Dr. Carl Fried and Mrs. Emilie Gertrud (Trude) Fried (with the kind permission of their granddaughters Sue Zurosky and Carla Chance)

Carl Fried was a medical doctor, who along with Lothar Heidenhain had systemized radiotherapy of benign diseases in the 1920s. In 1940 Fried wrote his book "Radium and Roentgentherapia". He was born in Bamberg to a Jewish family on July 22, 1889 and had two siblings, his sister Elsa and brother Stephan. His father, Wilhelm Fried[1] was a hops-trader. He was one of the few published exile-poets in Brazil. In 2016, a special bronze plate was laid in memory of Dr. Carl Fried.

Surgeon in Worms

Signature of the married couple Fried at the registry office in Worms 1923 (city archive)

Carl studied medicine in Berlin and Munich, considering it a privilege. Jews were denied positions in public services, such as administration, army, and justice, as well as in social life situations despite the fundamental equality of Jews stated in the Constitution of the First Reich in 1871.

Prof. Lothar Heidenhain from Worms am Rhein is known in medical history.[2] He performed the first successful operation of a diaphragmatic hernia. In 1920, he recruited the young surgeon Carl Fried. Fried received recognition on different occasions from the city council.[3][4] Carl and Emilie Gertrud (Trude) Fried had 2 sons, Rainer and Robert.

Reichsbund Jewish Frontline Soldiers (RJF)

During his years in Worms, he was one of the RJF-Chairmen. The military defeat in World War I and the economic problems thereafter called for a scapegoat. The Jews with a marginal percentage of 0.9% of the German population and their relatively good economic position made them the ideal target. Therefore, German Jews tried to remind the public of the fact that 100.000 fellow Jews had fought on the side of the German army and 12.000 had fallen.[5]

Carl Fried planned and realized the Worms Memorial for fallen members of the Israeli congregation of Worms in World War I. Gerold Boennen,[5] chief archivist of Worms, pointed out that this monument had not been mentioned in literature and almost forgotten, like so many other Jewish memories.

In 1929 Fried left Worms for a senior position in the newly established Radiology and X-ray Treatment Department in the Breslau Jewish Hospital.[6][7]

Radiation Therapy according to "Fried and Heidenhain"

Few examples of early radiotherapy (1896 – 1920)

W.C. Roentgen discovered the x-ray in December 1895. In the following year, L. Freund[8] in Vienna was the first to use x-rays for treatment in a benign lesion. Since Heidenhain was interested in this particular specialty, he sent Fried to Vienna. Radiation therapy in very small doses was at that time considered the strongest measure for the reduction of inflammation. Even severe bacterial inflammation was treated with radiation when other methods failed. Unlike today, radiotherapy was used in the early years more for benign diseases than malignant tumors. During the early period, pioneers in many countries gathered their observations from the treatment of small numbers of patients.

A few examples out of literature are Sotnikov[9] for childhood rheumatism in Kiev in 1898, Williams[10] in 1902 and Mayo[11] in 1904 for Morbus Basedow in the United States, Anders, Dahland and Pfahler[12] in 1906 for Osteoarthritis in the United States.

First systemized studies since 1923

Around 1923 the character of radiotherapy studies of benign diseases changed. Fried published about 100 papers;[13] many of them with his teacher Heidenhain.

In 1924 their team dealt with pyogenic inflammations.

In 1925 Schaefer[14] asserted: "Long before Heidenhain, works have been published on the favorable effects of X-rays dealing with inflammation. Heidenhain and Fried, nonetheless, are to be commended on their work of using the X-rays systematically. Since their lecture in 1924, the results of various clinics have been investigated and confirmed by the majority."

Concerning inflammations, v. Pannewitz[15] and Kohler[16] both in 1927 confirmed the notability of Heidenhain and Fried.

The two doctors in Worms established a logo in the scientific world.[17] A number of medical writers refer to this as the standard set in Worms: "Radiation Therapy according to Heidenhain and Fried".

What is characteristic for their work?

  • First systemized examinations
  • Critical thinking about self-deception?[18]
  • Large number of patients in 1924
  • X-ray dosage measurement
  • Innovative priority of discovering the smallest possible dose[19]
  • Standardized Radiation technic
  • Safety for patients and personnel[20][21]
  • Requirements for follow-up inspection
  • Limitation to difficult and serious cases. General surgical aspects as the guiding principle of action
  • Exclusion of certain conditions as inflammation in large body cavities, stiff thick-walled cavities and empyema
  • Bacteriological and experimental analysis of the reaction of small radiation dosage[22]

[23][24]

Concerning the last point, Carl Fried did further research and investigated[25] the serum of irradiated patients which had the tendency to inhibit or kill specific germs within a certain period of time. He learned these technics in the lab of Dresel and Freund.[26] Fried did additional research with Staphylococcus and Anthrax in 1926.

These early attempts have influenced modern radiation biology.[27][28] The effect of small X-ray dosages and also the side effects are able to be more accurately proven nowadays.

Test of time 46 years later

In 1970 Hoffmann[29] stated in the Handbook of Radiology: "Numerous disease pictures, listed by Heidenhain and Fried (1924) are no longer irradiated." But: "Due to the comprehensive description of Heidenhain and Fried, it seems justifiable to call that year the "birth year" of inflammatory radiation, strictly speaking."

In 1970 Reichel[30] said: "The foundation stone for the development of an essential area of radiotherapy for benign diseases was laid by the extensive nine-year clinical and experimental observations of Heidenhain and Fried, communicated at the Berlin surgeon congress in 1924."

In 1981, Scherer[31] wrote in his textbook about Radiotherapy of inflammations und functional Radiotherapy: "The first German authors, especially Heidenhain and Fried, played a decisive role in the elaboration of the methods and selection of indications. The treatment of neurohormonal disorders was predominantly promoted in France and other Romanic countries."

This article focuses on "pyogenic inflammations". This is just one example of the diverse interests of Fried and Heidenhain. Another area of their work was low-dose irradiation of osteoarthritis.[32][33][34]

What remains today

Many countries developed standards for radiation therapy of non-malignant diseases, its indications and risks. The DEGRO (the Germany Association for Radiation Therapy) has one working group of "Benign Diseases"[35] and has developed a solid foundation for radiation therapy of non-malignant diseases, its indications and risks. Modifications of Fried's principals have been made, such as the strict exclusion of juvenile patients. Sensitive organs and tissue are also principally avoided.[36] Methods changed significantly e.g. the application of radioactive isotopes in the thyroid hyperfunction. Fried published about it 1952.[37]

Breslau/Wrocław during the Nazi seizure of power in 1933

Although the financial situation of the Jewish hospital was declining, it was allowed to employ renowned doctors who had been dismissed elsewhere, for example, Ludwig Guttmann. He later became known as the innovator of Paraplegia-treatment and the Paralympic games.[38] He was a medical director in Breslau during the critical date of 1938:

On the 11/12 November 1938 (the night the synagogues and Jewish businesses were destroyed and Jews detained) Dr. Guttmann gave the order that any person in need should be admitted to the hospital. Until this time, it would have meant protection.

This information reached the Gestapo and SS, which resulted in a raid on the hospital, taking place during a time when a steady stream of victims of suicide and suicide attempts were being admitted. An exact description of that day comes from Fried's colleague, the surgeon, Siegmund Hadda:[39][40] "Dr. Fried, who at the time was busy administrating an X-ray and wore glasses with red lenses for the task, appeared in front of the Gestapo officials still wearing the glasses." He was immediately arrested because of disrespectful behavior and sent to the Buchenwald concentration camp where he remained until the end of 1939. The only evidence of Fried's bitterness is in his poems.

The national socialist repression

The synergy between legislative and executive powers characterized the repression. The laws laid the foundation for individual measures which resulted in boycotts, arrests, mistreatment, and rental agreement termination, denial of training and further education as well as cancellation of emergency services.[41][42]

Even memory was deleted (lat. Damnatio memoriae). The number of citations of Carl Fried and his nominations as author decreased drastically in 1933 and stopped completely in 1938.

The last step of the repression was the denial of professional medical recognition for Jewish doctors as well as the removal of permission to practice medicine in 1938.

An important document concerning Fried was written by Emilie Gertrud (Trude) Fried. Furtado Kestler[43] wrote to her in 1990. Mrs. Fried's reply - dated January 6, 1990 - was written 32 years after Carl Fried's death:

"Fried was imprisoned in the Buchenwald concentration camp from November to December 1938 because of his Jewish ancestry." She assumed that everyone knew that that was life-threatening. Fried was freed after an anxious period of waiting and was able to leave the Nazi area of control with his family. Trude Fried wrote: "Thanks to his scientific work, he received an invitation to work at the New York University. Therefore, he and his family immigrated to the United States in April 1939." Crucial for that opportunity was Fried's personal reputation as an author of several dozen pioneering publications.

Exile country Brazil

Since the mere existence of Jewish Doctors was a threat to the Nazi-ideology, they not only suffered in their home country but also in their new homeland. The search for an exile country was mostly tedious and humiliating for the victims.[44]

The Fried family went to Brazil which was not an immigration destination of choice. Nevertheless, the total number of exiles to Brazil was 16,000 as listed in 1988 vy van zur Muehlen.[44] Emilie Gertrud (Trude) Fried:[43] "Meanwhile, negotiations continued with Brazil and as they were much more promising than the offer from New York, we came to Brazil, where he was entrusted with the direction of a newly established institute of radiology." This was the X-ray and Radium Institute São Francisco de Assis in São Paulo, part of the recently founded University. The date was July 1940. "He was the scientific director; the clinical director was a fellow Brazilian. It was a harmonious collaboration, which unfortunately ended in 1958 due to the illness and death of my husband."

Political scenario in Brazil from 1930 to 1950 and Brazilian exile politics

The political scene in Brazil from 1930 to 1950 was influenced by a single figure at the head of state. Getúlio Vargas was hostile toward communists and fascists alike, which was a specialty of Brazilian politics. Despite cooperation with Hitler's Germany in the economy and police work, the local Brazilian branch of the NSDAP (Nazi party of the Third Reich) was banned. Presumably a significant number of German descendants sympathized with that party! Connections between Berlin and Rio lasted until October 7, 1941 when Japan attacked Pearl Harbor. At that time, Vargas decided to cut off diplomatic relations with the "Axis" (German Gross-Reich and Italy). Furthermore, the German language was forbidden to be used in public in Brazil in 1941, which must have affected the Fried family.

Fried's goal as a university teacher was to advance the Brazilian radiation therapy. His book, "Fundamentos de Radium e Roentgentherapia" [45] contains a systematic list of about 400 diseases - malignant and benign - with a brief statement about the following questions: Are experiences of radiotherapy available and what are the results? It is a critical compilation which has been carried forward in modern works. His experimental collection[46] was recognized in the American literature in 1941.

Carl Fried as a poet and writer

In 1954 twenty poems by Carl Fried and more by Louise Bresslau were published by B. A. Aust,[47] an editor and publisher in São Paulo. The two belonged to a very small group of "published exiled writers" (together with Ulrich Becher and Stefan Zweig). Fried's poetry centers around the painful loss of his beloved homeland and his love for America. Some poems were recited by Loebl. Two articles dealing with Fried's poetry will be published in Bamberg,[48] Germany and Vienna,[49] Austria.

Fried as a father and founder of Schlaraffia Paulista

Due to his Jewish origins Carl Fried, just like Bresslau-Hoff, had difficulties associating with some German Brazilians in Brazil.[43] Nazi enthusiasts were initially found among them. Carl Fried found a new homeland and reestablished Schlaraffia Paulista a part of a worldwide men's union with cultural ambitions originally founded by artists in Prague.[50] Carl, Emilie Gertrud (Trude) and their two sons Rainer and Robert are no longer alive. Rainer Fried became a Professor of Biochemistry in the United States and served as the chairman of the local chapter of Amnesty International."[13]

The last years of Carl Fried in Brazil

For Fried's last trip in postwar Germany confirmations[13][50][51] can be found.

A few Radiological societies appointed Fried as a "corresponding member" just as the German Roentgen Society did in 1952. Schmitt[4] considers this to be a - modest - vindication. Unfortunately, much of the eradication is irreversible.

Carl Fried died in São Paulo on June 2, 1958.[1]

In 2016, a special bronze plate was laid in honor of his work and the injustice he and his family suffered.[52]

References

  1. 1 2 Löbl (Loebl), Herbert (1999). Juden in Bamberg. (Jews in Bamberg). Bamberg: Verlag Fraenkischer Herbst.
  2. ↑ Leier, W. A. (1988). "Erste erfolgreiche Operation einer Zwerchfellhernie durch L.Heidenhain in Worms 1902 (First successful operation of a diaphragmatic hernia by L. Heidenhain in Worms 1902)". Dt. Ärzteblatt. 85 (16).
  3. ↑ Lucius, E. (1988). A memorandum to celebrate the 100th anniversary of the city hospital (Stadtkrankenhaus) in Worms. Worms.{{cite book}}: CS1 maint: location missing publisher (link)
  4. 1 2 Schmitt, W.G.H. (2016). Carl Fried, Poet and well–known physician at the Worms Hospital. Heimatjahrbuch Worms. ISBN 9783944380445.
  5. 1 2 Boennen, Gerold (2007). Das Ehrenmal für die Gefallenen des Ersten Weltkriegs auf dem neuen jüdischen Friedhof in Worms und seine Bedeutung im regionalen Vergleich. Jahrbuch für westdeutsche Landesgeschichte 32. pp. 367–396.
  6. ↑ Reinke, Andreas (1999). The Jewish hospital in Breslau (Das Jüdische Krankenhaus in Breslau) 1726 – 1944. Hannover. ISBN 9783775256179.{{cite book}}: CS1 maint: location missing publisher (link)
  7. ↑ "Akte: Stadtkrankenhaus 1920 – 1930, Carl Fried". Stadtarchiv Worms.
  8. ↑ Freund, L. (1897). "Ein mit Röntgen-Strahlen behandelter Fall von Naevus pigmentosus piliferus". Med. Wochenschrift Wien. 47: 428–434.
  9. ↑ Sotnikov (1898). "Über Heilung des Gelenkrheumatismus". Roentgen Fortschritte. 1: 209.
  10. ↑ Williams (1902). "Über Roentgenbehandlung des Morbus Basedow". Dt. Zeitschrift für Chirurgie. 176 (4): 254–271.
  11. ↑ Mayo (1904). "Über Roentgenbehandlung des Morbus Basedow". Dt. Zeitschrift für Chirurgie. 176 (4): 254–271.
  12. ↑ Anders; Dahland; Pfahler (1906). "The treatment of arthritis deformans with the Roentgen-rays". Journal of the American Medical Association. 46 (20): 1512–14. doi:10.1001/jama.1906.62510470026001g.
  13. 1 2 3 Bossmann, Reinaldo. ""CARL FRIED, DOCTOR AND POET", an obituary with several poems". Biblioteca Digital de Periódicos da UFPR. Retrieved 14 May 2017.
  14. ↑ Schaefer, W. (1927). "Experimentelle Untersuchungen ueber die Wirkung der Roentgenstrahlung auf bakterielle Entzuendungen". Strahlentherapie. 25: 370.
  15. ↑ v. Pannewitz, G. (1927). "Medizinische Indikationen zur Strahlentherapie". Zeitschrift für Chirurgie. 203 (4): 523–538. doi:10.1007/BF02806816. S2CID 40887059.
  16. ↑ Kohler, A. (1927). "Die Behandlung der akut-eitrigen Entzündungen durch Roentgenstrahlen". Dt. Zeitschrift für Chirurgie. 203/204 (1–6): 539–556. doi:10.1007/bf02806817. S2CID 35517131.
  17. ↑ Epstein, R. (1930). "(Contribution to treatment according to Heidenhain - Fried) Beitrag zur Bestrahlung nach Heidenhain - Fried". Strahlentherapie. 35: 170–172.
  18. ↑ Heidenhain, L. (1924). "Ueber die allgemeinsten Bedingungen für die Hypothesenbildung in der Röntgentherapie (On the most common conditions of the hypothesis in X-ray therapy)". Strahlentherapie. 17: 113–133.
  19. ↑ Heidenhain, L. (1926). "Dosierung der Röntgenstrahlen". Strahlentherapie. 21: 96–110.
  20. ↑ Fried, Carl (1923). "(A death due to intestinal rupture after deep X-ray irradiation) Ein Todesfall durch Darmruptur nach Röntgenbestrahlung". Strahlentherapie. 14: 688–706.
  21. ↑ Fried, Carl (1929). "Ein neues Bestrahlungsgerät in Verbindung mit der Metalix-Therapieröhre". Strahlentherapie. 33: 160–168.
  22. ↑ Fried, Carl (1926). "(Bactericidie after X-ray irradiation) Bakterizidie nach Röntgenbestrahlung". Strahlentherapie. 25: 56–72.
  23. ↑ Heidenhain, L.; Fried, C. (1924). "(X-ray treatment and inflammation) Röntgenstrahlung und Entzündung". Klinische Wochenschrift. 3: 71–72.
  24. ↑ Heidenhain, L.; Fried, C. (1924). "(X-ray treatment and inflammation) Röntgenbestrahlung und Entzündung". Archiv für Klinische Chirurgie, (Presented to German Surgery Society 26. April 1924). 133: 624–665.
  25. ↑ Fried, Carl (1927). "Die Röntgenbehandlung der akuten Entzündungen". Strahlentherapie. 41: 484–506.
  26. ↑ Dresel, E.G.; Freund, H. (1921). "(Studies on nonspecific stimulatory therapy) Studien zur unspezifischen Reiztherapie". Archiv für Experimentelle Pathologie und Pharmakologie. 91 (6): 317–331. doi:10.1007/bf01865105. S2CID 37079407.
  27. ↑ Schaue, D. J. Jahns; Hildebrandt, G.; Trott, K.-R. (2005). "Radiation treatment of acute inflammation in mice". International Journal of Radiation Biology. 81 (9): 657–667. doi:10.1080/09553000500385556. PMID 16368644. S2CID 25523404.
  28. ↑ Trott, K.-R. (2007). "Radiobiological studies on the analgetic effects of low doses". International Journal of Radiation Biology. 83 (6): 357–366.
  29. ↑ Hoffmann, G. (1970). "Akute und chronische Entzündungen". Encyclopedia of Med. Radiology. 17. Radiotherapy of Benign Diseases (22).
  30. ↑ Reichel, W. S. (1970). "Kurzer historischer Rückblick". Encyclopedia of Med. Radiology. 17. Radiotherapy of Benign Diseases (3).
  31. ↑ Scherer, E. (1981). Strahlentherapie. Stuttgart: Thieme.
  32. ↑ Heidenhain, L. (1923). "Ueber Arthritis senilis bilateralis symmetrica". Arch. Klin. Chir. (127): 514–528.
  33. ↑ Fried, C. (1930). "Die Roentgenbehandlung der chronischen Gelenkerkrankung". Beitr. Zur Klin. Chirurgie (98): 399–414.
  34. ↑ Fried, C. (1934). "Die Roentgentherapie der Arthritis". Strahlentherapie. 49: 634–675.
  35. ↑ Reinartz, Gabriele; Eich, Hans Theodor; Pohl, Fabian. "DEGRO practical guidelines for the radiotherapy of non-malignant disorders - Part IV". EBSCO Host Connection. Retrieved 7 June 2017.
  36. ↑ Court–Brown, M.; Doll, R. (1957). "mrc-report on leukemia and aplastic anemia in patients irradiated for ankylosing spondylitis". Journal of Radiological Protection. 195.
  37. ↑ Fried, C. (1952). "Medical applications of radioactive isotopes". Resen. Clin. Cient. 21 (5): 161–167. PMID 14942040.
  38. ↑ Dillmann, Hans-Ulrich (4 January 2015). "Poppa und die Paralympics. Sir Ludwig Guttmann". Jüdische Allgemeine.
  39. ↑ Hadda, Siegmund (1972). "As a physician at the Jewish hospital in Breslau". Jahrbuch der Schlesischen Friedrich Wilhelm Universität in Breslau. 17: 198–238.
  40. ↑ Kozuschek, Waldemar (2007). "SIEGMUND HADDA (1882 –1977) The last Head-Surgeon Chief-Surgeon of the Jewish hospital in Wroclaw". Polski Przegląd Chirurgiczny. 79 (3): 256–262. doi:10.2478/v10035-007-0037-3.
  41. ↑ Schwoch, Rebecca (2013). "Vor 75 Jahren entzog der NS-Gesetzgeber Ärztinnen und Ärzten die staatliche Berufszulassung". Strahlentherapie und Onkologie. 10: 908–914.
  42. ↑ Schwoch, Rebecca (2008). "THEMEN DER ZEIT. Approbationsentzug für jüdische Ärzte: "Bestallung erloschen"". Deutsches Ärzteblatt. 105 (39): C–1714.
  43. 1 2 3 Furtado–Kestler, Izabela Maria (1991). "Die Exilliteratur und das Exil der deutschsprachigen Schriftsteller und Publizisten in Brasilien". Europäische Hochschulschriften. 1344.
  44. 1 2 Crohn and Co-editors (1998). Handbuch der deutschsprachigen Emigration. Darmstadt: Wissensch. Buchgesellschaft. ISBN 978-3534219995. {{cite book}}: |last1= has generic name (help)
  45. ↑ Fried, Carl (1941). "Fundamentos de Radium e Roentgentherapia". Edicoes Melhoramentos.
  46. ↑ Fried, Carl (1941). "The Roentgen Treatment of Experimental Pneumonia in the Guinea-Pig". Radiology. 37 (2): 197–202. doi:10.1148/37.2.197.
  47. ↑ Bresslau-Hoff, Louise & Carl Fried (1954). Deutsche Dichtung aus Brasilien. Selbstverlag edited by B. Aust.
  48. ↑ Schmitt, WGH (2017). "Carl Fried. Search for home between Bamberg and Brazil". 153 Jahrbuch Historischer Verein, Bamberg: 339–354.
  49. ↑ Schmitt, WGH (2017). "Carl Fried. Poetry and Exile". Zwischenwelt 34 Heft 4, Vienna: 22–30.
  50. 1 2 "Festschrift zum 125. Stiftungsfest der Schlaraffia Wormatia". Juden in Worms: 28. 2006.
  51. ↑ "Schlaraffen Newspaper". São Paulo: 1196. 1956.
  52. ↑ Schaefer, U. (15 August 2016). "Erinnerung an "Uhu-Finsternis"". Wormser Zeitung: 12.
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