Kurt Goldstein's contribution to the development of neurorehabilitation

Peter Frommelt
Dept. Neurological and Neuropsychological Rehabilitation, Klinik Bavaria, Schaufling, Germany

Introduction. Kurt Goldstein (1878-1965) had worked since 1904 at the Senckenberg Neurological Institute in Frankfurt/M. with Ludwig Edinger as his principal. The wide spectrum and unconventional scope of the research at the institute facilitated the development of a pioneering concept for the rehabilitation of head injured soldiers. In 1915 Goldstein founded the military hospital for head injured soldiers in Frankfurt. The hospital had three departments: clinical, vocational and a psychological laboratory. Adhémar Gelb joined him as head of the psychological institute.

Outline of Goldstein 's concept and practice at the Frankfurt hospital. Goldstein's basic concept was to integrate medical, psychological and occupational interventions to enable the soldiers to compensate for their impairments.1 After a meticulous psychological examination the program consisted of a deficit-specific training, e.g. for motor aphasia and a vocational rehabilitation in different workshops. Goldstein and Gelb conducted series of single case studies focussing on the interaction of cognitive systems.2 Goldstein argued that beside their specific deficits in cognitive architecture the patients displayed a general change in behavior (Allgemeinstörung).

Discussion. Goldstein's contribution to the organisation and practice of neurorehabilitation will be discussed. His later theory of an organismic connectivity in the nervous system and its reaction to trauma has been influenced by his observation of head injured soldiers. Some of Goldstein's models seem to be confirmed by actual research in neuroimaging and neuropsychology.

1Goldstein K. Die Behandlung, Fürsorge und Begutachtung der Hirnverletzten. Vogel, Leipzig: 1919.
2Gelb A, Goldstein K. (Eds.) Psychologische Analyse hirnpathologischer Fälle. Barth, Leipzig: 1920.

Poster Session I
Friday, 20 June 1997, 12.15 - 12.45

Second Annual Meeting of the International Society for the History of the Neurosciences (ISHN) and 6th Meeting of the European Club on the History of Neurology (ECHN)

Leiden, The Netherlands