History of Medicine

THE FIRST BRAINWAVE RECORDINGS

     When we want to know if someone is “legally dead” we look at the brain waves – the electroencephalogram. This sophisticated diagnostic tool also helps diagnose a wide range of other neurologic problems, especially seizure disorders. The first electroencephalograms (EEGs), however, were performed for another purpose.

     The first to record human brain electrical activity was Hans Berger, a professor of Psychiatry at the University of Jena,

Hans Berger (Wikipedia)

Germany. Berger, born in 1873, was the son of a physician and grandson of a celebrated poet, Friedrich Rüchert. Without finishing university studies he enlisted in the military, after which he decided on a medical career. On receiving his degree he was taken on as assistant to Otto Biswanger, Professor of Psychiatry at Jena, who was working on general paresis (tertiary syphilis of the central nervous system), a common problem in mental hospitals of the time. In the 1890s, though, Berger veered off into other realms: the relation of mind and matter and the conservation of energy in the brain.

     The principle of conservation of energy had been established during the nineteenth century, and some investigators sought to apply these principles to the brain. The Viennese neuropsychiatrist Theodor Meynert, for example, felt that when energy is expended

Theodor Meynert (Wikipedia)

in an area to produce a thought or action, an equivalent energy must be transferred from another part. Meynert and a colleague, Alfred Lehmann, surmised that energy was distributed around through changes in blood flow, regulated from centers deeper in the brain. Brain energy could be in the form of heat, electrical energy, or “psychic” (mental) energy, all derived from chemical (nutritional) sources. 

     These ideas were attractive to Berger. He believed in an interaction between “mind and brain”, as opposed to another school, led by John Hughlings Jackson, a British neurologist, that insisted on a separation between brain physiology and psychologic processes. Berger's challenge was to demonstrate how the interaction happened. He started by measuring local blood flows as a marker for energy changes. He studied patients who had undergone brain surgery and were left with holes in the cranium, over which the brain was covered only with dura mater and skin. By placing small plethysmographs onto these gaps he measured changes in pressure after mental stimuli (light, sounds, thoughts) as a gauge of local blood flow. He noted increases in flow with pleasant sensations and decreases with unpleasant ones. Although interesting, the work was fraught with technical difficulties. These studies, however, were the forerunners of the ubiquitous functional MRI scans of today that demonstrate changes in regional blood flow in response to mental phenomena.

     He then tried measuring brain temperatures during brain surgery and recorded changes on emerging from anesthesia, during arithmetic calculations, etc. Though he generated much data, nothing meaningful came of it. So he turned to looking at electrical energy. Berger applied pairs of tiny electrodes under the  scalp, first in patients with cranial defects (later flat electrodes over intact skull). He used a sensitive string galvanometer made for EKG, moving later to more sensitive Siemens oscilloscopes. 

From Berger's first publication. Top line is EEG from 2 leads on scalp of 36 year-old bald male, placed
 fore and aft. Second line is EKG, third line is clock at 1/10 second intervals.

     Various stimuli, such as opening the eyes to bright light, produced different patterns, as previously seen in animals. He viewed seizures as an example of the consumption of all available brain energy, thus explaining the sleep that followed a seizure. He identified the basic alpha and beta wave patterns, though his interpretations have been modified.

     During this work Berger became secretive, working alone, avoiding discussions of his ideas with colleagues and in his lectures. His diaries indicate a depressive state of mind, frequent discouragement and insecurity. Finally, in 1929, after about 5 years of work, he published what is now a “classic” paper: “On the Human Encephalogram” (Über das Elektrenkephalogramm des Menschen), coining the new term “encephalogram” in the paper. Other papers followed.

     The work was received with some apathy in Germany, but was picked up by others, especially by Edgar Douglas Adrian at

Edgar Douglas Adrian (Wikipedia)

Cambridge, who was recording electrical impulses from individual axons (and who won a Nobel Prize in 1932). Adrian expanded the EEG work, opening it to the wider scientific community, and making Berger well known outside Germany.

     Berger fell in love with a laboratory technician before WWI, a Baroness - Ursula von Bülow, whom he married despite the social difference between them. He was called away during WWI as a psychiatrist near the Western front, but had few duties. Over time he was promoted and became a  professor and director of the Neurology and Psychiatric Clinic at  Jena University. He is described as an excellent diagnostician, but made almost no close friends and was considered “shy, reticent, and inhibited” by a colleague (Ginzberg).

University of Jena about 1910 (Wikipedia)

     As Nazism penetrated Germany in the 1930s the University of Jena was affected. Berger did not like the Nazis, did not join the party, and any papers he gave abroad had to be censured. But it has been recently reported that Berger accepted a position on the Erbsgesundheitgericht, the Court for Eugenics, in Jena. Nazi Germany had passed several eugenics laws, allowing for the sterilization of persons with various categories of neurologic and psychiatric diseases, such as dementia, deafness, multiple sclerosis, alcoholism, etc. Methods included tubal ligations, vasectomies, and radiation of gonads. Berger served on two levels of the regional Court, passing judgment on cases for sterilization during 1938.    

     On reaching age 65 that year he took mandatory University retirement and left the Court. His previous congestive heart failure worsened and he became more depressed. A final diary entry speaks of despair, sleepless nights, brooding, self accusations, and includes,"...I yearningly wished for my early end"(Gloor). Ten days later he committed suicide by hanging.

SOURCES:

Gloor, P. "Hans Berger and the Discovery of the 

      Electroencephalogram". Electroencephalography and Clinical 

      Neurophysiology, 1969, Suppl 28, pp 1-36.

Ginzberg, R. “Three Years with Hans Berger: A Contribution to  

      His Biography. J Hist Med and Allied Sci. 1949, pp 361-71.

Millett, D. “Hans Berger: From Psychic Energy to the EEG”. 

       Perspectives in Biol and Med, 2001. 44(4): 522-42.

Berger, H. “Über das Elektroenkephalogramm des Menschen”. 

       1929; Arch Psych und Nervenkrankeiten, 87: 527-70.

Zeidman, LA, et al. “New Revelations About Hans Berger, Father  

       of the Electroencephalogram (EEG), and his Ties to the Third 

        Reich”. 2014; J Child Neurology 29(7): 1002-1010.

Finger, S. Minds Behind the Brain: A History of the Pioneers and   

        their Discoveries. 2000, Oxford U. Press.