7th Annual Meeting of the International Society for the History of the Neurosciences (ISHN)

Los Angeles, California, USA
1 - 5 June 2002

Go to Meeting Program

Neurosciences in Los Angeles or Angels in neurosciences?

Geneviève AUBERT
Universitairé Catholique de Louvain; Department of Neurology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium

The range of topics covered by neurosciences is extremely diverse, from neuroanatomy to neurosurgery, through neurolinguistics and neurophilosophy. Recently, spectacular breakthroughs in neuromythology and neurotheology have been reported. Surprisingly, despite their ubiquity, angels have received scant attention in this context. We carried on an in-depth search through ancient and modern, scientific and general literature. We considered appropriate to present here the preliminary results of this study.

Wings are the best known attributes of angels. References to wings have been found in many neurological publications. Brain edema associated with sphenoid wing metastasis or meningioma, or winging of the scapulae observed in neuromuscular disorders are but two examples. However, angels' wings seem a recent acquisition, dating back to the fifth century AC only. In the Bible, angels commute between earth and heaven by a ladder. Ladder climbing still is part of standard function testing in behavioral assessment of motor skill learning in rats.

The common phenomenological base from which experiences of angels is derived, appears to be a right hemispheric homologue of the left hemispheric sense of self, according to an experimental study of exposition to weak complex magnetic fields (Cook & Persinger, 1997). Disappointingly, we were unable to trace any reference to experimental studies of angels in dreams. Similarly, the messenger role of angels is not reminded in the terminology of neurotransmitters.

The role of protective angels in pain relief has been addressed in one study of post-surgical pain management (Heilgman & al., 1983). On a neuropharmacological side, not surprisingly, Angelica archangelica, of the family Umbelliferae, has well-known antimigrainous properties.

The most numerous figures of angels in neurosciences have been found in the literature dedicated to neurorehabilitation and mental health nursing. Particularly interesting are the studies addressing such issues as professionalization and unionization, the division of labor and the gendered dimensions of nursing as women's work. This last subject raises a heated debate, as the sex of angels is still under discussion.

Session II -- Poster Session
Sunday, 2 June 2002, 10:00 - 11:00 am

Photography and cinematography before 1914: The neurosciences discover multimedia

Geneviève AUBERT
Universitairé Catholique de Louvain; Department of Neurology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium

At the beginning of the nineteenth century, the introduction of the experimental method and of the anatomo-clinical approach brought about a revolution in biomedical sciences. Observation, measure and experimentation called for new tools. The birth of photography was in line with these technological developments and with the advances in chemistry and optics. The objectivity of the photographic document held the scientific community spellbound. Photographic pictures were multiplied, distributed, projected at large gatherings.

Microphotography was one of the first scientific applications of the new technique. Microscopists such as Schwann, Cajal or Van Gehuchten were deeply interested in photography. However their use of this medium in their histological practice was very limited.

Clinical applications of photography quickly developed with the advent of new rapid emulsions. Physicians not only tried to highlight neurological signs but also attempted to explore their patient's mind. Neuroanatomical and neurophysiological studies were the topics of the first medical books illustrated with photography.

Study of movement and gait, made by a French physician, the physiologist E.J. Marey, and an English-American photographer, E.J. Muybridge, directly led to the development of cinematography. This new medium would show the human body in its physiological perfection as well as in its pathological clumsiness. At the beginning of the twentieth century, a few pioneers such as Van Gehuchten in Europe and Weisenburg in America would assemble the first collections of motion pictures of neurological patients.

Session VIII -- Frames of Viewing: Photography and Cinematography in Neuroscience History
Tuesday, 4 June 2002, 9:00 am - 12:30 pm

Brain plasticity and cognitive and behavioral changes in early development: 19th century perspectives

Isabelle BARRIERE1 and Marjorie Perlman LORCH2
1Department of Humanities, University of Hertfordshire & Department of Cognitive Science, The Johns Hopkins University, Baltimore, Maryland, USA; and 2Department of Applied Linguistics, Birkbeck College, University of London, UK

This paper discusses the findings which emerge from the examination of nineteenth century monographs and unpublished archives produced by prominent European and American clinicians, philosophers, neurologists and developmental psychologists. These writings demonstrate that a distinction was made between the possibilities of recovery in children and adults exhibiting behavioral and/or cognitive disorders. Secondly, they observed that the acquisition of certain cognitive abilities was easier for children than for adults (see Ball, in Kussmaul, 1881, for instance). Charcot (unpublished ms) and Ribot (1881) both evoked brain plasticity to explain these differences between adults and children when it comes to both recovery of functions and cognitive development while Ball (1881) and Baldwin (1906) evoke the interdependence of cognitive capacities.

The findings which emerge from this investigation pertain to the research strategies applied to the study of brain maturation (Parrot, 1879) and the behavioral evidence on the basis of which a causal relation was established between the maturation of the brain and cognitive development. The implication of this investigation for the conceptualizations of critical periods in development, the distinction between (typical and atypical) children and adult populations, and the current notion of 'modularisation' are discussed.

Baldwin, J.M. (1906) Mental development in the child and the race. 3rd edition. New York: MacMillan.

Kussmaul, A. (1884) Les troubles de la parole: traduction française augmentée de notes par le Dr. A. Rueff; précédée d'une introduction par B. Ball.

Parrot, M.J. (1879) Sur le développmernt du cerveau chez les enfants du premier âge. Archives de physiologie normale et pathologique, 2ème série, vol. 6, pp505-521.

Ribot, T. (1881) Les maladies de la Mémoire. Paris: Baillière.

Unpublished archive: Observations Charcot, Bibliothèque Charcot Paris VI, MA 8 12, Chemises 4-2.

Session II -- Poster Session
Sunday, 2 June 2002, 10:00 - 11:00 am

Can worms do more than squirm? Invertebrate learning in the early 20th century

Department of Psychology, Yale University, New Haven, Connecticut; and Center for the Neurobiology of Learning and Memory, University of California, Irvine

Today, invertebrate preparations are powerful model systems for examining the neural mechanisms of learning and memory. However, the fundamental assumption that invertebrates are capable of learning has not always received such universal support. Several prominent animal behaviorists of the early twentieth century, such as Loeb and Jennings, explained invertebrate behavior as arising from instincts or simple tropisms. This view seems to have arisen, in part, from both a general backlash to overextended claims of animal intelligence espoused by Romanes and others, and to societal changes reflecting advances in mechanical and electrical technologies. Thus, whereas present-day use of invertebrates is largely restricted to species amenable to a neurobiological analysis, early studies of invertebrate conditioning sought to determine the universality of learning capabilities and tested a broader range of species. It was not until advances in neurophysiological techniques in the 1950's and 1960's that invertebrates were appreciated for their brains, rather than their brawn.

Session II -- Poster Session
Sunday, 2 June 2002, 10:00 - 11:00 am

Surgery under general anesthesia in second-century China: The legend of Hwa Tuo

Nai-shin CHU
Department of Neurology, Chang Gung Medical College and Memorial Hospital, Taipei, Taiwan

In traditional Chinese medicine, Hwa Tuo (110? - 208 A.D.) is one of the most famous doctors. In medical treatment, he used only few herbs or few points in acupuncture and achieved excellent results. His ultimate fame came from his remarkable skills as surgeon and his discovery of the use of general anesthesia.

According to the Annals of the Later Han Dynasty (ca. 430 A.D.) and the Chronicle of the Three Kingdoms (ca. 270 A.D.), Hwa Tuo performed operations under general anesthesia and the operations even included major ones such as dissection of gangrenous intestines. Before the surgery, he gave patient a narcotic wine to drink to become drunk, numb and insensible. The anesthetic which was called "numbing effervescing powder" was dissolved in the wine.

Unfortunately, the exact composition of the anesthetic powder was not described in his or other Chinese medical writings. The herb has been thought to be datura flower which contains atropine and scopolamine, aconite root, or rhododendron flower.

Confucian teachings regarded the body sacred and surgery as a form of body mutilation was not encouraged or even became a taboo. Despite his great achievement, practice of surgery could hardly take off and the death of Hwa Tuo marked the end of Chinese surgery.

In Western medicine, the first operation under ether general anesthesia was performed by Morton in 1846. How could Hwa Tuo accomplish such scientific achievement in the second century has remained a mystery. Even so, it is quite remarkable that Hwa Tuo had come up with the idea of performing surgery under general anesthesia of narcotic wine.

Session IX -- Early Neuroscience: Chinese, Arabic and Islamic Medicine
Wednesday, 5 June 2002, 8:30 am

The hippocampus before H.M.

Department of Philosophy, Washington University, St. Louis, Missouri

William Scoville and Brenda Milner's patient H.M. rivals Phineas T. Gage and Paul Broca's "Tan" as the most well-known and influential case study in the history of functional localization in the brain. Specifically, the case of H.M. is frequently depicted as a crucial turning point in the understanding of the neural mechanisms of memory. An adequate account of the significance of H.M for the study of hippocampal function must address the state of the literature prior to Scoville and Milner's first report (1957). An investigation of research reports and textbooks reveals a wide variety of functions associated with the hippocampus prior to H.M., many of which echo well into the 1970's and 80's. I want to examine the evidential foundations of these functional attributions and the reasons, if any, for their gradual disappearance from scientific currency and pedagogy. By tracking developments in functional localization of the hippocampus, I hope to assess the extent to which different views were influenced by different experimental techniques, different field affiliations, and other developments (such as the discovery of Long-Term Potentiation) that are not directly relevant to assessing the function of the hippocampus.

Session III -- Neuropsychology, Language and Cognition
Sunday, 2 June 2002, 4:15 pm

Tatsuji Inouye's pioneering mapping of the cortical visual area by the effect of gunshot wounds

Division of Clinical Neurosciences, The Center for Applied Research in Head Injuries, Rambam (Maimonides) Medical Center, B. Rappaport Faculty of Medicine, The Technion-Israel Institute of technology, Haifa, Israel

At the end of the 19th century and by the turn of the 20th century, investigators, were engaged in a running controversy regarding the location and organization of the primary vision center in the brain.

Tatsuji Inouye (1880-1976), a young medical officer in the Japanese Imperial Army during the 1904-1905 Russo-Japanese war, devised a novel three-dimensional model of the human head and could locate the calcarine cortex in its coordinates, constructing a prototype of modern stereotaxis instrumentation. By using entrance and exit wounds he calculated the destroyed region of the primary visual center or its afferent fibers. Inouye studied, single handed, with a creative pioneering approach, the visual field defects in the brain-injured soldiers in relation to the injured cortex, being among the firsts to use war wounds for the mapping of brain centers. The analysis of accurate case reports enabled him to study the dynamics of recovery and was among the firsts to recognize the clinical evidence for the budding concept of diaschisis. He addressed fundamental questions about the cortical representation of central and peripheral vision and the areas devoted to each. Inouye established that the periphery of the visual field is represented anteriorly and the fovea posteriorly. His maps also show that there is a disproportionately larger of cortex devoted to central vs. peripheral vision. Inouye's work "Die Sehstörungen bei Scüßverletzungen der kortikalen Sehsphäre Nach Beobachtungen an Verwundeten der letzten japanischer Kriege" (Leipzig 1909) is a model of outstanding innovating clinical research; undertaken alone, with amazing skill and deep insight into the problems to be addressed. His studies preceded those of Holmes, who, assisted by the use of X-rays could study a larger number of isolated missile wounds of the brain after World War I. Holmes' map, the basis of our modern interpretation of visual fields, has been recently modified by Horton and Hoyt who showed, using MRI studies, as Inouye predicted, that the magnification of the central retinal projection onto the cerebral cortex to be even larger than was previously thought.

Session VI -- Anatomical and Physiological Models and Techniques
Monday, 3 June 2002, 2:30 pm

History of the discovery, physiology, and clinical use of the blink reflex

Edward J. FINE1 and Christopher VICENTE2
1Department of Neurology, Buffalo Veterans' Affairs Medical Center; and 2Clinical Neurophysiology, State University at Buffalo, New York

Soon after the blink reflex (BR) was first described by Walker Overend (1858-1926) in a letter to the Editor of Lancet in 1896 (I:619), American neurologist Daniel J. McCarthy (1874-1958) and Russian physiologist Vladmir Bekterev (1857-1927) made acrimonious claims for their individual "discovery" of the BR. This presentation will examine their claims, compare Overend and his competitors' concepts to current knowledge about the physiology and current clinical applications of the BR. Overend noted that" when the skin of the forehead is gently taped with the edge of an ordinary wooden stethoscope, a twitch in the lower eyelid of the same side may be observed ..and while severe percussion elicits a simultaneous movement of the opposite lids".."It is a true skin reflex" and the motor pathway is identical to the conjunctival reflex; the sensory channels lie in the ..supraorbital division of the frontal nerve and the centre is probably located in the midbrain". He noted that the area for eliciting the reflex was more in choreic patients than normal subjects.

In 1901 McCarthy (Neurologische Centralblatt 20:800-1) claimed priority for eliciting reflex contraction of the orbicularis oculi by taping the skin of the forehead with a percussion hammer. He noted that division of the supraorbital nerve extinguished the BR. McCarthy stated that the afferent portion of his reflex was through CN V because sectioning the sensory root of the Gasserian ganglion abolished the reflex. McCarthy concluded that his supra-orbital reflex was identical to a tendon reflex. Also in 1901 Vladmir Bekterev (Neurologische Centralblatt 20:930-6) overlooked Overend's report, disputed McCarthy's claim for priority but concurred with McCarthy that the BR was similar to a tendon reflex and lesions of the sensory root of the trigeminal abolish the reflex.

Erik Kugelberg electrically stimulated the supraorbital nerve, recorded the early latency R1 and the late R2 electromyographic (EMG) responses from orbicularis oculi muscles to confirm that the BR was a cutaneous reflex (Brain 75:385-396). The R1 and R2 of the BR was delayed or abolished by lesions in trigeminal nerve, confirming Overend's original observations about the afferent pathway of the BR. Overend was only partially correct about the anatomy of the BR; synapses for the R1 and R2 responses lie in the pons and medulla and not the midbrain. Overend was proven partially correct by the observation that the BR has a decreased stimulus threshold in chorea. The blink response has been shown to be the initial response of the startle. Currently the BR is used to monitor the function of CN V or VII in surgery for acoustic neuroma, predict the outcome of Bell's palsy, detect occult lesions in multiple sclerosis patients and assess activity of the brainstem reticular formation in patients with disorders of attention and startle. The blink reflex can elicited by mechanical tap, loud sound or electrical stimulus.

These observations favor our contention that Overend should be recognized for priority of discovery and accuracy of most of his observations about the BR.

Session VI -- Anatomical and Physiological Models and Techniques
Monday, 3 June 2002, 4:00 pm

Thus saw Zarathustra: The eyes and brain of Friedrich Nietzsche

St. Inigoes, Maryland

The iconoclastic philosopher Friedrich Nietzsche had poor vision throughout his life, well before becoming mentally deranged in 1889 at the age of 45. The admitting physician of the sanitarium to which Nietzsche was committed noted pupillary abnormalities and diagnosed "general paresis of the insane" or tertiary syphilis. Biographies of Neitzsche in the century since his death often refer to his alleged neurosyphilis, although the diagnosis is problematical: no Wasserman test was yet available, no autopsy was performed, and clinical grounds alone argue against the diagnosis. Schizophrenia, the more likely diagnosis, was just starting to emerge as a recognized entity. Emil Kraepelin's Clinical Psychiatry (Sixth Edition), in which he clearly distinguished manic-depressive disorder from dementia praecox, appeared in 1899, the year before Nietzsche's death.

Session VII -- Famous People and Disease
Monday, 3 June 2002, 4:45 pm

Parkinsonism-like disorders before Parkinson

Institute for the History of Medicine, University of Würzburg, Germany

James Parkinson indicated in the 1817 pamphlet on the disorder named for him that he was by no means describing a new disease, but rather one which until his time had been comparatively neglected by the medical community. Nevertheless, the question of the existence of parkinsonism before 1817 has often been posed since the appearance of his treatise, and not only through idle curiosity. The major factor that has impeded the development of an effective therapy for parkinsonism has been ignorance of its precise etiology. It is therefore important to know whether the disorder has long been a problem associated with aging, or whether it emerged only recently, perhaps in response to specific environmental, nutritional or social conditions. As the disease currently appears to be widely distributed geographically, it would appear unlikely that any single causative agent will suffice as an explanation for all cases of parkinsonism. But the temporal distribution of the disease in history is also important, as it might allow medical historians to correlate the disorder with a particular sets of specific environmental circumstances, including climate, other medical disorders or social and industrial development. References to tremor disorders and their treatment in pre-19th century literature will thus be discussed in this context. It is clear that retrospective diagnoses are rarely secure, and that parkinsonism is by no means the only disorder in which tremor is a prominent symptom, but the association of many of these disorders with old age or epidemic fever provides a tantalizing motivation for their cautious examination.

Session XI -- Scientific Methods and Metaphors
Wednesday, 5 June 2002, 4:15 pm

A comparative study of the views held by Galenus versus those held by Islamic (Iranian) physicians towards the neurosciences

Ali FORUHI and Behnam JAMEIE
Department of Anatomy, Iran Medical Sciences University, Tehran, Iran

Islamic physicians, apart from Greek medicine, were familiar with Ancient Iranian medicine and Indian medicine due to the effect of Gondi-Shapour on the School of Bakdad. However, the foundation of their knowledge, including their information on the neurosciences, was formed by Greco-Alexanderian medicine (basically Hippocrates and Galenus). Nervetheless, sometimes the viewpoints of these physicians, particularly Avicenna, has been different from those of pioneering Greco-Alexanderian ones, and have also had innovations in this regard.

This article will briefly compare and contrast the information of Galenus on the neurosciences with the following Islamic scholars:

  1. Rabee Ben Ahmad Akhveeni: author of Hedayat -ol Motaallemin in the 4th century A.H. = the 10th century A.D.
  2. Avicenna: author of the Canonin the 5th century A.H. = the 11th century A.D.
  3. Sayed Esmaeel Jorjani: author of Zakheereh - E - Kharazmshahee in the 6th A.H. = the 12th century A.D. .
  4. Mansoor-Ben Ahmad Shirazi: author of Tashrih-e-Mansouri in the 9th century A,H. = the 15th century A.D.
  5. Hakim Abdorrazagh Gilani: author of Kholaset -ol -Tashrih in the 10th century A.H. = the 16th century A.D.

Generally, in the writings of Iranian (Islamic) physicians, there are new bits of ideas about the branching of the cerebral and spinal nerves, better and more comperhensive explanations of cerebral ventricles and their connections with one another. Also, reasonable and realistic interpretation of the meninges are presented, which will be reported in this article, with a focus on the branches of cerebral nerves.

Session IX -- Early Neuroscience: Chinese, Arabic and Islamic Medicine
Wednesday, 5 June 2002, 9:30 am

Cajal's vision of a neuronal cytoskeleton

Department of Cell Biology, and Department of Physiology, Biophysics and Neurosciences, Center for Research and Advanced Studies IPN, Mexico City, Mexico

One hundred years ago, Santiago Ramón y Cajal was obliged to open a new front in his battle to prove that the nervous system is constituted of discrete units. Just as the neuron doctrine was beginning to gain momentum among neurologists, it was threatened once again by a recently reinvigorated theory claiming that nerve impulses might after all be conducted over an uninterrupted network. According to this view, the actual conductors were not the anastomosed nerve fibers and cells per se, as was postulated by the original reticulum model, but so-called "neurofibrils" threaded through the fibers and cells as a continuous cable-like system which ran across long distances in the animal body. Stephan von Apáthy and Albrecht Bethe, in particular, had succeeded in showing crisply stained neurofibrils within, and apparently passing between, series of nervous elements in various invertebrates and vertebrates.

The new theory admitted the numerous evidences indicating that nerve cells and their processes are immediately contiguous though not continuous with each other, and in fact required this condition in order to guarantee an adequate electrical insulation for the neurofibrils presumably conducting impulses within. Yet it also agreed with the widely accepted concept of a functionally continuous nervous system. Therefore, this was a reasonable and experimentally supported compromise between the positions held by the defenders of the reticulum model and the proponents of the neuron doctrine. However, none of all this pleased Cajal, who at once arose to save the neurons from being regarded as mere protective envelopes for the allegedly conducting neurofibrils. Thus, the Spanish histologist became one of the forerunners in the investigation of the neuronal cytoskeleton.

This relatively little known aspect of the history of the neuron doctrine is examined on the basis of Cajal's representative writings on the matter. He started by mastering the staining methods used by Apáthy and Bethe to reveal neurofibrils, and then applied a novel and still better procedure developed by his friend Luis Simarro. The initial public response, presented at the XIX International Congress of Medicine (1903), was vehemently critical of the continuous conductor line interpretation, insisting that neurofibrils are strictly intracellular and that they in no case extend out of a given cell. The following year, in a more relaxed mood, he patiently reported in a series of papers his own keen observations of neurofibrillar arrangements within nerve cells in a variety of specimens, from earthworms up to the vertebrate retina. Finally, his mature conclusions on this topic, which could not be included in the original version of the monumental treatise on the texture of the vertebrate nervous system (1899-1905), found their way a few years later into the French translation revised and updated by the author. Here Cajal distinguished two classes of fibrils forming the intracellular network: "a) thick spans or primary filaments [...] which run in the same direction as the [cell] processes, [and] become strongly colored by the reactants; b) fine or secondary spans, paler and more weakly colorable, [which] have varying orientations and join the primary filaments with each other in such a way as to make of the protoplasmic skeleton a unitary whole." (Ramón y Cajal, 1909, p. 179). The last five words suggest a visionary notion that hardly anyone else had at the time.

Ramón y Cajal S (1909): Histologie du Système Nerveux de l'Homme & des Vertébrés, Tome Premier, (L. Azoulay, transl.), Paris, Maloine.

Session VI -- Anatomical and Physiological Models and Techniques
Monday, 3 June 2002, 3:30 pm

Brains, bodies, and mad scientists: Hollywood does neuroscience

Sheryl GINN
Wingate University, Wingate, North Carolina

The primary purpose of horrific cinema is to entertain, but explanations for phenomena that are unexplainable are clearly explored in such films. One theme explored in these films is the duality of nature. While psychologists, philosophers, and neuroscientists continue to debate the issue of monism and dualism, cinematographers explore the duality of homo sapiens in films as diverse as From Beyond and Dr. Jekyll and Mr. Hyde. Another theme concerns the inherent nature of human beings: are we by nature good or evil? The novel Frankenstein has frequently been analyzed in terms of this theme. For example, is the Creature evil because the brain used to animate him was abnormal, a plot device used in some of the film adaptations of the novel. Or, is the Creature evil because the normal brain used in the Creature's construction could not stand the horrific sight confronting it when awakened? Brains are infused with much power in horror films. Brains can live outside of the human body, for example in The Lady and the Monster (directed by Eric von Stroheim, 1944), a film adaptation of the novel Donovan's Brain, in which an insane financier hopes to control the world. Donovan's brain lives in a container of fluid from which it begins influencing people in order to obtain surrogate bodies. Fiend without a Face, filmed in 1958 and directed by Arthur Crabtree, concerns a series of mysterious deaths that have occurred near an Air Force base. Upon investigation a reclusive scientist is found to be tapping into the "latent powers of the brain". Unfortunately, he succeeds and unleashes a horde of brains possessing snail-like antennae. These brains are hungry for knowledge; they attack their "prey" and suck them witless through holes punctured in the neck (in the vicinity of the medulla). Many of the "brain" films star the "mad scientist." These movies have the general effect of convincing people that science is not only bad, but also downright evil. Scientists attempt to explore "worlds" that no one should, including the inner world. Some of these movies are blatantly anti-vivisectionist, and thus, influence the general public's view that scientists are sadistic beings, wanting to inflict harm on sub-human animals for harm's sake or for sheer curiosity. One example of this theme is H. G. Wells' The Island of Dr. Moreau (1896). To a mad scientist knowledge must be obtained, at any cost. In many highly popular films (such as Alien and Watchers) and television programs (such as The X-Files and Space: Above and Beyond), scientists who work for the military and/or unidentified government agencies are totally unscrupulous in their quests for knowledge, fame, grant money, tenure, you name it. In most films dealing with this subject, scientists either create monsters that are truly horrific or locate alien creatures in the hopes of controlling the beasts. Usually these beasts turn on their creators, wreaking havoc on an unsuspecting populace, until finally the scientist receives his or her "just desserts." Considering the view that the general public receives from these films, is it any wonder that organizations such as NSF and NIH have difficulty obtaining funding for research? Or that scientific literacy in America is considered so abysmal?

Session VIII -- Frames of Viewing: Photography and Cinematography in Neuroscience History
Tuesday, 4 June 2002, 9:00 am - 12:30 pm

Historical cinematographic documents in neurology

Christopher G. GOETZ
Department of Neurological Sciences, and Department of Pharmacology, Rush University/Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois

The implicit visual nature of neurological diagnosis and the early introduction of medical photography in the neurological services of Charcot, SW Mitchell, and others positioned neurological specialists as natural beneficiaries of the new science of cinematography. The archives of the American Academy of Neurology, the Movement Disorder Society, and the private collections of international colleagues provide a variety of historically pertinent early film documents on neurological diseases. Luminaries including Marinescu, van Bogaert, Lance-Adams, Bucy, and Denny-Brown documented neurological diseases with moving film and captured diseases as diverse as post-encephalitic parkinsonism, locomotor ataxia, and numerous movement disorders. These documents provide insights into the creative methods of early neurologists and carefully document the clinical signs of many disorders that are no longer regularly seen. In addition, modern technology has allowed field investigators to travel worldwide and document neurological disorders confined to isolated geographical regions. Examples include kuru, latah, and parkinsonism-amyotrophic lateral sclerosis of Guam.

Session VIII -- Frames of Viewing: Photography and Cinematography in Neuroscience History
Tuesday, 4 June 2002, 9:00 am - 12:30 pm

Gomez Pereyra (1500-1567): Precursor of the scientific method

Jamie G. GOMEZ1 and Elizabeth A. LONG2
1Jupiter, Florida; and 2West Hollywood, California

Gomez Pereyra, 16th century medical doctor, philosopher and inventor, published his first work in 1554. The subject of his work was a specific outline of a Scientific Method, based upon the relation between Nature and cause and effect. His work depicted the way to discover the truth by verification using experimental evidence. (Cohen 1947)

All research laboratories throughout the world use the Scientific Method. The majority of researchers firmly believe it was Rene Descartes, (17th century) the famous French philosopher, who described the Method. Very few know that one century earlier Gomez Pereyra laid down the basis of the Experimental Method being used today.

The basis of this assessment lies in the publication of Gomez Pereyra's books, Antoniana Margarita (1554) and Novae Veraque Medicine (1558), two extremely rare books maintained only in a few libraries. Gomez Pereyra was a physician and philosopher of the University of Salamanca. His work is quite well known in Europe, but almost unknown in the U.S.A. Only five references of his work are found in the English language. Antoniana Margarita was reprinted as a facsimile in Latin and translated into Spanish in 2000 by the University of Santiago de Compostela (ISBN 84-8121-805-7).

Anastasio Chinchilla (1840) wrote, "Pereyra is "the physician whom greatest honor and glory has given to Spain." French author Guardia (1889) wrote, "Pereyra is the most important Spanish Philosopher and Spain has done nothing to divulge his memory."

In presenting this to the forthcoming conference, we believe attendees will find Gomez Pereyra's contributions uplifting and be rewarded in discovering this unknown scientist's work.

Session XI -- Scientific Methods and Metaphors
Wednesday, 5 June 2002, 3:00 pm

Dr. Charles West: a 19th century perspective on childhood aphasia

Paula HELLAL and Marjorie LORCH
Birkbeck College, University of London, UK

Dr. Charles West founded the first English specialist pediatric hospital, the Hospital for Sick Children in Great Ormond Street, London in 1852. He remained the hospitals senior physician for 23 years, devoting a great deal of his energies to describing the nervous diseases of infants and children. In 1871, West delivered the prestigious Lumleian lectures, the last of which concerned disorders of the nervous system in childhood. West divided this talk into two parts, the first concerning speech the highest endowment of our race the second, the mental and moral peculiarities of childhood.

Loss of speech in the child, West believed, was almost always a transitory condition. He had seen only one case in which the pattern of aphasia in a child was similar to those described in the adult literature. This particular case concerned a 5 year-old girl who, after sunstroke and a coma lasting a fortnight, was found to have right-sided hemiplegia and loss of speech. West describes the recovery of the paralysis (excepting the arm) and the child's attempts at vocalisation. She remained at the hospital for a number of months and was readmitted on 3 occasions during the following 3 years allowing West to follow her progress. He relates this case in the lecture because hers is the earliest age at which, as far as I know, aphasia, accompanied with paralysis of the right side, has been recorded.

Of greater interest to West were cases of temporary aphasia. Loss of the power of speech in the child would be absolute for a while, returning completely, and being independent of any grave disorder of the intellectual powers. He had no theory to offer to account for this state but observed that it occurred with greater frequency in the child than the adult.

West's lecture was delivered only a decade after the first papers on Broca's aphasia appeared in the medical literature. Throughout the 19th century cases of aphasia in childhood were overshadowed by reports of aphasia in adults. It was not even universally accepted that the condition could exist in children. West's lecture was an early attempt, based on his decades of clinical experience, to classify and categorise language loss and disturbance in children. The transitory nature, in many cases, of aphasic symptoms in childhood, already noted by West, was to become an important feature of the traditional picture of acquired aphasia in children by the turn of the century.

Session III -- Neuropsychology, Language and Cognition
Sunday, 2 June 2002, 3:15 pm

From the foundational time period in Berlin in which hospitals were built, and the development of clinical neurology until 1933

Neurology, Schlosspark Klinik, Berlin, Germany

During the so-called Gründerjahre or "founding years" in Berlin it became necessary to build new hospitals because of rapid population growth. As a result, several infirmaries, insane asylums and institutions for epileptics were built between 1877 and 1912. The University Neurology Clinic of the Charité was opened in 1905 according to plans made by Friedrich Jolly, the physician who named myasthenia gravis pseudoparalytica. A "Neurological Central Station" of Oskar and Cecil Vogt, in existence since 1895, was a research center dedicated more to morphology, where the study of the structure of the cerebral cortex by K. Brodmann and research into basal ganglia diseases by O. and C. Vogt began. The Kaiser-Wilhelm Institute for Cerebral Research which moved to a new building in 1931 also had its beginnings here. Hermann Oppenheim (1858-1918) promoted independent clinical neurology as did his younger contemporary Max Lewandowsky (1876-1918) who was already advising physician for neurology at the Berlin-Friedrichshain Hospital. Hugo Liepmann (1863-1925), the creator of apraxia teachings, worked at the insane asylums in Dalldorf (Berlin-Wittenau) and Berlin-Herzberge. In 1911 the first neurological unit was established in the large hospital in Berlin-Buch under the leadership of Otto Maas. Not until after the First World War were further neurological hospital units founded under the direction of Paul Schuster (1867-1940), Kurt Goldstein (1878-1965), Kurt Löwenstein (died 1953) and Friedrich Heinrich Lewy (1885-1950). These Jewish colleagues, as well as C. E. Benda and Otto Maas had to leave their posts in 1933 and emigrate. The clinical institutions and scientific achievements of these pioneers in independent clinical neurology will be presented up until the point of their violent dissolution.

Session X -- Politics of Science
Wednesday, 5 June 2002, 11:00 am

For and against physiological interaction of mind and brain: Animists and Vitalists against Leibnitz and psycho-physical parallelism

Hansruedi ISLER
Zürich, Switzerland

G.W. Leibnitz, the polymath who invented binary arithmetic, differential calculus, and German philosophy, rejected the interaction of body and soul. G.E. Stahl's animist school of medicine attributed all functions of the body to the soul. Stahl's book "Skiamachia", 'shadow-fight' of 1720 is a dialogue of Stahl and Leibnitz on these differing views. The controversy survived up to now, sometimes known as the body-mind-problem. Leibnitz' division of the soul from the body was adopted by Boerhaave, and by his student, Haller, who taught Europe experimental physiology. Haller rejected de Sauvages' early electrical theory of nerve conduction, and similarly, Unzer's findings of cerebral tracts and his theory of reflex action as the principle of brain function, which Unzer had learned from Willis. Unzer belonged to the Animist school which was replaced by the Vitalist school in the late 18th century, positing a specific "life force" as the principle of all living matter. The head of that school, Reil, traced tracts in brains preserved in alcohol, coined the term 'psychiatry', and founded the first psychiatric hospitals in early 19th century. Prochaska, a Vitalist in Vienna, matched Unzer's brain research. Unzer and Prochaska were rediscovered by Laycock who translated their works in English. Laycock was the first and most influential teacher of Hughlings Jackson who, however, preferred to return to the doctrine of Leibnitz (known via Laycock), adopting psycho-physical parallelism in his doctrine of concomitance. Meanwhile, the Vitalist Johannes Mueller in Berlin launched his pupils Du Bois Reymond, Helmhotz, Bruecke and a score of others on paradigm-changing careers in the life sciences, especially the neurosciences. Those three became sworn enemies of Vitalism in favour of strict Mechanism, again isolating the body from the psyche. This may have been the origin of the still existing bias of historians against Vitalism and Animism. In the late 19th century, brain localization and motor neurophysiology demonstrated the causal interaction of body and mind, reviving the need for psycho-physiological links. Vitalism was resurrected to help out, in the form of R. Semon's Mnemism: living organisms were distinguished by their ability to record sensory stimuli as engrams, and to reproduce them (ecphore), both in individual and in genetic memory (Mneme). And Wundt, a student of Mueller and Helmhotz, attempted to reintegrate the sciences, from physics through experimental psychology to the psychology of peoples. - Conclusion: Leibnitz' psycho-physical parallelism protected the mainstream of the neurosciences from psychology, and psychology from physiology, while Animists and Vitalists used their psychophysiological perspectives to develop new patterns of discovery.

Session I -- Mind, Brain and Consciousness
Sunday, 2 June 2002, 8:45 am

Henry Head and S.A. Kinnier Wilson: the contested Jacksonian legacy

Stephen JACYNA
Wellcome Trust Centre for the History of Medicine, London, United Kingdom

It is a commonplace of the history of the subject that John Hughlings Jackson was the most influential figure in nineteenth-century neurology. His influence was particularly strong among members of the Queen Square school who, through their teaching and publications, spread Jackson's doctrines throughout the world. What is less widely recognised is the diversity of interpretations made of this legacy. The paper considers the differences over the significance of Jackson's work between two of his notable self-professed disciples.

Samuel Alexander Kinnier Wilson (1878-1937) was among the most distinguished members of this school. Born in New Jersey, Kinnier Wilson's family moved to Great Britain where he was educated. He studied medicine at the University of Edinburgh where he first developed an interest in neurology. He undertook postgraduate training in Paris with Pierre Marie before settling in London. As well as his clinical and teaching work, Kinnier Wilson in 1920 was founding editor of the Journal of Neurology and Psychopathology.

Kinnier Wilson published extensively on various topics within neurology, including aphasia, apraxia, and the epilepsies. His work was marked by frequent references to and deferential quotations from the writings of John Hughlings Jackson. At the same time, however, he framed his views on the clinical and pathological manifestations of aphasia very much in opposition to those of another professed Jacksonian, Henry Head.

Head (1861-1940) studied in Cambridge and at University College London, as well as stays in Prague and Halle. Like Kinnier Wilson, Head spent most of his career as a clinician and teacher in London. He is best known for his work on sensation and aphasia. As editor of Brain, Head republished several of Jackson's papers in an effort to rescue his views from oblivion. In his highly polemical account of the history of aphasia studies, Head depicted Jackson as a solitary voice of sound reasoning in an era dominated by excessively schematic views. His own views on the subject were avowedly based on Jacksonian principles.

The paper will compare Kinnier Wilson's and Head's understanding of the Jacksonian legacy. It will aim thereby to gain additional insights into the state of neurological thinking in the early decades of the twentieth century with special reference to the debate between holist and more classical localizationist attitudes.

Session V -- Hughlings Jackson
Monday, 3 June 2002, 10:30 am

Spinal cord injuries in Islamic medicine

Abdul Nasser KAADAN
History of Medicine Department, Institute for the History of Arabic Science, Aleppo University, Syria

Muslim physicians, in the Middle Ages, played a considerable role in the field of medicine development as a whole and neurosciences in particular.

Al-Razi (Rhazes) medical writings greatly influenced the Islamic world as well as Western Europe. He devoted an important chapter in his encyclopedic medical book al-Hawi (Continens) for talking about vertebral fractures and cord injuries. In this regard he stresses on the necessity of removing the bone sequestrae which injuring the cord.

Ibn-Sina, or Avicenna as known in the west, is considered one of the most important Muslim physicians in Islam. Al-Qanunn Fit-tib (or Code of Laws in Medicine) represents the most important work of ibn-Sina, and as William Osler described it, the most famous medical textbook ever written. In the fourth volume, when ibn-Sina talked about vertebral fractures he mentioned that cervical vertebra dislocation might cause death. In some cases he advised surgical bone decompression.

Al-Zahrawi (Albucasis) is considered one of the most important Muslim surgeons who lived in al-Andalus. His book (Kitab al-Tasrif) was translated into many European languages. It contains a special chapter for setting vertebral fractures. He mentioned that the physician should take care when treating the patient if there were lose of sensations and movements in the upper limb in the case of cervical vertebra injuries.

The aim of this paper is to review and highlight spinal cord injuries as viewed by the most prominent Muslim physicians, and to reveal their contributions and achievements in this field of medicine.

Session IX -- Early Neuroscience: Chinese, Arabic and Islamic Medicine
Wednesday, 5 June 2002, 10:00 am

"My head! My head!" Cephalalgia in magical and medical texts of Pharaonic Egypt

Axel KARENBERG1 and Christian LEITZ2
1Institute for the History of Medicine and Medical Ethics, University of Cologne, Germany; and 2Department of Egyptology, University of Cologne, Germany

Interdisciplinary studies on the history of headache in ancient civilizations are scarcely extant. Following a brief introduction to basic historiographical issues and available sources, the main objective of this paper will be to provide a comprehensive and detailed outline of the subject.

Few references to various forms of headache can be extracted from the so-called magical papyri and from medical texts of the New Kingdom. Although little is known about the quality of headache and about accompanying symptoms (such as nausea and vomiting), the texts do specify four predominant localizations: the head or skull in general, half (i.e. one side) of the head, the temple, and the nape. The lack of precise descriptions make it definitely impossible to establish the retrospective diagnosis of migraine.

Attempts to interpret the phenomenon of headache, and corresponding therapeutic measures (magical, pharmacological, or surgical) range from supernatural to natural, and from magical to empirical. The dominant explanation - at least in the texts that have survived - is a magical one. This reminds us that most patients throughout the centuries, regardless of the contemporary mainstream medical opinion, relied on healers with an intimate connection to supernatural forces. To be successful, the ancient Egyptian headache therapist had to combine a threefold qualification: that of a priest on excellent terms with the divine sphere, that of a physician of long experience, and that of a magician undertaking the impossible. Perhaps present-day neurologists may feel that the expectations they are subject to are not dissimilar.

Session II -- Poster Session
Sunday, 2 June 2002, 10:00 - 11:00 am

Towards a modern understanding of medicine in ancient civilizations: new magical texts on general seizures in Pharaonic Egypt

Axel KARENBERG1, Christian LEITZ2, and Hans-Werner FISCHER-ELFERT3
1Institute for the History of Medicine and Medical Ethics, University of Cologne, Germany; 2Department of Egyptology, University of Cologne, Germany; and 3Institute and Museum of Egyptology, University of Leipzig, Germany

For almost a century, our perception of medicine in pharaonic Egypt has largely been shaped by medical texts, particularly by the Edwin Smith and Ebers papyri. In recent years, however, scholars have focused more intensively on so-called magical texts, thus putting the healing arts into a broad cultural context. Recently printed critical translations and the publishing of "new" texts enable us to revise a multitude of former results and convictions including various aspects of "neurological" signs and symptoms in ancient Egypt. Basic aspects of this modern approach will be outlined in the first part of this paper.

Using the case study method, this new approach will be exemplified in the second part with the presentation and analysis of texts on general seizures. Until the late 1980s, the modern nosological category "epilepsy" was regarded as a disease well-known in Ancient Egypt and described in the Ebers papyrus (EBBELL 1927, SCHNEBLE 1986). Meanwhile it is quite clear that the nsyt-disease mentioned in papyrus Ebers is not a form of epilepsy, but a skin condition (BARDINET 1988, LEITZ 2001). The discussion gained new momentum when two hitherto unnoticed texts on the "falling sickness" from the 13th/12th century BC were taken into account (FISCHER-ELFERT 2000).

Following the examination of these sources, the audience will be faced with a choice of at least two different interpretative approaches. The first is that of retrospective diagnosis, i.e. mainly the question of whether or not these texts are describing a grand mal . The second possibility is to explore in depth the cultural background of the magical treatment recommended in the textual documents. Advantages and shortcomings of both procedures will be discussed, thus adding a new variation to the perennial question: how should a historian of disease deal with descriptions from former civilizations?

BARDINET, Thierry (1988): Remarques sur les maladies de la peau, la lèpre, et le châtiment divin. Revue d'Égyptologie 39:3-36.
EBBELL, Bendix (1927): Die ägyptischen Krankheitsnamen. IX. nsyt = Epilepsie. Zeitschrift für ägyptische Sprache und Altertumskunde 62:13-16.
FISCHER-ELFERT, Heinz-Werner (2000): Fallsucht im Alten Ägypten. Ätiologie, Diagnose und ihre magiko-medizinische Behandlung. Würzburger medizinhistorische Mitteilungen 19:117-127.
LEITZ, Christian (2001): Epilepsie im Alten Ägypten? Schriftenreihe der Deutschen Gesellschaft für Geschichte der Nervenheilkunde 7:149-155.
SCHNEBLE, Hansjörg (1986): Nomen est omen - Krankheitsnamen und Krankheitsverständnis am Beispiel der Epilepsie. Der Nervenarzt 57:383-390.

Session IV -- Epilepsy
Monday, 3 June 2002, 8:30 am

A tale of two cities: Hermann Oppenheim of Berlin, Hermann Hoppe of Cincinnati, and myasthenia gravis

Department of Neurology, School of Medicine, University of California, Los Angeles

One of the earliest papers describing a case of what came to be known as myasthenia gravis was written in German by an American, Hermann Hoppe. After completing his medical school education and internship in Cincinnati, Ohio, Hoppe pursued medical studies in Europe, first with Naunym and von Recklinghausen in Strassburg and then with Herrmann Oppenheim in Oppenheim's private polyclinic in Berlin. Oppenheim had published one of the first descriptions of myasthenia gravis (MG) in 1887. He invited Hoppe to present another of Oppenheim's cases in 1892. Hoppe compared it to three previous cases in the literature. Hoppe then returned to Cinicinnati to begin a successful neuropsychiatric private practice, while Oppenheim's polyclinic became an international center of neurology. In his great textbook of nervous diseases, first published in 1894, Oppenheim credits Hoppe with establishing that myasthenia gravis was a special clinical condition. Oppenheim went on to produce the first monograph on myasthenia gravis, which he classified as a "neurosis" because there was no demonstrable pathology.

Session X -- Politics of Science
Wednesday, 5 June 2002, 11:30 am

Frames of viewing: How the evolution of science and technology has altered our visual world

Lawrence KRUGER
Getty Research Institute; and Department of Neurobiology, University of California, Los Angeles

The limitations of seeing are largely shaped by biological factors regulating the time domain of visual events but the scale and absolute dimensions of art can be traced historically initially to socio-political determinants, until the advances in photography in the early 19th century. The human visual scanning apparatus operates in a large series of temporal frames, and if the eyes and head are immobilized we quickly can detect little more than luminance. Oscillatory, saccadic and voluntary eye movements and enduring blinks impose temporal and spatial framing but we have only succeeded in overcoming the blurring effect of after-images and the disappearance of stabilized images through the development of "shutter" devices that have enabled visualization of the unseen. Technological advances in controlling the duration of image exposure on the retina and in the production of photosensitive emulsions and spatially distributed digital detector devices, has reshaped the degrees of freedom accessible for imaginative expression and consequently has become a key determinant of the course of modern art history. This presentation examines how the impact of quantification in physiological science and the birth of photography led to new art forms tied to the inventive spirit of technology that has expanded and refashioned our understanding of the human visual apparatus and how we examine and display our visual world.

Session VIII -- Frames of Viewing: Photography and Cinematography in Neuroscience History
Tuesday, 4 June 2002, 9:00 am - 12:30 pm

Metaphors behind the brain

NPO "Meditsynskaya Encyclopedia", Moscow, Russia

Did metaphors play a crucial role in the development of neuroscience? How they were used? Psychologists claim that metaphors serve two communicative functions: 1) the expression of otherwise inexpressible or 2) the use of a metaphor might be more economical and hence more effective way to understand the matter.

Neuroanatomy is full of metaphors: David's lyre, Ammon's horn, globus pallidus (a pale ball), locus coeruleus (a blue sport), pons (a bridge), aqueduct (a water-pipe), vermis ( a worm), velum (a sail), fissura calcarine (a spurred furrow), parahippocampal gyrus (a bend around a sea-horse), thalamus (a sleeping chamber), pulvinar (a pillow), mamillary (nipple-like) bodies, pallim (a cloak), tentorium (a tent) etc. Many clinical symptoms such as "sunset sign" (gaze paresis) in hydrocephalus, "cracked pot sign" in cranial fracture, "pill-rolling" tremor in Parkinson's disease, "pose of a hunting dog" (when patient is lying on the side with flexed legs abducted to the abdomen) in acute meningitis etc. are also metaphorical, as well as the so-called "vegetative (i.e. vegetable) state".

With the advent of modern diagnostic equipment new metaphors are being used. For example, in bilateral subdural hematomas "symptom of hare's ears" (when anterior horns of lateral ventricles are brought nearer and straightened) on CT- or MRI-scans has been described. "Salt and pepper symptom" could be seen on CT-scans (a combination of tiny zones of high and low brain density) in hemorrhagic cerebral contusion. The advantage of such metaphors is their vivid imagery and easy memorization.

All concepts of brain functioning are also metaphorical. The use of metaphors reflects the level of our knowledge about the nature. For example, Réné Descartes coined the term "reflex" from the idea that nerve impulses are reflected in the brain like in the mirror. Another Cartesian metaphor is that pineal gland regulates the flow of animal spirit similar to an oven-door. These were mechanical metaphors. In a computer era they underwent a considerable change. In late 1950-ies Carl Pribram claimed that brain functioning is analogous to computer programming. In the late 1960-s the same author suggested that metaphorically speaking the mechanism of formation the images of a surrounding world inside the brain is holographic.

Metaphors are important instruments for studying and understanding the brain both before and behind the mind.

Session XI -- Scientific Methods and Metaphors
Wednesday, 5 June 2002, 3:30 pm

Epilepsy, paralysis and aphasia: The influence of Jabez Spence Ramskills (1824-1897) on John Hughlings Jackson

Marjorie LORCH
Applied Linguistics, Birkbeck College, University of London, United Kingdom

Much of the work on John Hughlings Jacksons early years of development point to the influences of Jonathan Hutchinson and Charles Edward Brown-Siquard (e.g., Critchley, 1998 and Greenblatt, 1970). These men are credited both with influencing Jacksons choice of focus on neurological disorders, and the appointments he secured at the National Hospital in Queen Square and the London Hospital. There is another figure who has until now remained in the background. He appears to have been significant in providing the opportunity and context which led Jackson to make his innovative and insightful theoretical advances in the understanding of higher cerebral function disorders.

Jabez Spence Ramskill (1824-1897), born in the same year as Broca, was 10 years Jacksons senior. In the 1860s, Ramskill was Physician and Lecturer in Medicine at the London Hospital, Physician at the Metropolitan Free Hospital, and the first member of staff of a new specialist hospital in Queen Square. It was Ramskill who was responsible for persuading the founders to include epilepsy as focus for the National Hospital which was originally conceived to provided exclusively for those suffering from paralysis. Ramskill was also instrumental, along with Hutchinson and Brown-Siquard, in gaining Jackson each of his appointments: at the National Hospital as his assistant in 1862, at the Metropolitan Free Hospital, and later at the London Hospital as both physician and lecturer. In addition, Ramskill was a significant source of case material upon which Jacksons earliest ideas on the function of the nervous system were based. Ramskill was responsible for the caseload at the National Hospital which grew from 8 inpatient beds in 1860 to include over 8,000 outpatients by 1868.

As assistant physician to Ramskill at the National Hospital, Jackson was provided with the vast case series which provided the source of inspiration for his work on the heirarchical organization of the nervous system. While Ramskills concerns were primarily focussed on patient care and efficacy of treatment, he provided a context for Jacksons more theoretical work on epilepsy, hemiplegia and aphasia. The early writings and case notes of Ramskill and Jackson provide evidence for the close link of interests between the two, and the debt that Jackson had to Ramskill for providing him with the opportunities to develop his original ideas.

Critchley, M and Critchley, E. 1998. John Hughlings Jackson: Father of English Neurlogy. Oxford University Press, Oxford.

Session V -- Hughlings Jackson
Monday, 3 June 2002, 11:00 am

Epilepsy care in 15th century Northern Italy

1Neurology Department, "M.Mellini" Hospital, Chiari, Italy; 2Spedali Civili Library, Brescia, Italy; 3Social Studies Department, The Faculty of Economics, University of Brescia, Italy; and 4Foundation "Morcelli" Library & "Repossi" Picture Gallery, Chiari, Italy

In the 15th century, two institutions administered hospitals in Northern Italy: the Christian Congregation - the only centralized organization to survive the collapse of the Roman Empire - and the City Council.

The Church taught that it was a religious duty to care for the sick and had set up universities to train doctors. Galeno's works were seen as fulfilling Christian ideas and were still read by doctors in the 1400s.

The City Council also recognized that public health was important for all of the community. At first, the Council gave money for the building of hospitals but did not become involved in their running. Later, many hospitals had financial problems and could not provide for the needs of the people. The Council decided with collaboration of the religious congregations to amalgamate their oldest hospitals in one big hospital.

By the middle of the 15th century, Brixia (today called Brescia) had thirteen important hospitals managed by the Christian Congregations. In addition, there were two small lazarettes that cared for those with bubonic plague - the Black Death. On 26th March 1447, the building of a Great Hospital by the Republic of Venice, Doge Francesco Foscari (Brixia was under the dominion of " La Serenissima"), and Pope Eugenio IV, was approved. The Municipality Administration in agreement with local Bishop Pietro del Monte joined 7 of 13 hospitals to create the Great Hospital.

Before this, the Council was influenced by the practice in several major European cities and had decided that some hospitals should specialize in the care of particular diseases. One hospital was set up for women and another for men. In 1442, the Municipality had designated one of the two lazarettes of the city by a resolution - St. Bartholomew's in Clausuris - to care for patients with epilepsy. Maybe St. Austin's Congregation (Congregazione di S.Agostino) - that managed this lazaretto - admitted patients with "falling sickness" for devotion into St. Bartholomew's Church and into hospital. For several time this hospital cared patients with Epilepsy. In 1451, St. Bartholomew's in Clausuris became part of the Great Hospital.

Although the causes of epilepsy were unknown, it is clear that epilepsy was recognized as a condition that required specialized care. We will discuss of the role of religious and civil institutions to care Epilepsy in 15th century Northern Italy.

1) Archivio Storico di Brescia, Fondo Ospedale Maggiore, Bolle di Fondazione
2) Guerrini P. S.Bartolomeo al lazzaretto.Memorie storiche della diocesi di Brescia, Vol. XV, pp 64-67, 1948
3) Mariella A. Le origini degli ospedali Bresciani. Commentari dell'Ateneo di Brescia. Geraldi, Brescia, pp 122-123, 1963

Session IV -- Epilepsy
Monday, 3 June 2002, 9:00 am

Stephen Walter Ranson's organized research unit at Northwestern University Medical School: its leadership style

Neuroscience History Archives, University of California, Los Angeles

During the late 19th and early 20th centuries, progress in knowledge of the brain was facilitated by the famous Continental and British ORUs and "schools" where basic research on nervous systems, from invertebrate to human, was the core pursuit of investigators trained in the biomedical sciences. In Germany, for example, the Edinger Institute at Frankfort, formalized in 1914; the Kaiser Wilhelm Institute for Brain Research of Cecile and Oskar Vogt, in Berlin-Buch, Neustadt (1914); and Wilhelm Wundt's department of physiological psychology at Leipzig, since 1879, easily come to mind. The influence of those and many other centers on American neuroscience was the direct result of visits of various lengths by Americans (and other nationalities) intent on learning more about nervous systems. The ORUs subsequently established by Henry Donaldson, Wilder Penfield, and John Fulton (1930) were among many others.

At least one productive American center made its immediate mark in that era while preserving a decidedly old-world type of leadership style, the Institute of Neurology of Stephen Walter Ranson (1880-1942). He had had two sojourns abroad before he organized his institute at Northwestern University Medical School in Chicago in 1928, and was already an established investigator and teacher. The team he subsequently assembled consisted of six scientists plus technicians and custodians. His revival of the use of the Horsley-Clarke stereotaxic apparatus in exploration of the hypothalamus and other subcortical regions brought a continuous stream of graduate and postdoctoral students and visitors. Ranson's sudden death in 1942 precipitated the gradual dismantling of the institute. It is informative to speculate on what made the short-lived institute an outstanding influence in neuroscience while its leader adhered to a tightly controlled system of management.

Session II -- Poster Session
Sunday, 2 June 2002, 10:00 - 11:00 am

The origins of EEG

Department of Neurology, UCLA Medical Center, Los Angeles, California

Hans Berger's invention of the electroencephalogram (EEG) is one of the most surprising, remarkable, and momentous developments in the history of clinical neurology. It is a well-known fact that Berger was the first to record the human EEG. Yet the unusual motivation for Berger's psychophysical research program, his eccentric model of cerebral energetics, and the technical, personal, and political obstacles that marked the path of his discovery deserve historical attention. Understanding Berger's work within the context of his own scientific era and life's experiences highlights both the familiar and the foreign in Berger's story, and provides an historical prelude to the modern investigation of the brain and its functions.

As a young man, Berger was involved in a bizarre military accident that almost cost him his life. Thereafter he maintained an unwavering belief in mental telepathy and embraced the philosophical concept of interactionism, arguing for a physical connection between mind and brain at a time when the world of brain research was polarized by recurrent debates between localizationism and holism, having already divorced itself from philosophical speculation. As a former student of the physical sciences Berger adopted a naturwissenschaftlich approach to psychophysical research, applying the most rigorous scientific law of his day - conservation of energy - to the functions of the brain. Indeed, energy conservation was applied for models of brain function by figures as the Gustav Fechner, August Forel, Theodor Meynert, and experimental psychologists Hugo Munsterberg, Oswald Külpe, and Alfred Lehmann.

It was Lehmann's theory of cerebral energetics that clearly identified the boundary conditions for Berger's psychophysical study of brain function: namely, the supply of metabolic energy to the brain and its transformation into heat, electricity, and mental phenomena. He speculated that with reasonable estimates of cortical energy stores and precise measurements of the heat and electricity produced in cortical tissue, it would be possible to calculate the energy converted into thought, feelings and emotions, i.e. psychic energy! Over the next three decades, Berger adopted this thermodynamic model of brain function and pursued each of these lines of investigation. Following the earlier work of Angelo Mosso, Berger first recorded changes in cerebral blood flow in patients with cranial defects with the use of a plethysmograph. Later, Berger turned from recording the energy supply to the brain, to measuring the energy converted into heat and electricity during various mental tasks. It was the last of these challenges, recording the electrical current of the brain from the surface of the scalp, that ultimately Berger led to his Hirnspiegel (brain-mirror), the human EEG.

There were many obstacles to his achievement. Berger had only minimal training in basic electrophysiology and he was constantly operating the most delicate of physiological instruments at the outer limits of their sensitivity. Every improvement in recording technique or apparatus brought its own set of technical difficulties, exacerbating Berger's self critical attitude and bouts of depression. In addition, many of Berger's colleagues at Jena were critical of his work and alienated by his promotion to Professor of Psychiatry, adding to his isolation at Jena. Berger perservered throughout, however, and pioneered the theory and application of EEG in many neurological and psychiatric diseases. When Berger described his technique for recording the electrical activity of the human brain from the surface of the head in 1929, the medical and scientific establishments met him with incredulity and overwhelming skepticism when they did not ignore him altogether, only accepting the human EEG after Berger's discovery was replicated by the Cambridge physiologist Lord Adrian in 1934.

Session VI -- Anatomical and Physiological Models and Techniques
Monday, 3 June 2002, 3:00 pm

Inside and outside the professions: Lobotomy in the professional and lay spheres in Scandinavia during the introduction and growth of the procedure

Kenneth Ögren
Department of Culture and Media, and Department of Psychiatry, University of Umeå, Sweden

The history of lobotomy can be observed by looking at the professional as well as the lay representations. What is the professional story on lobotomy in the medical journal, the psychiatric congress and the annual report of the state mental hospital and what is this story when it comes to representations in the daily newspaper, the yellow press and the popular press? These questions are approached in my paper.

The first lobotomy procedures in Sweden, 1944, were performed on a limited scale by neurosurgeons in Stockholm in collaboration with psychiatrists. The studies performed were thoroughly researched indicating a skeptical view especially regarding the effectiveness of the operation on patients with a diagnosis of schizophrenia. These pioneers of the lobotomy procedure in Sweden obviously issued a warning to enter a practice including this group indiscriminately.

When lobotomy was introduced in the State Mental Hospitals in Sweden, 1946-1948, the overweighing group of patients to be operated on was the schizophrenic group. What factors contributed to such a practice which seems to be opposing the very early warnings of the pioneers ?

When the lobotomy procedure is presented in the Swedish public sphere, in the daily newspapers and the popular press, the operation is mainly mirrored in bright colors and the new surgical approach to mental illness is described as a new and hopeful opportunity to the thousands of hospitalized patients. and there relatives.

This paper also deals with the professional discourse of lobotomy represented in a series of Scandinavian psychiatric congresses during the years of 1946-1952 reflecting a psychosurgery debate which mainly was hidden to, or not reflected in the public sphere.

Session XI -- Scientific Methods and Metaphors
Wednesday, 5 June 2002, 5:15 pm

A neglected pioneer of psychological testing: an up-date on the life and work of Howard Andrew Knox (1885-1949)

Institute of Educational Technology, The Open University, United Kingdom

Howard Knox was a physician who was employed by the U.S. Public Health Service between 1912 and 1916 as an assistant surgeon in the immigration station at Ellis Island, New York. In response to professional and public concern that the physicians at Ellis Island were failing to detect mental retardation among potential immigrants, Knox and his colleagues devised early psychological tests that made minimal use of language. After 1916, Knox did no further work on this problem, but his tests were widely used both in the United States and around the world.

Knox has been a wholly neglected figure in the history of psychological testing. However, his writings contain many insights on the aims and limitations of intelligence tests, and his work is a key link between the initial research of Binet and Goddard and the later research of Pintner, Yerkes, and Wechsler. Nowadays, indeed, we take it for granted that any adequate measure of intelligence must include both verbal and performance tests, and it is thanks to Knox that we have a much broader view of the nature of intelligence and of how it can be measured.

At the 5th Annual Meeting of the ISHN, I gave an introduction to Howard Knox's life and work, based solely upon the limited evidence that was available in the published literature. Since then, I have been able to built up a far richer picture from U.S. Government archives and particularly from documentation and other information supplied by Knox's own family. In this presentation, I want to share this picture and discuss what we now know of someone who, for just four years, was such a prolific scientist at the forefront of test construction.

Session III -- Neuropsychology, Language and Cognition
Sunday, 2 June 2002, 3:45 pm

What do Hunayn ibn Ishaq and Ibn al-Haytham have in common?

Department of Humanities in Medicine, Texas A&M College of Medicine, College Station, Texas

How to describe a three-dimensional structure such as the eye, whether verbally or graphically, has been a problem starting with Graeco-Arabic to early modern texts on vision. The lack of its recognition as a problem has been an impediment in interpretations.

This question will be taken up with reference to two Arabic texts which contain the oldest extant set of schematic diagrams of the eye (The Ten Treatises on the Eye by Hunayn ibn Ishaq; the Latin Johanntius; d. 877), and of the visual system (The Optics or the Kitab al-Manazir of Ibn al-Haytham; the Latin, Alhazen; d. 1040).

Although both of these texts have been immensely influential in the west, the diagrams have received attention only as a catalogue of parts.

They have features in common which are not only significant for the history of ocular iconography but closely related to the explanations of vision in the texts.

It will be argued that contrary to the established views, Ibn al-Haytham's own diagram can be seen to faithfully convey the visual optics of the text. Despite attempts to replace it with later ones, the diagram is, in fact, the key to the underlying logic of Ibn al-Haytham's description of the dioptric mechanism of the eye.

Finally, it will be shown that the diagram represents an attempt to establish a set of graphic conventions to deal precisely with the problem of how to convey the spatial relationships of the structure of the eye.

In addition, the principles underlying the diagrams will be illustrated with reference to the 'brain-teasing' works of the Dutch painter Escher.

Session IX -- Early Neuroscience: Chinese, Arabic and Islamic Medicine
Wednesday, 5 June 2002, 9:00 am

All from fibres: Erasmus Darwin's neuroscience

Chris U.M. SMITH
Zürich, Switzerland

Erasmus Darwin was a major figure in the medico-scientific world of mid to late eighteenth century England. He died on April 18 1802 and hence 2002 is his bicentenary. Trained in medicine at Cambridge and Edinburgh his medico-scientific interests were extensive. In his last publication, The Temple of Nature (1803), he developed an evolution theory which closely resembles, though predating, that of Lamarck. In the Zoonomia (1794; 1796) he outlines a neuropsychology which has resonances with that of Haller, Boerhaave and Julien Offray de la Mettrie. Like his more famous grandson he was concerned to develop an over-arching theory to account for his wide-ranging observations,in his case of medical practice. Like Boerhaave and la Mettrie, but unlike his more sensible grandson, he was part of that Western intellectual tradition engaged in the mind-brain debate. In his endeavour to distance himself both from the hydraulics of the Cartesians and the Newtonian vibrationism of David Hartley he developed a neuropsychology based on an elementary unit that, in his theory, is a 'living fibre'. He uses this concept to account not only for motor outflow but also, and more interestingly, for sensation, perception and mentation. In his attempted unification of psychology and physiology he has been regarded as one of the founders of psychosomatic medicine. In this paper I shall discuss his neuropsychology and compare it with the other psychophysiologies of the eighteenth century. How original is Darwin's thought? Has it exerted any influence on subsequent neuroscience?

Session I -- Mind, Brain and Consciousness
Sunday, 2 June 2002, 9:45 am

Acetylcholine, atropine and their ups and downs in epilepsy theory and treatment

Neurology Division, Children's Hospital, Los Angeles, California

Acetylcholine, atropine, muscarine and nicotine were all known (in crude form) in the 19th century, but chemical neurotransmission was a 20th century idea. Sir Henry Dale proposed acetylcholine as a cellular regulator in 1907; its neurotransmitter role was proven by Otto Loewi in 1921, who showed that "vagusstoff" released by nerve stimulation was acetylcholine. Dale and Loewi shared the 1936 Nobel Prize. Sakel's use of insulin coma for schizophrenia, starting in 1927, is well known. Some know that Meduna replaced insulin with metrazol, but how many realize that acetylcho-line was injected intracisternally to produce convulsions for the treatment of general paresis?

The famous British neurologist S.A. K. Wilson listed four primary anticonvulsant drugs in 1933. They were phenobarbital, potassium bromide, belladonna and borax. Atropine is the active principle of belladonna. Acetylcholine was used as a convul-sant in clinical medicine and laboratory investigation. Frank Forster noted in 1945 that acetylcholine (Ach) was the only convulsant found in the mammalian brain, and therefore likely to be of special importance in epilepsy. However, by 1955, the use of atropine and atropine-like drugs for epilepsy had greatly declined. There were no controlled trials, but good results obtained with hydantoins and succinimides after World War II seemed to sweep borax and belladonna from the field, and the discov-ery of GABA in 1953 was followed by the realization that many convulsants were GABA antagonists.

Acetylcholine is not dead. The lithium-pilocarpine epilepsy model, introduced by Olney and coworkers, has been fruitful in epilepsy research. The 1990s saw the de-lineation of autosomal dominant nocturnal frontal lobe epilepsy as an epilepsy syndrome usually due to mutations in nicotinic cholinergic receptors. This syndrome is uncommon and genetically heterogeneous, but one form is associated with mutated nicotinic Ach receptors, shown to be especially sensitive to carbamazepine. Atropine was not a good antagonist of most ACh convulsant effects studied in the 1930s and 1940s. Cholinergic receptors are important in learning and brain excitability. Today we know many neurotransmitters, and don't expect any one to "explain epilepsy". We see that nicotinic receptors are as important as muscarinic receptors for human epilepsy.

Session IV -- Epilepsy
Monday, 3 June 2002, 9:30 am

Instrument transfer as knowledge transfer in neurophysiology: François Magendie's early attempts to measure cerebrospinal fluid pressure

Institute for History of Medicine and Medical Ethics, Friedrich-Alexander-University Erlangen-Nuremberg, Germany

François Magendie's (1783-1855) experimental model to measure blood pressure in animals had a major impact on the development of 19th-century-French physiology. It was based on the empiricist view that hydraulic models and physical analysis had a legitimate place in physiological research. Magendie's experimental paradigm was soon received by other European physiologists, such as Carl Ludwig (1816-1895) and Jules Marey (1830-1904), as well as by clinicians who developed it into a major measuring technique for blood pressure during the later half of the 19th-century.

Yet, hardly any attention has been paid by historians of science and medicine to Magendie's further investigations conducted with the help of Jean-Louis Marie Poiseuille's (1799-1869) sphygmometer developed in 1828: After having used the apparatus to experiment on a variety of blood vessels, Magendie applied the sphygmometer to the ventricular system to measure cerebrospinal fluid (CSF) pressure. The scope and limit of this new procedure, however, still had to be defined. The new measuring device invited many speculative interpretations regarding the meaning of CSF flow in the physiology of the ventricular system as well as in terms of the state of brain function in normal life and psychic illness. Magendie's experiments produced phenomena in very heterogeneous knowledge spaces, and CSF measurement was situated at the interface of disparate investigative perspectives on brain structure and function.

Magendie's constitutive work on the subject began with an experimental shift: In his 1840/41 Leçons sur les fonctions et les maladies du système nerveux, he describes the application of the measuring "apparatus of Poiseuille" from blood vessels to parts of the brain. The instrument really became a sort of liquordynamometer. In the explorative manner of Magendie's experimental setting, this liquordynamometer led to new scientific interpretations and paved the way for diagnostic intracranial pressure (ICP) measurement by Theodor Kocher (1841-1917) or Harvey Cushing (1869-1939). My paper will focus on the epistemological contingencies that prompted the instrument transfer in Magendie's laboratory.

Neuron doctrine or reticular theory? The benefits of incorporating historical events into neuroscience classes

Laurie SWAN
Program in Physical Therapy, Central Michigan University, Mount Pleasant, Michigan

Purpose: Foundation courses in neuroscience are often a process of memorization at a factual level. The purpose of this presentation is to demonstrate how incorporating historical episodes into beginning level neuroscience courses can give contextual meaning and life to neuroscience.

Description: This presentation uses the controversy between Cajal and Golgi to illustrate three reasons why history can be beneficial in teaching neuroscience. First, "those who cannot remember the past are condemned to repeat it". Cajal's reductionism extended into the twentieth century, precluding a holistic view of the nervous system for many years. Late in the twentieth century, scientists began to understand that behavior is the integration of many different neurological systems, and a holistic view of the nervous system re-emerged. This lesson from the past has taught us that both reductionism and holism need to be included in the study of the nervous system. Second, incorporating history can move the cognitive level of Bloom's Taxonomy from a knowledge level (remembering facts) to an application level (using a concept to solve a problem). When teaching about chemical versus electrical synaptic transmission, Cajal's Neuron Doctrine and Golgi's Reticular Theory can be introduced. Students can be asked to defend one or both of these theories using current knowledge of synaptic transmission. Lastly, incorporating historical incidents encourages students to see that in science, personal attacks are a normal state of affairs. The opposing viewpoints of Cajal and Golgi were hotly contested during their acceptance speeches for the Nobel Prize. Should both of these scientists have won the Nobel Prize? What were some possible considerations in that time period of the people that decided that both Cajal and Golgi should be recognized?

Conclusion: This poster reviews potential benefits of incorporating historical events into a neuroscience class. Faculty may use this presentation as a starting point to incorporate the history of neuroscience into their classrooms.

Session II -- Poster Session
Sunday, 2 June 2002, 10:00 - 11:00 am

Instrumentalized vision: reflections on the mediated "modern" eye

Frances TERPAK
Getty Research Institute, Los Angeles, California

The Getty Research Institute recently mounted an exhibition entitled: Devices of Wonder: From the World in a Box to Images on a Screen. Seven years in the making, this exhibition clustered together optical devices, scientific instruments, rare natural history books, zoological, botanical, and mineral specimens, trompe l'oeil paintings, games, toys, prints, ephemera, and even a 17th-century Wunderkabinett that unfurled its rich collection of naturae/ and artificia. This fascinating and difficult to classify cultural material was provocatively grouped into concentrated thematic areas where objects ranging from the early modern to the contemporary resonated with each other to create an ocular history of visual culture and to pose inquiry. Among other things, the exhibition attempted to show how the supposedly "natural" eye was transformed in the past and continues to be altered today. The exhibition demonstrated how wondrous devices-existing at the interface between art and science-reflected, refracted, diminished, magnified, stretched, dissolved, projected, and animated objects to reveal how an enhanced perception occasioned new forms of consciousness in different historical moments.

Session VIII -- Frames of Viewing: Photography and Cinematography in Neuroscience History
Tuesday, 4 June 2002, 9:00 am - 12:30 pm

Charles Bonnet (1720-1793): On the neural basis of memory

Department of Psychology, Northern Michigan University, Marquette, Michigan

Charles Bonnet (1720-1793) of Geneva is known primarily for his contributions to biology, e.g. parthenogenesis in aphids and photosynthesis in plants. His contributions to cognitive neuroscience are rarely discussed. In his Essai de Psychologie (1754) and in his Essai Analytique sur les Facultes de l'Ame (1760) he proposed a unique (for the 18th century) view of the neural representation of memory processes as occurring in a group of fibers, somewhat prescient of a Hebbian model. Bonnet believed that the memory trace caused a change in neural fibers, a physical restructuring of its constituents ("corpuscules"). A bundle of fibers were able to interact, leading to recall and recognition; the more fibers were stimulated the stronger the memory trace. He claimed that different fibers carried different types of information, foreshadowing the doctrine of specific nerve energies of Johannes Mueller. Memory decline, forgetting, was the gradual deterioration of the fiber structures that were no longer being stimulated. Bonnet's change-in-structure view is easily distinguished from that of his contemporary David Hartley whose model of neural representation was based on (Newtonian) vibrations. Bonnet's influence seems to have been primarily on German physiological psychology ("fibernpsychologie") in the late 18th and early 19th century.

Session II -- Poster Session
Sunday, 2 June 2002, 10:00 - 11:00 am

Denny-Brown and British Anti-Lewisite (BAL, [2,3-Dimercaptopropanol]): The first curative treatment for Wilson's Disease (Hepatolenticular Degeneration)

1Department of Anatomy and Cell Biology, Indiana University School of Medicine, Fort Wayne, Indiana; 2Department of Neurology, Henry Ford Health System, Detroit, Michigan; and 3Department of Neurology, University of Michigan School of Medicine, Ann Arbor

Wilson's disease is a neurological disorder characterized by tremors, ataxia, rigidity, ballistic movements, dystonia, drooling and speech defects, and is now known to result from insufficient bilary copper excretion. Copper accumulates preferentially in several body structures, particularly the liver, brain and cornea. Cumings (1948) first demonstrated copper accumulation in Wilson's disease, and he stated, based on a study by Mandelbrote et al. (1948) of BAL (a chelating agent developed as an antidote to arsenic poisoning after WWI) that BAL might be useful in treating Wilson?s disease.

Derek Denny-Brown (1901-1981) was Director of the Neurological Unit of the Boston City Hospital (affiliated with Harvard University) at this time and had many Wilson's disease patients. After Cumings' report Denny-Brown, with the assistance of Huntington Porter (a research fellow), conducted the first clinical trial using BAL to treat five patients with Wilson's disease. The results of the trial were presented at the American Neurological Association's Meeting in 1951 and described in an article that appeared that year in the New England Journal of Medicine (NEJM). Denny-Brown also filmed these patients and showed sequences of them before and after treatment at the meeting (these films are currently in our possession and sequences from the films will be depicted with our presentation).

It is clear from the NEJM article that Denny-Brown was very unsure of dosages and frequency of BAL applications, which were injected intramuscularly. Nevertheless, the results were striking. The tremors and rigidity disappeared and previously mute patients could speak.

Unfortunately, BAL alleviated symptoms only temporarily. The injections had to be repeated every few months, and they were expensive and painful, and lost their effectiveness over time. Nevertheless, BAL continued to be used in Boston and at other major medical centers (e.g., New York) until 1956 when Walshe introduced a safer and more effective chelating agent, Penicillamine.

Although relatively short-lived in its application, Denny-Brown's demonstration of the effectiveness of BAL constituted a major innovation in the treatment of movement disorders, as it was first curative (rather than palliative) treatment devised for such a disease.

Cumings JN, Brain 71:410-15, 1948
Mamdelbrote BM et al, Brain 71
Denny-Brown D, Porter H, NEJM 245:917-923, 1951

Session VII -- Famous People and Disease
Monday, 3 June 2002, 5:15 pm

John Bulwer (1606-1656) and the significance of gesture in 17th-century theories of language and cognition

Solidarity Foundation, New York, New York

John Bulwer (1606-1656) published five books on the semiotics of the human body, giving most attention to gesture. His ideas on gesture have been studied from the standpoint of rhetorical theory, but little attention has been paid to them in relation to language and cognition. In this regard, Bulwer was a conscious disciple of Francis Bacon, who characterized gesture as a "transient hieroglyphic" in the same passage that inspired many attempts to develop a "real character" -- a sort of rationalized, non-figurative hieroglyphic intended to bypass ordinary language by symbolizing all things directly. Bulwer, however, completely ignores the real character idea and concentrates solely on gesture. This was partly because he held Rosicrucian views on the inherent ontological harmony between man and the universe, but largely because, as a physician, he saw an underlying neurophysiological basis for the reality of gesture as the universal "language" of humanity. In this respect his ideas foreshadow recent scientific work on gesture, language and cognition.

Session III -- Neuropsychology, Language and Cognition
Sunday, 2 June 2002, 2:30 pm

Progress report: The bibliography of John Hughlings Jackson

George K. YORK and David A. STEINBERG
Kaiser Permanente Stockton Medical Center and Såa Institute, Fiddletown, California

John Hughlings Jackson (1835-1911) instructed his cousin Charles Samuel Jackson to destroy all of his papers at the time of his death. Charles Jackson executed his cousin's wish; as a result, the only extant source of Hughlings Jackson's original scientific ideas is his published writing, found exclusively in contemporaneous medical periodicals and pamphlets. We collected these published writings, compiling them from previously published bibliographies, from our examination of the relevant periodicals, and internal references in his writings. We classified each article by year of publication and source periodical, and assigned a unique identification number. We assorted the articles into exclusive categories of bylined articles, case reports, letters, book chapters in multi-authored textbooks, pamphlets, case reports under his care, unsigned works that he later claimed, and third person commentaries. We assigned each paper to one or several subject categories. We then compared our bibliography to other published ones.

We have collected 545 papers by and about Hughlings Jackson published during his lifetime, 84 of which do not appear in any other bibliography. Eighty percent appear in five periodicals: Medical Times and Gazette, Lancet, British Medical Journal, Medical Press and Circular and Brain. Of the oeuvre, 392 papers were bylined pieces, 81 were reports of cases under his care and 72 were third person commentaries. Nineteen percent were devoted to epilepsy, 17% to cerebral localization and clinical neurophysiology, 13% to neuro-ophthalmology, 10% to paralysis and 5% to aphasia. Our catalogue raisonné shows the breadth of Hughlings Jackson's neurological interests. This bibliography, which should supersede previously published ones, will aid the study of Hughlings Jackson's neurology, and the historical origins of neuroscience.

Session V -- Hughlings Jackson
Monday, 3 June 2002, 11:30 am

ISHN-ECHN 2002 Annual Meeting -- Abstracts

Last updated 26 April 2002