Professional Documents
Culture Documents
Annals of Anatomy
journal homepage: www.elsevier.com/locate/aanat
RESEARCH ARTICLE
a r t i c l e i n f o a b s t r a c t
Article history: Eduard Pernkopf (1888–1955) became head of the Second Anatomical Institute in 1933, dean of the
Received 29 January 2021 medical faculty in 1938 with the Annexation of Austria into Nazi Germany, and rector of the University
Accepted 29 January 2021 of Vienna in 1943. He gained worldwide recognition with his anatomical atlas, which many consider
Available online 23 February 2021
unequaled to this day. In the decades that followed, suspicion arose that the drawings were made using
corpses of people who had been victims of Nazi persecution and, following international inquiries and
Keywords:
critique, the University of Vienna appointed a historical commission to the matter. The commission
History of anatomy
published its results in 1998, concluding that anatomical specimens used for the illustrations in Pernkopf’s
Vienna Anatomical Institute
Anatomical illustrations atlas had in all likelihood been made using corpses of victims of the Nazi judicial system. In total, the
National socialism Anatomical Institute received the corpses of at least 1377 executed people, including many members of
Nazi victims the anti-Nazi resistance.
Eduard Pernkopf Through the acquisition of Pernkopf’s original publisher Urban & Schwarzenberg in 2003, the original
Pernkopf atlas drawings and the publishing rights went to Elsevier. While existing copies of Pernkopf’s Anatomy remain
in use, printing or licensing of the atlas or its illustrations were stopped in 1994, inducing an effective ban
on publishing the illustrations in other contexts, for example in works dealing with history and ethics of
anatomy.
In December 2019, Elsevier donated the remaining original drawings and proofs to the Medical Univer-
sity of Vienna, ensuring that these returned to the institution where they originated. They are now part
of the university’s historical collections held at the Josephinum. Moreover, the transfer of the originals
to Vienna ensures appropriate archiving and conservation, cataloging and digitization, as well as access
to the illustrations for historical and related research.
© 2021 The Authors. Published by Elsevier GmbH. This is an open access article under the CC
BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
https://doi.org/10.1016/j.aanat.2021.151693
0940-9602/© 2021 The Authors. Published by Elsevier GmbH. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/
4.0/).
H. Czech, C. Druml, M. Müller et al. Annals of Anatomy 237 (2021) 151693
under emperor Joseph II as a military-surgical academy that has Wiesenthal “non-Jewish Austrian patriots, communists and other
served since 1920 for the study of the history of medicine. The aim enemies of the Nazis,” raising the question if these had been used
of the present paper is to inform the anatomical community of this for Pernkopf’s atlas. Williams furthermore documented the Nazi
important step towards a musealization of the Pernkopf collection, allegiances of the primary illustrators employed by Pernkopf, Erich
to describe its present state and to lay out principles for its handling Lepier (1898–1974), Ludwig Schrott (1906–1970), Karl Endtresser
in the future. (1903–1978), and Franz Batke (1903–1983), as well as various Nazi
Pernkopf’s book was first published in German as a combina- symbols integrated in the original paintings, most (but not all) of
tion of textbook and atlas, under the title Topographische Anatomie which were removed in later editions (Williams, 1986, 1988).5
des Menschen. Lehrbuch und Atlas der regionär-stratigraphischen It took further critical comments from concerned scholars like
Präparation (Topographical Anatomy of Man. Textbook and Atlas of Howard Israel and William Seidelman (Seidelman and Israel, 1996,
Regional-Stratigraphic Preparation), between 1937 and 1960: vol- 1997) and an official inquiry from Israel’s Holocaust Remembrance
ume I was first published in two books in 1937, before Austria’s Center Yad Vashem to induce the University of Vienna to institute
Annexation to Nazi Germany; volume II in two books in 1941, a Senatorial Commission to examine the issue. Because cadavers
during WWII; after the war, volume III in one book in 1952; and were anonymized after arriving at the institute, and because many
volume IV posthumously in two books in 1957 and, edited by documents were lost after a bomb hit in 1945 it was not possible
Alexander Pichler, in 1960 (Pernkopf, 1937–1960).2 For the second to identify the specific individuals behind the anatomical illustra-
edition, published in two volumes in 1963 and 1964, the editor tions. Nevertheless, the commission documented the transfer of at
Helmut Ferner dropped Pernkopf’s extremely detailed descrip- least 1377 corpses of executed people (including seven Jews) to the
tions, allowing for easy translation and thus laying the basis for Anatomical Institute, as well as thousands of corpses more from
the international success of successive foreign language editions public hospitals (but not from concentration camps, as had also
(Pernkopf, 1963–1964a; in English as Pernkopf, 1963–1964b).3 been alleged). Close to one hundred specimens derived from these
In 1987, volume I of a third edition, edited by Werner Platzer, bodies were found in the collections of the Institute of Histology
appeared, followed by volume II in 1989 (Pernkopf, 1987/1989; and Embryology, while the Neurological Institute held specimens
English version Pernkopf, 1989–1990). An edition in one volume from victims of the “child euthanasia” program at the Viennese
was published in 1994 (Pernkopf, 1994). Between 1960 and 1998, Spiegelgrund (Akademischer Senat der Univ. Wien Ed., 1998).6 The
versions were also published in Spanish, Italian, French, Japanese evidence supported the conclusion that in all likelihood, a sizeable
and modern Greek.4 number of the illustrations in the Pernkopf atlas were produced
Eduard Pernkopf was born in 1888 in Rappottenstein, a remote using victims of the Nazi judicial system (Angetter, 2000; for criti-
village in Lower Austria. He graduated in medicine from Vienna cal reactions to Angetter’s report, see Hubenstorf, 2000; Seidelman
University in 1912, became a lecturer in anatomy in 1921 and and Israel, 2000; and, more recently, Seidelman, 2012).
associate professor in 1927. He was appointed head of the Second Following these revelations, a debate about what should be done
Anatomical Institute in 1933, dean of the Faculty of Medicine in about the book ensued. As opposed to other examples of science
1938, and rector of the University of Vienna in 1943. This stellar tainted by Nazi crimes, the scientific and artistic value of Pernkopf’s
career was possible because he was an early supporter of National atlas was not in dispute. Most authors also seemed to agree that the
Socialism in Austria, joining the Nazi party in April 1933 and the atlas should continue to be accessible as a historical artifact, a testi-
SA (storm troopers or Brownshirts) in January 1934. The timing mony to the involuntary body donors who had suffered at the hands
is relevant because the Austro-Fascist government outlawed the of the regime, an opportunity to commemorate the victims, and to
Nazi party following a deadly terrorist attack in June 1933, forc- teach about the Nazi crimes and the medical professions’ involve-
ing its militants to renounce their allegiance, or to risk criminal ment (Wade, 1996; Israel, 1998; Riggs, 1998; Spann, 1998a; Atlas,
prosecution. Pernkopf’s continued loyalty during this period of 2001; Hubbard, 2001; for more recent summaries of relevant argu-
underground activity of the National Socialist movement paved ments, see Pringle, 2010; Carstens, 2012; Hartsock and Beckman,
the way for his remarkable advancement after Austria’s annexa- 2019). Removing the books from libraries and trying to “unlearn”
tion to Germany. As dean of the Faculty of Medicine from March the scientific knowledge contained in them was even likened to the
1938, he was instrumental in integrating ‘race hygiene’ and other Nazis’ burning of books (Spiro, 1998). It is in this context that Else-
elements of Nazi ideology in the medical curriculum, and in imple- vier, upon acquiring Urban & Fischer in 2003 (the successor of the
menting anti-Jewish policies and the purge of political opponents original publisher Urban & Schwarzenberg), maintained the earlier
that led to the dismissal of more than half of the professors and hold on the production of the Pernkopf atlas and the licensing of
university lecturers. In 1945 he was dismissed from his university the images now in its possession. Since then, scholars and medical
positions as ‘politically heavily incriminated’ and interned for two practitioners have placed the issue back on the table, advocating
years in a denazification camp run by the US forces in Salzburg. for the continued use of the Pernkopf illustrations in anatomical
After his release, he was, until his early death in 1955, able to teaching, and in the preparation for surgical interventions, often
continue working on his atlas at Vienna University’s Institute of citing the unsurpassed quality of the images. The aim is to develop
Neurology, having access to the Anatomical Institute’s supply of an ethically sound approach that helps improve medical care and
corpses (Malina, 1998). includes commemoration of the historical circumstances and the
The outlines of Pernkopf’s affiliation with National Socialism suffering of the victims (Hildebrandt, 2006; Coombs and Peitzman,
were first documented in 1985 in an article which at the time of
its publication went largely unnoticed (Weissmann, 1985). In 1988,
the anatomical illustrator David J. Williams, based on information
5
For the correspondence between Williams and Wiesenthal, including the sup-
received from Simon Wiesenthal, first publicly stated that many
porting documentation, see Vienna Wiesenthal Institute (VWI), SWA-I-1, Dossier
of the cadavers received by the Vienna Anatomical Institute dur- Eduard Pernkopf and Alexander Pichler. Using the body of people who were exe-
ing WWII were those of executed prisoners, in the formulation of cuted has a long tradition in anatomy, and partly went on after WWII. For example,
the Visible Human Project used the body of an executed prisoner in 1993. The
man had given his consent, but the instance was nevertheless heavily criticized
as unethical because of its link to the death penalty (Roeggla et al., 1995).
2 6
The first two volumes were reprinted in 1943. At the Institute of Anatomy, close to one hundred specimens were removed from
3
In 1980, the second edition was completed by an index (Ferner, 1980a,b). the museum collection and buried because provenance from the Nazi period could
4
According to www.worldcat.org [accessed August 18, 2020]. not be excluded (Angetter, 1998b).
2
H. Czech, C. Druml, M. Müller et al. Annals of Anatomy 237 (2021) 151693
2017; Polak, 2018; Polak and Grodin, 2018; Yee et al., 2018a, b;
Yee et al., 2018c; Hildebrandt and Seidelman, 2018; Caplan, 2019;
Müller et al., 2019; Hildebrandt, 2020; Kershner, 2020; Mackinnon,
2020). Against this backdrop, the donation of the original draw-
ings — as far as they have been preserved — acquires a heightened
significance.
3
H. Czech, C. Druml, M. Müller et al. Annals of Anatomy 237 (2021) 151693
Fig. 3. Karl Endtresser produced many of the paintings for volume 3 of the first
edition, which was published in 1952, when the Institute of Anatomy still held many
bodies from the National Socialist period (Czech, 2015) (preparation of the viscera of
the neck from the back, between pp. 186 and 187) [MUW-ZE-003250-0005-0205r].
Fig. 2. One of Lepier’s works for volume 2 of the first edition, published in 1941 (Situs
viscerum abdominis towards the end of pregnancy, p. 590) [MUW-ZE-003250-0005-
0455r].
4
H. Czech, C. Druml, M. Müller et al. Annals of Anatomy 237 (2021) 151693
Fig. 5. The first swastikas in Erich Lepier’s signatures appeared in 1937, when the National Socialist party was still banned in Austria. On top, the image as it appeared in
volume I of the first edition (between pp. 290 and 291). Below are details from the atlas, the orignal drawing and the proof, the latter two with the Nazi symbol retouched
[MUW-ZE-003250-0005-0186].
5
H. Czech, C. Druml, M. Müller et al. Annals of Anatomy 237 (2021) 151693
Fig. 7. Karl Endtresser and Franz Batke included what looks like the symbol of the
SS in some of their signatures. The commission considered these signs as more
ambiguous and ultimately inconclusive evidence of National Socialist sentiments
than Lepier’s Swastikas (Spann, 1998b). (a) Shows the incriminated number “44”
Fig. 6. In this example, first published in 1941 in volume II (between pp. 76 and
written by Batke (detail of panel 13 in volume III, between pp. 50 and 51). In 1941
77), successive proofs illustrate the retouching process (6a is a detail from the 1941
(b) and 1946 (c), Batke wrote the “4” differently, suggesting that he indeed adapted
edition of the atlas, 6b to 6d are details of the proofs for the 1989 edition. The red
his signature in 1944 to resemble the runic insignia of the SS. However, as the detail
sign in 6c means ‘deleatur’, to be deleted) [MUW-AD-003250-0006].
of an otherwise unrelated government document from 1946 shows (d), this partic-
ular way of writing the number “4” also appeared in contexts where no reference to
the SS can be reasonably assumed.
6
H. Czech, C. Druml, M. Müller et al. Annals of Anatomy 237 (2021) 151693
the fate of the victims whose bodies were delivered to the Insti- Hildebrandt, S., 2020. The Vienna protocol: medicine’s confrontation with continu-
tute of Anatomy under the responsibility of Pernkopf will be duly ing legacies of its Nazi past. Ann. Anat. 229, 1–4.
Hildebrandt, S., Seidelman, W.E., 2018. To use or not to use: the legitimacy of using
acknowledged. unethically obtained scientific results or human tissues from the National Social-
ist era. Wien. Klin. Wochenschr. 130, 228–230.
Conflict of interest statement Hubbard, C., 2001. Eduard Pernkopf’s atlas of topographical and applied human
anatomy: the continuing ethical controversy. Anat. Rec. 265, 207–211.
Hubenstorf, M., 2000. Anatomical science in Vienna, 1938–45. Lancet 355,
AB, NF and MV are employees of Elsevier and facilitated the 1385–1386.
donation of the drawings to the Josephinum. MM, CD and HC Israel, H., 1998. The Nazi Origins of Eduard Pernkopf’s Topographische Anatomie des
Menschen: the biomedical ethical issues. Ref. Libr., 131–146.
declare no conflicts of interest. Kershner, I., 2020. In Israel, Modern Medicine Grapples With Ghosts of the Third
Reich. New York Times.
Ethical statement Mackinnon, S.E., 2020. When medical information comes from Nazi atrocities. Br.
Med. J. 368, l7075.
Malina, P., 1998. Eduard Pernkopf. Versuch einer “stratigraphischen” Biographie. In:
No research on human subjects was involved. Akademischer Senat der Univ. Wien (Ed.), Untersuchungen zur anatomischen
Wissenschaft in Wien 1938–1945. Senatsprojekt der Universität Wien, Wien,
pp. 420–458.
Funding statement Müller, M., Czech, H., Druml, C., 2019. Commentary: The Medical Univer-
sity of Vienna and the historic legacy of Pernkopf’s atlas. Surgery 165,
No external funds were used for this research. 871–872.
Pernkopf, E., 1994. Pernkopf-Anatomie: Atlas der topographischen und ange-
wandten Anatomie des Menschen, Ed. Werner Platzer. Urban & Schwarzenberg,
CRediT authorship contribution statement München/Wien/Baltimore.
Pernkopf, E., 1960. Topographische Anatomie des Menschen, Band 1 bis 4. Urban
und Schwarzenberg, Berlin/Wien/München.
Herwig Czech: Writing - original draft, Writing - review & edit-
Pernkopf, E., 1963–1964a. Atlas der topographischen und angewandten Anatomie
ing. Christiane Druml: Project administration, Writing - review des Menschen in zwei Bänden, herausgegeben von Helmut Ferner. Erster
& editing. Markus Müller: Supervision. Max Voegler: Writing - Band: Kopf und Hals. Zweiter Band: Brust, Bauch und Extremitäten. Urban &
Schwarzenberg, München/Berlin.
review & editing. Andrea Beilmann: Writing - review & editing.
Pernkopf, E., 1963–1964b. Atlas of topographical and applied human anatomy. Vol-
Nick Fowler: Supervision. ume 1: Head and neck, 1963. Volume 2: Thorax, abdomen and extremities, 1964.
W.B. Saunders Co., Philadelphia and London.
Pernkopf, E., 1987/1989. Pernkopf Anatomie: Atlas der topographischen und ange-
Acknowledgements
wanten Anatomie des Menschen, Ed. Werner Platzer. Erster Band: Kopf und
Hals. Zweiter Band: Brust, Bauch und Extremitäten. Urban & Schwarzenberg,
Sabine Hildebrandt (Boston Children’s Hospital, Harvard Medi- München/Wien/Baltimore.
cal School) was instrumental in making the transfer of the collection Pernkopf, E., 1989–1990. Pernkopf anatomy: atlas of topographic and applied human
anatomy, ed. Werner Platzer. Vol. 1, Head and Neck. Vol. 2, Thorax, abdomen and
to Vienna possible. Julia Wechselberger, Bernd Schulz and Jakob extremities. Urban & Schwarzenberg, Baltimore/München.
Lehne are in charge of the collection at the Josephinum and pro- Polak, R.J.A., 2018. Vienna protocol for when Jewish or possibly-Jewish human
vided valuable input for this article. Last but not least, the authors remains are discovered. In: Czech, H., Druml, C., Weindling, P. (Eds.), Medical
Ethics in the 70 Years after the Nuremberg Code, 1947 to the Present. Inter-
wish to thank Oonagh Hayes for her help with editing the final national Conference at the Medical University of Vienna, 2nd and 3rd March
text. 2017. Wiener klinische Wochenschrift 130 (Supplement 3). Springer, Wien, pp.
S239–S243.
Polak, R.J.A., Grodin, M.A., 2018. Letter: nerve surgeons’ assessment of the role of
References Eduard Pernkopf’s atlas of topographic and applied human anatomy in surgical
practice. Neurosurgery 83, E188.
Akademischer Senat der Univ. Wien (Ed.), 1998. Untersuchungen zur anatomis- Pringle, H., 2010. Confronting anatomy’s Nazi past. Science 329, 274–275.
chen Wissenschaft in Wien 1938–1945. Senatsprojekt der Universität Wien, Riggs, G., 1998. What should we do about Eduard Pernkopf’s atlas? Acad. Med. 73,
Wien. 380–386.
Angetter, D., 1998a. Überprüfung der Originale der Abbildungen der Anatomischen Roeggla, G., Landesmann, U., Roeggla, M., 1995. Ethics of executed person on Internet
Atlanten, beim Verlag Urban & Schwarzenberg in München, Landwehrstraße 61. (Letter). Lancet 345, 260.
In: Akademischer Senat der Univ. Wien (Ed.), Untersuchungen zur anatomis- Seidelman, W.E., 2012. Dissecting the history of anatomy in the Third
chen Wissenschaft in Wien 1938–1945. Senatsprojekt der Universität Wien. Reich—1989–2010: a personal account. Ann. Anat. 194, http://dx.doi.org/10.
Akademischer Senat der Univ. Wien, Wien, pp. 387–410. 1016/j.aanat.2011.1011.1013.
Angetter, D., 1998b. Überprüfung der Präparate des Anatomischen Museums der Seidelman, W.E., Israel, H., 1996. Nazi origins of an anatomy text: the Pernkopf atlas.
Universität Wien, 1090 Wien, Währingerstraße 13. In: Akademischer Senat JAMA 276, 1633.
der Univ. Wien (Ed.), Untersuchungen zur anatomischen Wissenschaft in Wien Seidelman, W.E., Israel, H., 1997. Nazi origins of the Pernkopf atlas: in reply. JAMA
1938–1945. Senatsprojekt der Universität Wien, Wien, pp. 198–217. 277, 1123.
Angetter, D., 2000. Anatomical science at University of Vienna 1938–45. Lancet, Seidelman, W.E., Israel, H., 2000. Anatomy in Vienna. Lancet 356, 343.
1454–1457. Spann, G., 1998a. Die internationale Diskussion um Eduard Pernkopfs Atlas
Atlas, M., 2001. Ethics and access to teaching materials in the medical library: the “Topographische Anatomie des Menschen” und die anatomische Wissenschaft
case of the Pernkopf atlas. Bull. Med. Libr. Assoc. 89, 51–58. in Wien 1938/1945 (Zusammenfassung). In: Akademischer Senat der Univ. Wien
Caplan, A.L., 2019. Commentary: Consulting evil. Surgery 165, 870. (Ed.), Untersuchungen zur anatomischen Wissenschaft in Wien 1938–1945.
Carstens, P., 2012. Revisiting the infamous Pernkopf anatomy atlas: historical lessons Senatsprojekt der Universität Wien, Wien, pp. 17–28.
for medical law and ethics. Fundamina 18, 23–49. Spann, G., 1998b. Untersuchung der Verdachtsmomente betreffend die Abbildungen
Coombs, D.M., Peitzman, S.J., 2017. Medical Students’ Assessment of Eduard im Anatomieatlas von Eduard Pernkopf. In: Akademischer Senat der Univ. Wien
Pernkopf’s Atlas: Topographical Anatomy of Man. Ann. Anat. 212, 11–16. (Ed.), Untersuchungen zur anatomischen Wissenschaft in Wien 1938–1945.
Czech, H., 2015. Von der Richtstätte auf den Seziertisch. Zur anatomischen Ver- Senatsprojekt der Universität Wien, Wien, pp. 369–386.
wertung von NS-Opfern in Wien, Innsbruck und Graz. Feindbilder. Jahrbuch Spiro, H.M., 1998. The silence of words: some thoughts on the Pernkopf atlas. Wien.
des Dokumentationsarchivs des österreichischen Widerstandes 2015., pp. 141– Klin. Wochenschr. 110, 183–184.
190. Wade, N., 1996. Doctors Question Use of Nazi’s Medical Atlas. New York Times.
Ferner, H., 1980a. Pernkopf Atlas der topographischen Anatomie des Menschen. Reg- Weissmann, G., 1985. Springtime for Pernkopf. Hospital Practice., pp. 142–168.
isterband zur 2. Auflage. Urban & Schwarzenberg, München/Wien/Baltimore. Williams, D.J., 1986. Eduard Pernkopf and the Pernkopf painters. In:
Ferner, H., 1980b. Pernkopf Atlas of Topographical and Applied Human Anatomy. Actes/Proceedings of the XXX. International Congress of the History of
Volume III: Index for the 2nd Edition. Urban & Schwarzenberg, Balti- Medicine Düsseldorf 1986, Düsseldorf, n/a, pp. 524–533.
more/Munich. Williams, D., 1988. The history of Eduard Pernkopf’s Topographische Anatomie des
Hartsock, J.A., Beckman, E., 2019. A human paradox: the Nazi legacy of Pernkopf’s Menschen. J. Biocommun. 15, 12.
atlas. Conatus J. Philos. 4, 317–339. Yee, A., Coombs, D.M., Hildebrandt, S., Seidelman, W.E., Coert, J.H., Mackinnon, S.E.,
Hildebrandt, S., 2006. How the Pernkopf controversy facilitated a historical and 2018a. In reply: Nerve surgeons’ assessment of the role of Eduard Pernkopf’s
ethical analysis of the anatomical sciences in Austria and Germany: a recom- Atlas of topographic and applied human anatomy in surgical practice. Neuro-
mendation for the continued use of the Pernkopf atlas. Clin. Anat. 19, 91–100. surgery 83, E189.
7
H. Czech, C. Druml, M. Müller et al. Annals of Anatomy 237 (2021) 151693
Yee, A., Coombs, D.M., Hildebrandt, S., Seidelman, W.E., Coert, J.H., Mackinnon, S.E., Yee, A., Zubovic, E., Yu, J., Ray, S., Hildebrandt, S., Seidelman, W.E., Polak, R.J.A., Grodin,
2018b. Nerve surgeons’ assessment of the role of Eduard Pernkopf’s atlas of M.A., Coert, H., Brown, D., Kodner, I.J., Mackinnon, S.E., 2018c. Ethical consider-
topographic and applied human anatomy in surgical practice. Neurosurgery 84, ations in the use of Pernkopf’s atlas of anatomy: a surgical case study. Surgery
491–498. 165, 860–867.