Bernhard Naunyn
Bernhard Naunyn (1839-1925) was a German physician and pathologist.
Naunyn was a pioneering figure in experimental and metabolic medicine. Immersed in the scientific milieu of Virchow and Liebig, he carried physiological and chemical methods into clinical medicine, shaping the emerging field of experimental pathology.
His research interests were vast but centered on metabolic and gastrointestinal disease. He published classics on cholelithiasis (1892) and diabetes mellitus (1898), the latter laying foundations for dietary and metabolic management of diabetes before the insulin era. He contributed key insights into gallstone formation, icterus, fever, aphasia, speech disorders, cirrhosis, syphilitic nervous disease, coagulation, and the chemical pathology of exudates and transudates. He introduced the concept of “acidosis” and emphasized quantitative diets in diabetes care, advancing understanding of protein metabolism in glucose production. His work on bile and hepatic function placed him at the forefront of hepatology in the 19th century.
Despite his stature, Naunyn never received the Nobel Prize, though he was repeatedly nominated in the early 20th century. He retired to Baden-Baden in 1905, where he continued writing until his death on 26 July 1925. Remembered by Friedrich Müller as “the last of those truly great men who lifted German medicine to the level of a natural experimental science,” Naunyn left a lasting legacy in internal medicine, pharmacology, and clinical teaching.
Biographical Timeline
- 1839 – Born September 2 in Berlin, Germany, into a prominent East Prussian family.
- 1862 – Graduated in medicine from the University of Berlin; assistant to Friedrich Theodor von Frerichs (1819–1885) at the Charité.
- 1862–1868 – Early studies in zoology and anatomy at Bonn under Lieberkühn and Wagener; influenced by Frerichs to focus on internal medicine.
- 1868 – Appointed Professor of Medicine at the University of Dorpat (Tartu).
- 1871 – Brief tenure at the University of Bern as Professor of Medicine.
- 1872 – Moved to the University of Königsberg as Professor of Medicine (1872–1888). Co-founded the Archiv für experimentelle Pathologie und Pharmakologie with Oswald Schmiedeberg (1838–1921) and Edwin Klebs (1834–1913).
- 1877 – Friedrich Walter (Schmiedeberg pupil) published study on acid metabolism; Naunyn later coined and defined the term acidosis.
- 1888 – Appointed Professor of Medicine at the University of Strassburg, succeeding Adolf Kussmaul (1822–1902).
- 1892 – Published landmark monograph on cholelithiasis, translated by Archibald E. Garrod (1857–1936) in 1896.
- 1896 – Founded Mitteilungen aus den Grenzgebieten der Medizin und Chirurgie with surgeon Jan Mikulicz-Radecki (1850–1905).
- 1898 – Published Der Diabetes Mellitus, a major treatise on diabetes, dietary therapy, and metabolic pathology.
- 1905 – Retired from Strassburg; settled in Baden-Baden, remaining academically active.
- 1908 – Published The Berlin School 50 Years Ago, reflecting on the development of internal medicine.
- 1909–1918 – Nominated multiple times for the Nobel Prize in Physiology or Medicine, but not awarded.
- 1913 – His theory (with Minkowski) that bile pigment formation was exclusively hepatic was disproved by John William McNee.
- 1925 – Died July 26 in Baden-Baden, aged 85; autobiography Erinnerungen Bedanken und Meinungen published posthumously
Key Medical Contributions
Gallstone Disease (1892)
Naunyn’s Klinik der Cholelithiasis (1892) was the first comprehensive scientific treatise on gallstone disease, based on decades of clinical observation, autopsy material, and chemical studies of bile.
Naunyn systematically addressed the pathogenesis, chemistry, and clinical course of gallstones. He emphasized the role of altered bile composition and stasis in stone formation, anticipating modern concepts of supersaturation, nucleation, and impaired motility. He also described the variable clinical presentation of cholelithiasis, from silent stones to acute biliary colic, jaundice, and cholangitis
The work was translated into English as A treatise on cholelithiasis by Archibald E. Garrod (1857–1936) for the New Sydenham Society in 1896, ensuring its wide international influence.
The formation of gallstones depends above all on the chemical constitution of the bile… The changes are not secondary, but primary disturbances of secretion
Naunyn 1892
Murphy Sign (1892)
Naunyn described the characteristic pain elicited by palpation beneath the right costal margin during inspiration, now more commonly known as Murphy’s sign. His account predates that of John B. Murphy (1857–1916) by more than a decade and closely matches the method of clinical examination still in use today:
If the liver is swollen as the result of the attack (i.e., recently) the organ is always more or less tender, and often very acutely so; but frequently it is tender without being swollen. In such cases it is found that pain is induced when, during a deep inspiration, pressure is made with the hand as far upwards as possible beneath the right costal border. At the moment when the liver impinges upon the tips of the fingers the patient experiences a deep-seated pain which sometimes radiates over the entire hepatic region and on to the epigastrium
He further noted that in some patients the sign may be observed indirectly as unilateral abdominal wall tension:
By no means rarely, however, the tenderness of the liver is only manifested by tension of the muscles of the anterior abdominal wall on the right side, and in such cases the difference in tension of the right and left side respectively is best observed in the rectus abdominis
Naunyn 1892
Acidosis (1877)
The concept and the term “acidosis” were introduced by Naunyn in the late 1870s. He defined it as a pathological condition resulting from abnormal accumulation of acids in the body, most notably in relation to diabetes mellitus and disturbances of intermediary metabolism.
The immediate stimulus was a pivotal 1877 paper titled Untersuchungen über die Wirkung der Säuren auf den thierischen Organismus by Friedrich Walter, a pupil of Schmiedeberg, on the action of acids in the animal body.
Walter demonstrated that infusion of acids into animals produced profound metabolic derangements, respiratory disturbances, and eventually coma. His work was controversial, sparking a critique by Ernst Salkowski, followed immediately by Oswald Schmiedeberg’s rejoinder in defense of Walter’s findings.
Naunyn recognised its broader implications and provided the first clinical definition of “Acidose” (acidosis) linking biochemical derangements to metabolic disease. He introduced the concept of acidosis as the biochemical substrate of diabetic coma
The peculiar intoxication which develops in severe diabetes is dependent upon an excessive accumulation of acid bodies… This condition I have termed acidosis, and it must be considered the essential cause of the fatal coma.
Naunyn, 1898
By connecting ketone production, acid retention, and diabetic coma, Naunyn introduced a pathophysiological framework that remains the basis of modern understanding of diabetic ketoacidosis (DKA) and acid–base balance.
Diabetes Mellitus (1898)
Naunyn’s monograph Der Diabetes melitus (1898) consolidated decades of clinical observation, laboratory study, and metabolic experimentation and became the authoritative pre-insulin era textbook on the disease.
Naunyn drew on the work of his colleague Oskar Minkowski (1858–1931), whose 1889 pancreatectomy experiments in dogs with Joseph von Mering had demonstrated the pancreas as central to diabetes. Building on this, Naunyn systematically explored dietary therapy, protein metabolism, and coma in human diabetes. He introduced the concept of acidosis as the biochemical substrate of diabetic coma:
Naunyn was a strong advocate of quantitative dietary control, prescribing high-protein, low-carbohydrate regimens and fasting strategies to manage glycosuria. Though arduous and only partially effective, his approach represented the best available therapy until the introduction of insulin in 1922.
Through Der Diabetes Mellitus, Naunyn firmly established metabolic medicine as a scientific discipline, linking clinical observation with physiology and chemical pathology. His influence persisted well into the 20th century, shaping diabetic management and acid–base physiology.
Experimental Pharmacology and Naunyn–Schmiedeberg’s Archives (1872)
In 1872, Bernhard Naunyn, together with Oswald Schmiedeberg (1838–1921) and Edwin Klebs (1834–1913), founded the Archiv für experimentelle Pathologie und Pharmakologie in Strasbourg. The journal became the principal outlet for experimental studies in pharmacology, pathology, and metabolism, and is today known as Naunyn–Schmiedeberg’s Archives of Pharmacology.
The journal reflected Naunyn’s vision of integrating chemical and physiological experimentation with clinical medicine. It published landmark studies on acids and metabolism, drug action, and disease mechanisms.
By offering a forum for rigorous experimental work, the Archiv helped establish experimental pharmacology as an academic discipline, and gave a voice to a new generation of physician-scientists who bridged laboratory and clinic.
The Archiv will concern itself with the scientific foundations of medicine, in particular the experimental study of disease processes and therapeutic agents. Editorial statement, 1872
Controversies
Not…The Nobel Prize
Naunyn was widely regarded as one of the giants of 19th-century internal medicine, yet much like his colleague Heinrich Quincke, he was never awarded a Nobel Prize.
He was nominated multiple times between 1905 and 1918 for his pioneering work in metabolic medicine, including his classic treatises on cholelithiasis and diabetes mellitus. His contributions to the understanding of acidosis, diabetic coma, and bile chemistry were considered fundamental advances.
Despite these achievements, the Nobel Committee repeatedly declined to award him the prize. By the time his candidacy was again reviewed in 1918, Naunyn was approaching 80 years of age, and like Quincke before him, was judged too old for the honour.
Notably, Nobel rules evolved: in 1966, Peyton Rous (1879–1970) received the Nobel Prize at age 87, for a discovery published 55 years earlier, correcting the ageist principle that once excluded Quincke, Babinski and Naunyn.
Major Publications
- Naunyn B, Schreiber J. Ueber Gehirndruck. 1881
- Nothnagel H, Naunyn B. Über die Localisation der Gehirnkrankheiten. 1887
- Naunyn B. Mittheilungen aus der medicinischen Klinik zu Königsberg i. Pr. 1888
- Naunyn B. Kurzer Leitfaden für die Punction der Pleura- und Peritonealergüsse. 1889
- Naunyn B. Klinik der Cholelelithiasis. 1892 [Translated: A treatise on cholelithiasis. 1896] [Murphy sign]
- Naunyn B. Der Diabetes melitus. 1898
- Naunyn B. The development of internal medicine with hygiene and bacteriology in the 19th century. 1900
- Naunyn B. Erinnerungen Bedanken und Meinungen. 1925 [English translation and publication: Memories, Thoughts, and Convictions Ed: Cowen DL. 1994]
References
Biography
- Müller F. Bernhard Naunyn. Deutsches Archiv für klinische Medizin. 1926; 150(1):
- Bernhard Naunyn (1839–1925). Nature 1939; 144: 410
- Woodyatt RT. Bernhard Naunyn. Diabetes. 1952; 1(3): 240-1.
- Bernhard Naunyn (1839-1925), clinician, teacher, scientist. JAMA. 1969; 208(7): 1182-3.
- Loriaux DL. Bernhard Naunyn (1839–1925). The Endocrinologist 2006; 16(5): 239-240
Eponymous terms
- Walter F. Untersuchungen über die Wirkung der Säuren auf den thierischen Organismus. Archiv für experimentelle Pathologie und Pharmakologie 1877; 7: 148-178
- Pohar M, Hansson N. The “Nobel Population” in Pharmacology: Nobel Prize laureates, nominees and nominators 1901-1953 with a focus on B. Naunyn and O. Schmiedeberg. Naunyn Schmiedebergs Arch Pharmacol. 2020 Jul;393(7):1173-1185
Eponym
the person behind the name
