ZusammenfassungPaul Ferdinand Schilder (1886–1940) blieb der Nachwelt insbesondere in Erinnerung als Psychoanalytiker und Psychotherapeut. Allerdings forschte er auch auf neurowissenschaftlichem Gebiet umfassend und innovativ, so gilt er z. B. als Erstbeschreiber der nach ihm benannten Schilder-Krankheit. Im Mittelpunkt der hier vorliegenden Studie steht das ebenfalls von ihm erstbeschriebene Störungsbild der Schmerzasymbolie, das heute eher wenig bekannt ist und als selten gilt. Dabei handelt es sich um eine zentral bedingte Beeinträchtigung des Schmerzerlebens, die charakterisiert ist durch das Fehlen negativ-emotionaler Wahrnehmungen. Basis für Schilders Entdeckung und differenzialdiagnostische Abgrenzung der Schmerzasymbolie war die ausführliche Untersuchung von elf Krankengeschichten zwischen 1928 und 1930. Seine diesbezüglichen Publikationen kennzeichnen Akribie, vorwärtsgewandtes Denken und kritische Selbstreflexion. Er ordnete die Schmerzasymbolie nosologisch den Agnosien zu und integrierte sie in das Konzept des Körperschemas, das zeitlebens ein zentrales Thema seines wissenschaftlichen Wirkens war. Dieser Artikel geht auch auf die Frage ein, inwieweit Schilders Annahmen noch heute gültig sind und welche Konsequenzen sich hieraus ergeben könnten.
Paul Ferdinand Schilder was born in Vienna in 1886 and died in New York in 1940. He is nowadays remembered predominantly for his contributions to modern psychiatry and psychotherapy; however, he was also a neurologist and neuroscientist and in particular in his early years, he researched and published on neuropathological topics. This paper focuses on his scientific work during his years in Middle Germany (1909-1914), where he worked with Gabriel Anton in Halle and Paul Flechsig in Leipzig. During those years, he laid the foundations for his definition, clinical classification and differentiation of encephalitis periaxialis diffusa. Today, this inflammatory brain disease is known as Schilder's disease and is of some importance as a rare differential diagnosis of multiple sclerosis (MS), especially in children. Schilder's reflections and findings were based on his scrupulous and detailed analysis of only a few medical histories, which also comprised histological neuropathological examinations, as well as on his extensive and critical review of the relevant literature of the time. His aim was to differentiate encephalitis periaxialis diffusa from brain tumors, MS and Heubner's diffuse sclerosis. Schilder's scientific achievement, made in relatively young years, is still impressive even to the present day due do its thoroughness and accuracy as well as the enormous workload and ambition it required. Even though ambitious, Schilder was always prepared to critically review his own ideas.
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