Title Page and Publishers Page from "The Anatomy of Murder" by Sabine Hildebrandt, MD (2016).



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The Pernkopf ControversyFurther discussions on the role of ethics in anatomy came much later when Pernkopf's atlas became a focal point of international debate. The popular Topographische Anatomie des Menschen was first published in 1937, with the first American edition published in 1963.[110] Surgeons valued its intricacy, as it contained detailed and extensively annotated color illustrations enhanced in quality by the beauty of the coloration, which was the product of an innovative printing technique.[111] The origins of the bodies in these illustrations were not publicly discussed until 1980, when physician Gerald Weissmann inquired into the political changes at the Vienna Medical School in 1938 and its new dean, Pernkopf.[112] David J. Williams, a professor of medical illustration, published the first detailed investigation into the background of the creation of the atlas in 1988. During a sabbatical in Vienna, Williams studied the more than 800 original paintings for the atlas and conducted interviews with Franz Batke, at that time the last living contributing artist to the atlas, from whom he had hoped to learn his painting technique. Williams learned from Batke that not only Pernkopf, but also illustrators Erich Lepier, Ludwig Schrott, Karl Endtresser, and Batke were either active members of the NSDAP (National Sozialistische Deutsche Arbeiterpartei) or participants in the war. Evidence of the illustrators' NS sympathies was visible in the first edition of the atlas: Lepier had added a swastika to his signature in some of the plates created between 1938 and 1945, while Endtresser signed the double "ss" in his name in the shape of the typical SS symbols and Batke shaped the 44 in the date 1944 like the SS runes. Williams also found evidence that the Viennese Anatomy Institute regularly received the bodies of victims of executions.


In 1995 Edzard Ernst, former faculty member at the Vienna Medical School, reported that Pernkopf, as dean of the medical faculty, had been personally responsible for the removal of all Jewish faculty members, spouses of Jews, and political dissidents, 153 of the total of 197 members of the medical faculty.[113] Ernst claimed that Pernkopf used material from children killed in a Viennese hospital in his atlas and bodies of executed persons for teaching purposes. In direct response to Ernst's publication, physicians Panusch and Briggs[114]asked their medical center to remove the Pernkopf atlas from circulation and entered into a discussion about the ethics of a continued publication of the atlas with the distributors of the atlas. Edward E. Hutton Jr., as spokesman for the publisher Waverly Inc. for the German subsidiary Urban and Schwarzenberg, stated that, in spite of their own inquiries into the matter, they continued publishing the Pernkopf atlas "because of its scientific merit and the fact that, to date, no concrete evidence exists to substantiate Pernkopf's use of cadavers originating from Nazi concentration camp victims," and that they tried to "separate Pernkopf, the man, from the work." [115] Hutton stated that the publisher supported the request for an inquiry conducted by the University of Vienna, put to the Austrian authorities and the publishers by the Israel Holocaust and Martyrs Remembrance Authority, Yad Vashem. Authors Howard Israel and William Seidelman reported these events [116], and supported Yad Vashem's demand for a commemoration of potential victims of NS terror and an acknowledgment documenting the history of Pernkopf in future editions of the atlas. This opinion was endorsed by Daniel Cutler, a medical illustrator at the University of Michigan.[117]


At this point in 1997, the president of the University of Vienna Alfred Ebenbauer[118]admitted for the first time publicly that the university, and specifically the department of anatomy, had systematically suppressed and even denied its NS (National Socialist) past, and that relevant investigations had not been performed. Ebenbauer, together with a number of new university faculty members from a younger generation without NS ties, explained that the attitude of the university had changed due to "increasing pressure from abroad" and a new political atmosphere in Austria after former chancellor Vranitzky's public recognition of Austria's responsibility for the events of 1938–45. They gave a preliminary report of the history as far as it was known, and announced a research project by the senate of the university named "The Anatomical Sciences 1938–1945." This was followed by a lively discussion in the general media.[119]


The senatorial project of the University of Vienna investigated two sets of circumstances: first, those dealing with the origin and destiny of the bodies used by Pernkopf; second, those concerning Pernkopf's political activity. The design of this project was based in part on the Tübingen project, which dealt with the history of the anatomical institute during the NS period at that university. The Vienna project revealed that throughout his tenure Pernkopf was actively involved in the acquisition of bodies for his institute. During the war the influx of bodies increased to such an extent that the anatomy institute's storage rooms sometimes became overfilled, and executions were postponed because of this. Pernkopf applied for an increase of the institute's budget for 1943 in order to handle the rising number of bodies.[120] The study further disclosed the origin of the bodies delivered to the anatomical institute from 1938 to 1945.[121] Among them were 3,964 unclaimed or, rarely, donated bodies from hospitals and geriatric and charitable institutions; about 7,000 bodies of fetuses and children, including miscarriages and premature and stillborn babies; and there were at least 1,377 bodies of executed persons, including eight Jews, who had been decapitated at the Vienna assize court or shot by the Gestapo at a rifle range. Due to incomplete documentation, it was impossible to obtain the exact number of all executed persons. There was no evidence that bodies from the concentration camp Mauthausen or the affiliated camp Gusen were brought to Vienna, but such bodies seem to have been transported to the anatomical institute at Graz. More than half of the executions had been carried out for political reasons, including 526 verdicts of "high treason." Of the bodies of the eight Jews, one was handed over to his family, while the other seven were delivered to the anatomical institute. The investigations of the anatomical collections at different institutes of the University of Vienna revealed the existence of specimens from NS victims that were then removed and interred in a grave of honor provided by the city of Vienna in 2012.[122] Previous findings encountered in Pernkopf's and Lepier's biographies were confirmed.[123]


After the war, Lepier continued his highly praised work as an anatomical illustrator, contributing to other popular atlases such as the Sobotta/ Becher atlas, [124] and the one by Carmine Clemente. Clemente initially used the Pernkopf plates, including those drawn by Lepier, for his own atlas. [125] Lepier received the title of professor in 1959 in recognition of his contribution to science. [126] About half of the original 791 illustrations in the Pernkopf atlas were created during the Nazi years; the other half either predated 1937 or were produced after 1945. Forty-one plates were definitely signed with dates from the Nazi period, and it is likely that at least some of the persons depicted were executed NS victims. For the remaining 350 plates the date of creation as well as the provenance of the bodies used as models is unclear. [127]


After the results of the Vienna Senatorial Project were disclosed, Howard Spiro, director of the Yale Program for Humanities in Medicine, felt that the "silence of words" had finally been broken. [128] Early reports on the NS activities in Austrian medical schools had not found a wide audience, with the exception of the controversy surrounding Heinrich Gross, the physician implicated in NS "euthanasia." [129] The critiques by Seidelman, Israel, and Weissmann concerning the lack of historical analysis of the origin of the Pernkopf atlas and its authors [130] created a "push from the other side of the Atlantic and from Yad Vashem" [131] that initiated a "belated [...] research into this shameful era." [132]


In addition to this impulse, several other factors contributed to a new openness for the discussion of the NS past and ethics in anatomy. Many scientists active during the NS period had died and the general political climate in Austria had changed, initiated by the international controversy in the 1980s surrounding former president Kurt Waldheim's NS affiliation. The country did not represent itself any longer only as a victim of the Nazi regime but also as a collaborator in NS crimes. [133] In addition, the ethical debate concerning body acquisition and demonstration had become very active in Germany among anatomists, philosophers, artists, lawyers, physicians, theologians, sociologists, and journalists following the controversial "Body World" exhibitions by Gunther von Hagens in the 1990s. [134]


The Pernkopf controversy also questioned whether it was ethical to continue to use the atlas, spurring many arguments. [135] On one side, detractors wanted the books removed from all libraries. [136] Arguments for complete banishment included, among other things, that fundamental evil contributed to the creation of the atlas; that nobody should profit from the exploitation of human life, especially of victims of the NS regime; that the active use of results from research by NS scientists could not justify the atrocities committed; that a work cannot be separated from its creator (thus if the creator is evil, the work is too); that the use of NS data might initiate society's slide down a "slippery slope" toward amorality; and that the atlas is easily replaceable by other anatomical atlases or more modern means of medical imaging. On the other side, supporters of the atlas argued for its continued use as a historical document, preferably in its original form (including the NS symbols), and with the addition of a historical note commenting on the origin of the work. These arguments included the opinion that good may derive from evil in providing new doctors with the means to perform better operations; that victims of the NS regime and their sacrifice are best honored by a continued use of the atlas; that publishing the atlas in its original form, including NS symbols and information about the historical context, can be used not only for the anatomical but also ethical and historical education of future physicians; that eliminating or suppressing books is a symptom of totalitarian systems; and that the atlas is a work of great aesthetic value.


On balance it seems justifiable to continue using Pernkopf's book under the condition that information on its historic background is made available at the time of use. To see the atlas as a masterwork of greatest aesthetic value or as the evil manifestation of NS science [137] seems to ascribe this book too much power. The atlas is neither of these things, but the product of an obsessive perfectionist who would have pursued his work under any political circumstances. Indeed, the first and the last parts of the atlas were not created during the time of the NS regime in Austria, but before and after it and under very different political and material circumstances. The atlas is still one of the best in terms of accuracy, showing levels of detail that are of direct relevance for the actual dissection process.


Pernkopf's story remains an object lesson for modern anatomy in that the inquiry into the sources of human bodies cannot be careful enough and that rigorous standards have to be formulated and followed. Meanwhile, the publisher has stopped printing the atlas, citing the possible use of NS victims in its creation as the reason for this decision. [138]




110. Second volume 1942, third volume 1952, fourth volume 1956-57, 1961; first American edition: Pernkopf 1963.

111. Williams 1988.

112. Weissmann 1985.

113.Mühlberger 1998b.

114. Panush and Briggs 1995; Panush 1996; Panush 1997

115. Hutton 1996.

116. Israel and Seidelman 1996; Israel and Seidelman 1997.

117. Cutler 1997.

118. Ebenbauer and Schutz 1997.

119. Examples: Michigan Daily Online 1997; McManus 1996; Williams 1999.

120.Mühlberger 1998a.

121. Malina and Spann 1999; Angetter 2000.

122.Malina and Spann 1999; Angetter 2000; Seidelman, personal communication

123.Malina 1997; Malina and Spann 1999; Abgetter 2000.

124. Ferner and Staubesand 1973; Atlas 2001.

125. Clemente 1975.

126. Urban and Schwarzenberg 1997.

127. Angetter 2000.

128. Spiro 1998.

129. Hubenstorf 2000; Neugebauer 1998.

130. Israel and Seidelman 1996 and 1997; Cutler 1997; Seidelman 1996; Seidelman 1999.

131. Holubar 2000.

132. Ebenbauer and Schütz 1997; Schütz et al. 1998; Malina and Spann 1999.

133. Ebenbauer and Schütz 1997.

134. Röbel and Wassermann 2004; Peuker and Schulz 2004; Wetz and Tag 2001

135. See Atlas 2001; Williams 1999; Field 1999; Marcuse 2002; Spiro 1998.

136. Panush and Briggs 1995.

137. Paterniti 2003.

138. Hubbard 2001; personal communication via electronic mail from the editorial director of Elsevier GmbH, Urban & Fischer Verlag, 9 August 2005.



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About the Author

Sabine Hildebrandt is an associate professor of pediatrics in the Division of General Pediatrics, Department of Pediatrics at Boston Children's Hospital, and a lecturer on Global Health and Social Medicine at Harvard Medical School. She teaches anatomy and history of anatomy at Harvard Medical School and Harvard College. Her book "The Anatomy of Murder: Ethical Transgressions and Anatomical Science during the Third Reich" (Berghahn Books 2016) is the first systematic study of anatomy during National Socialism. The biography of Jewish physician refugee Käthe Beutler was published by Hentrich& Hentrich in 2019. She is currently researching the history of the Anatomical Institute as a member of the Historical Commission on the Reichsuniversität Strassburg 1941-44. She is also co-editor of "Recognizing the Past in the Present: Medicine before, during and after the Holocaust" to be published by Berghahn Books in 2021.


Sabine Hildebrandt, M.D.
Associate Professor of Pediatrics;
Lecturer on Global Health and Social Medicine
Boston Children's Hospital, Harvard Medical School
Contact: Sabine.Hildebrandt@childrens.harvard.edu

Conflict of Interest Statement

The Journal of Biocommunication Management Board and Editors believe that transparency in academic research is essential. Our JBC authors are now required to disclose any possible conflict of interest when submitting a manuscript. In accordance with the Journal of Biocommunication's editorial policy, no potential conflict of interest has been reported or declared by this author.