero (106-42 BC), Hippocrates (460-377 BC), Aristotle (384-322 BC), Galen (150-200 AD), and Celsus (1st century AD), Solon (638-558 BC) and Plato (424-348 BC) have mentioned the symptoms.
Prior to its identification as a neurologic condition separate and distinct from insanity, patients that would later be diagnosed with Alzheimer's disease often languished in asylums. The picture you see to the left is the actual City Asylum for the Insane and Epileptic, in Frankfurt am Main, Germany. This is where the diagnoses of dementia and mental illness became identified as Alzheimer's disease.
Alzheimer-Munich: Cerebral Cortex On an Unusual Illness of the Cerebral Cortex
What is your name?
The file begins as follows ( italics denote Auguste D’s answers):
Nov 26, 1901
She sits on the bed with a helpless expression. What is your name? Auguste. Last name? Auguste. What is your husband’s name? Auguste, I think. Your husband? Ah, my husband. She looks as if she didn’t understand the question. Are you married? To Auguste. Mrs D? Yes, yes, Auguste D. How long have you been here? She seems to be trying to remember. Three weeks. What is this? I show her a pencil. A pen. A purse and key, diary, cigar are identified correctly. At lunch she eats cauliflower and pork. Asked what she is eating she answers spinach. When she was chewing meat and asked what she was doing, she answered potatoes and then horseradish. When objects are shown to her, she does not remember after a short time which objects have been shown. In between she always speaks about twins. When she is asked to write, she holds the book in such a way that one has the impression that she has a loss in the right visual field. Asked to write Auguste D, she tries to write Mrs and forgets the rest. It is necessary to repeat every word. Amnestic writing disorder. In the evening her spontaneous speech is full of paraphrasic derailments and perseverations.
Extracts from Nov 29, 1901
. . .What year is it? Eighteen hundred. Are you ill? Second month. What are the names of the patients? She answers quickly and correctly. What month is it now? The 11th. What is the name of the 11th month? The last one, if not the last one. Which one? I don’t know. What colour is snow? White. Soot? Black. The sky? Blue. Meadows? Green. How many fingers do you have? 5. Eyes? 2. Legs? 2.
. . . If you buy 6 eggs, at 7 dimes each, how much is it? Differently. On what street do you live? I can tell you, I must wait a bit. What did I ask you? Well, this is Frankfurt am Main. On what street do you live? Waldemarstreet, not, no. . . . When did you marry? I don’t know at present. The woman lives on the same floor. Which woman? The woman where we are living. The patient calls Mrs G, Mrs G, here a step deeper, she lives. . . .I show her a key, a pencil and a book and she names them correctly. What did I show you? I don’t know, I don’t know. It’s difficult isn’t it? So anxious, so anxious. I show her 3 fingers; how many fingers? 3. Are you still anxious Yes. How many fingers did I show you? Well this is Frankfurt am Main.
In spite of these remarkable findings the case presentation received lukewarm attention and little to no discussion following the conference for quite some time--in spite of the symptoms characterized in a woman significantly younger than a typical patient with dementia. Questions to explore include the questionable naming of the disease after Alois Alzheimer and the disappearance and reappearance of Auguste Deter's brain many years later...