During the Franco-Prussian War he worked as a volunteer in a Typhuslazarett in Metz, and in 1875 earned his medical doctorate at the University of Strasbourg. From 1877 to 1879 he was an assistant to Robert Ferdinand Wilms (1824-1880) at the Bethanien Hospital in Berlin. When Wilms was incapacitated due to illness, he was provisional head at the hospital.