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In 1911 he went to Hamburg to work with Theodor Kaes and became head of the laboratory of anatomical pathology at the psychiatric State Hospital Hamburg-Friedrichsberg.
Following the death of Kaes in 1913, Jakob succeeded him as prosector.
After serving in the German army in World War I, he returned to Hamburg and climbed the academic ladder.
He was habilitated in neurology in 1919 and in 1924 became professor of neurology.
Under Jakob's guidance the department grew rapidly.
He made notable contributions to knowledge on concussion and secondary nerve degeneration and became a doyen of neuropathology.

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