Henderson JK, Henderson MA. Arthur Schüller: Founder of Neuroradiology. A Life on Two Continents. Hybrid Publishers; 2021; 218 pp; $18.41
While radiologists (mostly those in the older age group) recognize the name “Schüller” to be associated with the lateral oblique view of the mastoid air cells, the contributions of Arthur Schüller go far beyond a single eponym in radiography. This biography traces the life of Arthur Schüller from his birth in 1874 in Brno in what is now the Czech Republic to his death in Melbourne, Australia in 1972. The triumphs and tragedies that unfolded in this 98-year odyssey are revealing not only from a medical/radiologic/neurosurgical standpoint, but also from a historical perspective, since his life and the life of his family spanned a lengthy period in Europe, part of which was gruesome nearly beyond description.
This biography was written jointly by John Keith Henderson (a now-deceased neurosurgeon from Melbourne) and his son, Michael Henderson (a surgical oncologist). The life of Schüller was chronicled over years by John Henderson, a man who worked with Schüller and greatly admired his work and contributions to the neurologic sciences.
This brief review serves not to summarize the life of Arthur Schüller, his family, and his associates, but instead is intended to pique the curiosity of those who are interested in understanding why Schüller has been considered the founder of neuroradiology. Contained in this book is a history lesson concerning Europe, the Austrian-Hungarian Empire, anti-Semitism, the rise of national socialism in Germany, and the atrocities that accompanied nazism during the early to mid-20th century.
During his years as a student in Vienna and in the time after graduation, Arthur’s intellectual curiosity and talents (music among them) were significant and helped shape approaches to neurologic disorders, and he was the first to describe the rudiments of imaging of the skull. Woven into this biography is a description of the status of medical education in Vienna and other emerging centers in Europe, allowing one to understand how the tides of medical and scientific dominance changed from country to country.
Schüller’s post–medical school training was in neurology and psychiatry; his early publications were in those fields, and this expanded to research into detailing the anatomy and deep brain nuclei, such as the caudate nucleus. In doing so, he developed biopsy instruments that were among the earliest used in brain biopsies. While procedures such as cordectomies are now basically of just historical interest, other concepts and implementation were cisternal punctures and drainage of CSF in hydrocephalus. These allow us to see the man who established the early beginnings of neuroradiology. Note should be made that these contributions occurred before and up to the time of World War I. In addition, he did possess one of the early pieces of x-ray equipment (installed in 1905), which allowed him to begin a systematic analysis of the skull. He rose to the rank of professor in Vienna and taught one of the earliest courses in radiology, entitled “Radiology from the Standpoint of the Neurologist.”
The third chapter of the book, “Images and Imagination: Neuroradiology,” gets to the heart of why Schüller is considered by many to be the founder of neuroradiology. Characterization of structures at the skull base was another major subject of Schüller’s attention in the development of neuroradiology. Well interspersed within this chapter are descriptions of the early surgical approaches to skull base masses, such as pituitary tumors, and how he was intently involved in the surgical discussions of these patients. We also learn of the naming of Hand-Schüller-Christian disease (one of the components of histiocytosis).
The issue of who should be considered the founder of neuroradiology was not uncontentious, but that unofficial title was linked to him by many luminaries in the field in the 1930s. Suffice it to say that there is solid agreement that Schüller did introduce the term “neuroradiology” to medicine. Of side interest is the mention of the first Symposium Neuroradiologicum in Antwerp in 1938 and the prominent radiologists who attended.
Moving from medicine, radiology, and neurosurgery, the fourth chapter describes the tragic events that overtook Germany and Austria in the 1930s. Eduard Pernkopf, the well-known anatomist, rose to power because of his devotion to nazism, and this in turn allowed him not only to become Dean of the Medical School in Vienna, but also enabled him to purge those of the Jewish faith from the faculty, Schüller among them. What follows is a description of the travails and tragedies that had befallen the Jewish community, resulting in the exodus of Schüller to Australia. The reasons for immigration to Australia via Oxford rather than the United States were multifold, but in the end he and his wife settled in Melbourne.
The ensuing chapter describes Schüller’s integration into life in Melbourne and his main sponsors/supporters and colleagues—Dr. O’Sullivan, a radiologist, and Dr. Morgan, a neurosurgeon—both of whom were at St. Vincent’s Hospital. There, Schüller was a clinical radiologist, a teacher, and acted frequently as a consultant to the neurologic/neurosurgery services. While successes in Australia accumulated, he and his wife learned in 1945 of the murder of members of his immediate family by the nazis in concentration camps. How he remained steadfast through this time is remarkable.
For neuroradiologists who are interested in the early historical development of our specialty and wish to gather a deep insight into those who shaped it, this book is recommended.