Gaetano Perusini (24 February 1879 – 8 December 1915) was an Italian physician. He was the pupil and colleague of Alois Alzheimer and contributed to the definition of Alzheimer's disease.
Education and early family life Gaetano Perusini was born in Udine on February 24, 1879, to a successful family of physicians. Perusini's father, Andrea, was the Chief Physician of the Civil Hospital of Udine and his mother, Paolina Cumano, was the daughter of two prominent surgeons from Trieste. Perusini lost his father when he was only seven years old. This lack of a paternal force in the family enabled his growth and upbringing to be influenced mainly by his mother, a strong maternal personality, who guided his studies and encouraged his interest in medicine. Perusini began studying medicine at the University of Pisa and then went on to finish his training at the University of Rome. In Rome, he often visited the local psychiatric clinic, the Lungara Mental hospital. After graduating, Perusini decided to specialize in psychiatry, spending time at the psychiatric clinic of Augusto Giannelli and the neuropathology laboratory of Giovanni Mingazzini. Thanks to his time at professor Giovanni Mingazzini's laboratory, Perusini gained a deep passion for mental illnesses and an interest in pathological anatomy, which led to his enthusiasm to discover the organic basis of mental illnesses. Perusini graduated with a degree in Medicine at the age of 22, defending a thesis on Criminal Anthropology written under the guidance of prof. Giannelli.
The Auguste Deter case In November 1906, during a meeting of the psychiatry society in Tübingen, Alzheimer presented a case of premature dementia: Auguste Deter, a 51-year-old woman, who died only four years after she was diagnosed. The anatomical findings highlighted cortical atrophy, and diagnostic methods revealed accumulations of neurofibrils within neurons and "miliary foci" (rounded foci) deposit of "an abnormal substance" outside of them. The presentation of the case was received coldly and no questions were asked for clarification from the speaker, much less from the moderator of the debate, the psychiatrist Alfred Hoche, of Freudian origin and therefore an opponent of Kraepelin, who made Alzheimer's report seem clinically and scientifically irrelevant. Only the following year, after having changed the title, will Alzheimer be able to publish it in a brief report, without iconographic material. Alzheimer was convinced that he was facing a rare brain pathology and therefore decided to entrust the case to Perusini for a more in-depth and detailed evaluation of both the clinical aspects and the histopathological findings. Perusini re-examined the case of Auguste Deter and collected three other cases (47, 63 and 67 years old) of severe and rapid dementia in a 59 pages treatment accompanied by 79 drawings depicting the neuronal alterations, made by Perusini and collected in four tables. Perusini believed that the neuro-pathological findings of the early onset cases did not differ from the senile ones, in fact in his discussion, he deliberately included the two senile cases (63 and 67 years old). By doing this, Perusini would have predicted the modern conception of this disease according to which presenile and senile dementia are not two isolated entities and, at the same time, disproved the position of Kraepelin that rejected this possibility.
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