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Hitler’s Inner Enemy : Study Suggests the Dictator Suffered From Dementia Brought on by Parkinson’s Disease

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TIMES MEDICAL WRITER

In the 1930s, Adolf Hitler’s tactics were brilliant, his foresight remarkable, according to many military historians. Working directly in opposition to the best advice of his generals, he conquered most of Europe militarily and his prospects seemed unlimited.

If he had retained his wits, some critics speculate, he might have continued his expansion--winning the war in Europe and dictating a peace with the United States.

But he didn’t. Beginning in 1941, while still engaged in a bitter battle with Britain, he attacked the Soviet Union, opening a second front that eventually proved to be his downfall. His decision-making grew continually worse and, by 1945, he was a delusionary old man isolated in a Berlin bunker and moving imaginary troops around in final battles.

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How Hitler came to be the tyrant he was and why he lost his decision-making abilities have been topics of great interest in the 50 years since the end of World War II. Was his brain affected by syphilis contracted while the young Hitler was a student in Bavaria? Perhaps it was the copious quantities of esoteric drugs--”uppers,” “nerve tonics” and heart medications, among others--prescribed for him by his personal physician for symptoms real and imagined. Or was it the psychological aftereffects of an attempted assassination?

Now, a new study suggests it may have been a virus that caused him to develop Parkinson’s disease, which crippled his arm, bent his body, sent him into hiding and impaired his ability to handle complex decisions. That is the conclusion of Dr. Abraham N. Lieberman, an eminent neurologist at the Barrow Neurological Institute in Phoenix and the clinical director of the National Parkinson Foundation.

Lieberman has been studying Hitler for many years and, like a few other researchers, is firmly convinced that the German Fuhrer suffered from Parkinson’s disease. Hitler’s Parkinson’s, he argues, may have been caused by a viral infection incurred around 1916, when a pandemic of Von Economo’s encephalitis hit Europe. Encephalitis is an inflammation of the brain caused, in this case, by a still-unidentified virus. Researchers have found that almost half of those who contracted the disease in the 1916 outbreak later developed a form of Parkinson’s.

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Parkinson’s disease is a progressive, debilitating disorder of the brain that currently affects at least 1 million Americans, most of them over 60. It is characterized by tremors, rigidity of the limbs and loss of muscle control. As many as a third of victims also suffer dementia, a loss of critical thought processes.

The first symptoms of Hitler’s Parkinson’s were apparent, Lieberman says, in Leni Reifenstahl’s 1934 film “Triumph of the Will,” made when Hitler was 45 years old. The decreased and slowed movement of his left arm, a symptom called bradykinesia, was visible when he arrived at a Nazi Party congress in the morning, Lieberman says, and became more apparent during the course of the day and the evening, as is typical with Parkinson’s.

By 1940, according to eyewitness accounts, Hitler had developed a so-called resting tremor in his left hand. Such tremors occur when the muscles of the hand are relaxed, as opposed to when they are “activated,” such as while grasping objects. Thereafter, Hitler tried to camouflage the tremor by keeping his left hand in his pocket, holding something in it or grasping it with his other hand.

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In a 1945 Swedish newsreel that escaped German censors, his disorder is quite apparent, Lieberman says. The film shows him walking slowly, not moving his left arm at all. He has a rigid, mask-like expression on his face, a bent-forward, stooped posture and a resting tremor. Other symptoms that had become obvious by this time, Lieberman says, include speech problems, small, cramped handwriting and episodes of depression. Other signs Lieberman points to as suggestive of post-encephalitic Parkinson’s include oculogyric crises, spasms that force the eyeballs to turn up for several seconds; sleep disturbances; palilalia, a repetitive speech pattern; and rage attacks.

Some physicians contemporary with Hitler also thought he had Parkinson’s. According to a soon-to-be-published book by Brown University historian Robert G.L. Waite, at least three neurologists--none of whom actually examined Hitler--concluded in 1945 and 1946 that he suffered from Parkinson’s.

But that interpretation fell out of favor in the 1950s, only to be resuscitated now by Lieberman. His is still a minority voice, however. “The standard interpretation now is that [Hitler’s] health looks sort of shaky by the end of the war . . . because of ministrations by his quack personal doctor,” Dr. Theodor Morrell, according to historian Sam Goodfellow of Westminster College in Fulton, Mo. “He was [also] physically debilitated after the July 20, 1944, assassination attempt,” in which he barely escaped from a bomb.

Historian Robert J. Maddox of Pennsylvania State University agrees that Hitler certainly shook a lot, especially after he was nearly killed by the bomb. According to Maddox, Hitler had a meeting with Mussolini the same day or the next, and his hands were trembling noticeably.

For his part, Waite concedes that Hitler might, in fact, have suffered from Parkinson’s. He believes that the disease played no part in Hitler’s conduct of the war, however, while Lieberman argues forcefully that it did.

When Hitler became aware of his tremor in 1940, Lieberman argues, he “feared the German public and the Allies would associate it with senility or, even worse in his mind, with syphilis. Thus, after 1940, Hitler, who had always been accessible, isolated himself,” thereby cutting himself off from needed information and depriving himself of the ability to remain in touch with events.

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Hitler, “always in a hurry,” also wanted to settle Germany’s chronic social, political and economic problems in his lifetime, Lieberman said. “After he became aware of his tremor, and thinking he had syphilis, he . . . became a man even more in a hurry,” no longer displaying the patience that had been a major asset in prewar years.

That impatience may have induced him to attack the Soviet Union before he could defeat Britain, producing a two-front war, Lieberman speculates. Two years earlier, Hitler had gone to extraordinary lengths to sign a treaty with the Soviets to prevent such a duplication of effort.

Similarly, impatience may have seduced him into declaring war on the United States after Pearl Harbor was attacked, despite his previous efforts to avoid doing anything to provoke America into declaring war.

And finally, Lieberman says, Hitler was initially able to grasp theoretical and practical concepts and strongly supported basic research and weapons development. But after 1941, he failed to understand the importance of jet airplanes, atomic energy, radar and a host of other technological advances that were well within the reach of German research and development, Lieberman says. The Allies’ development of these technologies played a major role in Hitler’s defeat.

While Lieberman blames Parkinson’s for these tactical errors, Goodfellow attributes them to bad luck. “He got away with a lot of decisions early on that look brilliant,” Goodfellow said. “He was making the same sort of decisions later in the war, but they didn’t work out as well. He just got lucky early, but it caught up with him.”

Waite also argues that Hitler’s thought processes remained constant throughout the period. “There was no . . . abrupt psychological transformation” in Hitler’s character, he said. “Indeed, the most striking single thing about Hitler’s behavior is not change, but remarkable continuity and the intensification of tendencies whose roots can clearly be traced to his early years.” Neurological illness during the war cannot “explain his foibles, his passions, his wickedness, or why his mental aberrations took specific forms and patterns.”

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Lieberman is unconvinced by such arguments. “I’ve seen enough Parkinson’s disease,” he said. “I think that is the explanation. I think it did affect his conduct of the war.”

He also thinks researchers will be arguing about it for another 50 years.

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Origin of Tremor

Parkinson’s disease results from the death of brain cells that secrete dopamine, a messenger that is important in controlling movements. The main areas affected are the basal ganglia (nerve cell clusters in the brain) and the motor cortex.

Motor cortex

Basal Gangila

Caudate

Putamen

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