NL 2015/04

The Prague Years of an Exceptional Physician





The gynaecologist Hermann Knaus spent over a decade in the Golden City of Prague practicing medicine and doing research. During this time, he made some childless couples happy, and also made some enemies in the National Socialist party machine.

In Prague’s teaching hospital, you can see a plaque with the names of great physicians who have worked there. One of them was the Austrian native Hermann Knaus (1892-1970), head of the obstetrics clinic in Apolinárská and the gynaecological clinic in U Nemocnice from 1934 to 1945.

Knaus was an extremely gifted surgeon whose ‘golden hands’ saved quite a few women’s lives. Also renowned as a scientist, he was even nominated for the 1936 Nobel prize for medicine. Knaus’ research involved the menstrual cycle, during which women are able to conceive for only a few days. In 1929, while still a university assistant in Graz, he proved that a fully developed egg cell is ready to be fertilized 14 days before the next menstrual period. But how can a woman know when her next period will start? She would have to keep records for at least twelve months in order to calculate her longest and shortest periods. This observation allows her to be aware of the period of time during which she should not have unprotected sex because of a risk of becoming pregnant. Figuring out the opposite is simpler: what’s called the Konzeptionsoptimum – the time period in which conception is most likely – lasts only one or two days. In far-away Japan, another gynaecologist, Kyusaku Ogino, had come to a similar conclusion, which is why calculation of the fertile and infertile days is called the Knaus-Ogino method. Women who were unable to have children came from near and far to consult Dr Knaus.

Knaus had just started working in Prague in 1934 when massive demonstrations by university students took place. Demands were made that the German university hand over the historical university insignia, a seal, sceptre and chain of office, and the archive of the Charles University. Nazi Germany and nationalistic groups in Czechoslovakia were enraged.

Then the council of ministers changed the way in which new professors were appointed. The National Socialist periodical Zeitschrift für Kulturpolitik raised the alarm: “The fact is obvious that this struggle provides an opportunity to gradually eliminate the German character of the universities.” The claim was made that the Czechoslovakian government’s goal was “to slowly but surely destroy Germanness in Czechoslovakia, whereby the deprivation of cultural rights has always had priority.” It continued: “The rights of 9,000 German students and more than 400 German instructors at universities infused with German spirit are involved!”

In September 1938, the Third Reich annexed the Sudetenland, after which many professors, doctors and nurses left the country. Knaus and his colleagues sensed an obligation to their patients and did what they could to keep the university and clinics open. In March of the next year, he yielded to the political pressure to join the Sudeten German Party, since he had been a member of the Greater Germany Party in Graz from 1921 to 1924. Because Knaus stayed in Prague during the September 1938 crisis, the new political leadership considered him ‘politically unreliable’.

 

Doubted and not taken seriously

As Dean of the Department of Medicine, Knaus saw how the Berlin surgeon Kurt Strauß, an SS officer, was imposed upon the university. But this incompetent surgeon overestimated his own abilities, and that and his professional ambition cost many patients their lives, the reason he wasn’t welcome in Prague. While the department resisted his appointment, it had no chance of winning out over Strauß’s politically high-ranking friends.

Knaus protested this move. After just a few months, he noted that his doubts concerning Strauß’s appointment in light of the other man’s abilities as a scientist and a surgeon “proved to be thoroughly justified, as his work as a surgeon has resulted in such a comparatively high rate of mortality as to produce the wildest rumours in the city and around the entire country....” In fact, 102 patients died at his clinic during the first eleven months of Strauß’s time in office (1940).

Knaus’ report was inopportune in a political sense, and so a commission headed by Berlin surgeon Ferdinand Sauerbruch was formed to investigate. According to their findings, Strauß’s malpractice wasn’t very serious. However, they had discovered “unquestionable technical inadequacies” in his case and ruled that he should leave his position in Prague and be transferred to “some other function”.

As a result, Knaus made some powerful enemies who summoned him before the party’s supreme court. At the same time, he also had supporters, such as the undersecretary of state von Burgsdorff, who criticised the fact that “an official who was ordered to prepare an expert opinion was then called to appear before the party court because of it”. Reinhard Heydrich, the Deputy Reich Protector of Bohemia and Moravia, was also involved. The trial dragged on until 1942, and both sides did what they could to foil the other’s plans. During the proceedings, Knaus received a warning even though there was no evidence of inappropriate behaviour on his part. But it was just not tolerable that as a result of his statement “the honour of a party member in a leading position in public life, who had served the party and state in significant ways, was attacked”. Knaus was accused of “seriously incriminating his colleague Strauß without investigating the circumstances sufficiently”.

In medical circles, Knaus’ theories were regarded with a great deal of scepticism for some time. One claim, that a woman’s egg cells could be fertilised for solely a few hours, was easy to believe, but that men’s sperm cells are capable of fertilising for a maximum of five days only was accepted only after ten years and the presence of a great deal of new evidence. His third discovery – regarding the constant time period between ovulation and subsequent menstruation – was still widely doubted or simply not taken seriously into the 1950s. The expression ‘Knaus’ kids’ was a reference to the supposed failure of his methods. In all cases that could be examined, Knaus himself either identified an error in calculation or medical deviations.

In contrast to the sceptical medical community, the press showed an early interest in Knaus’ discoveries. Many married couples, and also some Catholic priests, believed that a contraceptive method for married couples which “took advantage of naturally infertile days on the basis of serious grounds” wouldn’t violate the divine command. The greatest honour for Knaus, a devout Catholic, was recognition of his theories by Pope Pius XII in 1951 as the only contraceptive method tolerated by the church.

 

Attentive and gruff

Knaus’ duties included training students and young doctors. He was an excellent teacher, and strict and unrelenting as a boss. When Hugo Husslein, who became famous somewhat later, was made a professor at the University of Vienna, he said, “I owe what I am and can do to Knaus most of all. He was my real teacher. I learned to operate from him.”

In addition to working at the clinic, teaching and performing research, Knaus also ran a private surgery in what is now Opletalova Street near Prague’s main railway station. Patients remember how the rooms were furnished with antiques, reflecting Knaus’ love of art and culture. Knaus and his wife, Ruzica, went to concerts and the opera as often as possible. He was also close to nature: ever since his boyhood in Carinthia, Knaus was a daring mountain-climber and skier, and he enjoyed hunting and rode horses as often as permitted by his schedule. A great deal of time was spent with his wife and daughter at his estate in Lojovice, about 30 kilometres from Prague, and the location of his extensive scientific library, necessary for his academic writing.

Though Knaus had been a member of the National Socialist party since 1939 and was a nationalist, he was for the most part apolitical and attached more importance to his patients’ well-being than their ethnic origin, nationality or party membership. Knaus also wanted to stay at his clinic in 1945. While this hope was shattered, he was permitted to take his household with him when leaving the country thanks to his irreproachable conduct. He wasn’t welcomed with open arms in Austria: other doctors were also waiting for professional opportunities, and the climate was unfriendly to newcomers. Furthermore, while Knaus treated his patients kindly and attentively, with others he was gruff and mercilessly critical. As a result, he fell out of favour with a number of individuals who would otherwise have supported or helped him in some way.

In 1950, Knaus was made head of the gynaecological department at Lainz Hospital, where he worked until 1960. He continued to give lectures on medicine and for continuing-education classes, wrote articles, and worked as an expert witness. In 1970, Knaus passed away in Graz.

 

Source:

“Deutsche Hochschulen in Gefahr”, in Volk im Werden, ed. Ernst Krieck, 5, 1937, pp. 211-212.
Anonymous (Hegewald?), 25 November 1942, Czech National Archives, 110-4/116/207; communication from W. Jacobi to H.J. Fischer, 14 February 1945, German Federal Archives, ZB 6980.
Communication from H. Knaus to W. Saure, 2 July 1940, Czech National Archives, 110-4/116/455.
K.P. Behrendt, “Die Kriegschirurgie von 1939-1945 aus der Sicht der Beratenden Chirurgen des deutschen Heeres im Zweiten Weltkrieg”, dissertation, 2003, pp. 243-244.
Communication from L. Conti to R. Heydrich, 9 February 1942, Czech National Archives, 110-4/116/373.
Communication from C. v. Burgsdorff an K.H. Frank, 22 October 1941, Czech National Archives, 110-4/116/425f.
Anonymous document, 26 November 1941, Czech National Archives, 110-4/116/400.
A. Miskova, Die Deutsche (Karls-)Universität vom Münchener Abkommen bis zum Ende des Zweiten Weltkrieges – Universitätsleitung und Wandel des Professorenkollegiums, Prague: Karolinum, 2007, p. 114.

30 October 2014, Prager Zeitung, no. 44

 

Visit the Museum for Contraception and Abortion (MUVS), Mariahilfer Gürtel 37, 1150 Vienna, open Wednesday to Sunday, 2 to 6 p.m., or visit our website on http://en.muvs.org/ and our facebooksite http://www.facebook.com/eMUVS.