Cortical Chauvinism

John Elder Robison and Georg Frankl: A Third Man at the Genesis of the Autism Diagnosis

Recently I had the opportunity to read an article by John Elder Robison. The same was titled, “Kanner, Asperger, and Frankl: A Third Man at the Genesis of the Autism Diagnosis”. The article was printed by the English publishing house Sage in their journal Autism and can be downloaded from http://bit.ly/2cApEZh. It is a lengthy 10-page original article that bears on the historical coincidence of 2 Austrians, Kanner and Asperger, coming to describe different tail ends of the severity spectrum of autism while using the same terminology borrowed from Bleuler. In this regard Robison points to the possible influence of Georg Frankl acting as a middle man between both Kanner and Asperger.

I was very impressed with the quality of John’s article. It marks a transition for John Elder Robison the bestselling author of different autobiographical accounts into a serious investigative journalist. The main point of the article, that Georg Frankl went from working with Asperger to working with Kanner, was brought to public attention by Steve Silberman in his book Neurotribes. However, John Robison expands on the story and gives a detailed documentation of this transition based on work he did at the Johns Hopkins archives, genealogical databases, Ellis island immigration documents, and a large number of articles in the medical literature.

At least in terms of Kanner, the queries as to how he came about diagnosing autism, bear in part on how he recruited his original series of patients.  I must say that even though a lot of credit has been given to Silberman, Donvan and Zucker for bringing to light the medical record of Donald Triplett (patient 1 for Kanner) from Johns Hopkins very little praise has been bestowed on the person who originally discovered and published the same. This was the work of Dan Olmsted who published a series of articles on the subject in 2005. His main discovery was how Donald was given gold salts to treat a crippling disabling juvenile arthritis. The treatment was not recorded by Kanner, but according to Donald’s brother, the treatment cured his arthritis and some of the affective symptoms associated with his autism. In 2011 Olmsted published in a book the story of Donald along with all other participants from Kanner’s original series. This was several years before Silberman, Donvan or Zucker published their efforts.

What I like about Robison’s story is the ideas by which he ties Frankl’s love affair with Ami Weiss and brings it to play in the diagnostic controversy involving Kanner and Asperger. In doing so Robison talks about the Nazi prosecution of the 1930’s, Kanner’s generous nature as a sponsor of many refugees, Frankl’s contributions to the medical literature, and how the dreams and jobs of all of these important people became entangled at a particular chronological singularity.

Personally I like many of the insights offered by John Robison. One of them was the possibility that Asperger saw higher functioning individuals because, at the time, the Third Reich would have involved lower functioning ones in their euthanasia movement and killed them  (this is something I have spoken about in previous blogs).  Robison is also careful to point out the importance of many Jewish physicians in the early history of autism as well as in clearly defining some of the controversy involving the use of translated terms and their etymology. Lastly, I would like to point out that many of the clinical observations provided by John Robison are as astute as they are relevant. John is a very insightful individual.

Personally I disagree with the importance given to Frankl in the history of autism and have enjoyed a congenial email exchange with John on this matter . For those interested in reading a counter point to John’s arguments see http://bit.ly/1RI9asz . However, I must praise John’s effort in giving a balanced appraisal on the subject. The story he pieced together reflects several years of investigative efforts. This is a must read for anybody interested in the history of autism. They will find that 10 pages are too short and and that you are left wanting more. I wish this was the beginning of a book with a historical account from John’s own viewpoint.