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

Providence, Rhode Island, USA
11 - 14 June 2000

Go to 2000 ISHN Meeting Program

History matters: Putting the brain back into a history of brain death

Gary S. BELKIN
Erich Lindemann Mental Health Center, Harvard University, Boston, Massachusetts 02114 USA

When death occurs remains an active area of controversy, debate and uncertainty, unresolved by the advent of the 1968 "Harvard Committee" report declaring irreversible coma as a preferred standard method for declaring death. Debates swirling around the brain death construct, from calls to restrict it to "higher" cortical functions, to those wishing to abandon it altogether, often rest upon certain historical narratives of the development of the idea in the first place. Similarly, the appearance of brain death and reaction to it was an early skirmish defining and giving impetus to the early bioethics movement in the 1960's. Histories of that now flourishing and influential movement have generally cast the Harvard accomplishment as a narrow, self-protective assertion of medical authority, thus reinforcing the movement's own claims to provide unique and legitimate scrutiny and insight.

These histories of brain death, however, generally fail to actually study the roots of this idea and practice. In this paper I will detail, through close readings of successive drafts of the Harvard report, and in particular the papers and central contributions of MGH neurologist and Committee member Robert Schwab, how the neuroscientific and clinical context shaped selection of the criteria. I examine the EEG-neurophysiological and clinical-neurological literatures and context during the decades prior and up to 1968 that were resources for his, and other's, efforts to explore relationships between coma, consciousness and death. By doing so, insights are made available to inform current debates about brain death, and bioethics emerges as a discipline requiring new historical and intellectual models of itself.

Providence, Rhode Island, USA

The Hawi by Razi (ca. 865 - 965 C.E.), Book One on nerve, brain, and mental disorders: Arabic sources for the history of neuroscience

Jennifer BRYSON <jennifer.bryson@yale.edu>
Department of Near Eastern Languages and Civilizations, Yale University, New Haven, Connecticut 06510 USA

The Hawi is a tenth century C.E. anthology of excerpts from Greek, Indian, and Arabic medical texts arranged loosely by topic from head to toe in about 25 volumes. The Hawi appears to have been a form of "notebook" used by the Persian physician Razi (Latin: Rhazes, ca. 865 - 925 C.E.); these excerpts were compiled into a text after Razi's death by his students and became known as Kitab al-Hawi, i.e. The Comprehensive Book. The Hawi was translated into Latin in the thirteenth century, and this Latin translation, titled Liber Continens, was printed several times in Brescia and Venice in the fifteenth and sixteenth centuries and circulated widely in Europe.

In this paper I would like to discuss Book One of the Hawi, on nerve, brain, and mental disorders. I will explore the Greek, Indian, and Arabic works cited in Book One, providing an overview the sources included in Book One of the Hawi, and identify the methods by which Razi selected texts and excerpted passages from them.

The focus of this paper will be the information provided by the Hawi about the transmission of medical texts on nerve, brain, and mental disorders from Greek into Syriac into Arabic into Latin from about 200 - 1300 C.E.

Also, I will identify the topics which are included in Book One (stroke, trembling, convulsion, melancholy, epilepsy, headache, etc.) and discuss the types of sources cited by Razi for these topics.

This will not be a paper about Razi's views on brain, nerve, and mental disorders, nor will it cover medical "firsts" or "discoveries" in the Hawi. The Hawi is not a treatise by Razi about his own personal views. (In this paper I will discuss the common misperceptions in secondary literature that the Hawi is a collection of Razi's own clinical observations; it is not. I will explain the textual evidence which demonstrates that this text cannot be characterized as a collection of Razi's own clinical observations). The Hawi is rather an anthology of many different sources. It contains a variety of views. It is characterized by eclecticism, repetition, and general lack of order. The most important aspect of the Hawi for the history of neuroscience is the variety and the types of sources excerpted in this anthology, and the evidence we have for these sources today in Arabic manuscripts of the Hawi and in the Latin translation of this text, the Liber Continens.

The research for this paper has been conducted for my dissertation on Book One of the Hawi for the Ph.D. degree in the Dept. of Near Eastern Languages and Civilizations at Yale University; I intend to submit this dissertation by May 2000.

Providence, Rhode Island, USA

Lesions as therapy: Rigidity and Parkinson's Disease

William CLOWER
VA Medical Center, Syracuse, New York USA

Since James Parkinson first characterized the shaking palsy as a unique condition, significant confusion has remained concerning the causes and treatments of Parkinson's disease (PD). Through the 19th century, a wide variety of approaches were attempted in an effort to reduce its cardinal signs - rigidity, tremor, and bradykinesia - but to little effect. Today, approaching 200 years after Parkinson's seminal work, this disorder is commonly treated by surgical means, providing a lesion to one specific portion of the globus pallidus nucleus within the central nervous system.

The notion of providing a lesion to the nervous system as a therapy for PD, however, began in earnest at the beginning of the 20th century. The first attempt to alleviate the symptoms of PD through surgical means involved cutting the dorsal (sensory) roots of the spinal cord supplying the affected limb (also known as dorsal rhizotomy). Although ultimately resulting in disastrous effects, these early surgical attempts proceeded from a firm body of clinical and experimental research on both the central and peripheral nervous systems. After briefly reviewing the use and failure of dorsal rhizotomy as a treatment for Parkinsonian rigidity, this paper will examine the clinical and experimental foundations underlying this procedure.

Providence, Rhode Island, USA

Science and language in J.-M. Charcot's neurological works: A compositional and linguistic experiment applied to scientific historiography

Liborio DIBATTISTA and Lucia DI PALO
Seminario di Storia della Scienza, Dipartimento di Filosofia Università di Bari, Italia

Aims and purposes: This work, whose main feature is experimental, sets to locate, by computational and linguistic tools, a technical, specific language in neurological domain, considering Charcot's corpora textual analysis. A language that purposes to be a conceptual frame, able to reflect the described object, a stylistic symbol, Charcot's "syntactic-semantic" signature. So these linguistic and technical elements can be considered a proof (at least in France) of the birth of Neurology as a specific branch, distinct from medical and general Pathology.

Materials and methods: The first 3 volumes (1873, 1877, 1887, ed. by Delahaye and Lecrosnier) of Charcot's complete works were reduced in machine readable form, scanning them, in succession corrected and formatted. INTEX, a software produced by Mad Silberstein at LADL (Laboratoire d'Automatique Documentaire et Linguistique), University of Paris 7, was, subsequently, applied.

Preliminary results: Analysis of frequency lists where lemmas appear as elements of Charcot's neurological topics. The first substantives that occur in the texts are: "malade", its plural form "malades" and "maladies". They totalize 1402 occurrences. In succession, in accordance with the frequency list, there are: "nerf", "nerveux" (1210), "membre". This textual analysis points out Charcot's way to intend nervous diseases clinic. It's interesting to observe that "malade" and "malades" are conjugated at the feminine form, on the other hand, Charcot's job milieu is feminine - la Vieillesse Femme - a hospital where women are the main subjects, whose typical symptom is motor paralysis and following results are muscular atrophies with medulla lesions, generally nerve's lesions. This is the anatomical-clinical model. Analysis of ambiguous terms, not recognized by INTEX. It's a question of lexical items not acknowledged in Neurology specific lexicon, because they refer to syndromes and diseases, refused by the modern medicine. But, in a sense, they emphasize "l'histoire périmée" (the history) in Charcot's works, as for instance the affection of the ovaries doctrine and its rich linguistic vocabulary. Following researches foresee an analysis of sanctioned language, investigating a particular set of lexical items and linguistic structures that founded Neurology as an autonomous branch.

Providence, Rhode Island, USA

Gall's visit to the Netherlands

D. DRAAISMA¹ and Paul ELING^2
1Department of Psychology, State University Groningen; and ²Department of Psychology, University of Nijmegen, Nijmegen, The Netherlands

In March 1805, Franz Jospeh Gall left Vienna to start what has become known as his 'cranioscopic tour'. He traveled through Germany, Denmark and the Netherlands. His visit to the Netherlands has not yet received due attention. Gall was eager to go to Amsterdam since he was interested in the large collection of skulls of Petrus Camper, who was interested in physiognomy. Gall presented a series of lectures and reports of these can be found in a local newspaper and in a few books, published at that time. We will summarize this material. We will first outline what the Dutch knew about Gall's doctrine before his arrival. We will present a reconstruction of the contents of the lectures. Finally, we will discuss the reception of his ideas in the scientific community.

Providence, Rhode Island, USA

Morris J. Lewis discovered the jaw jerk reflex in 1885

Edward J. FINE^1,2 and Linda LOHR^2
1Department of Veterans' Affairs Medical Center, East Amherst, New York 14051; and ²Neurology Department, State University of New York, Buffalo, New York USA

OBJECTIVES: To trace the history of the jaw jerk reflex (JJR): substantiate its discovery by the American neurologist, Morris James Lewis, MD, PhD (1852-1928), examine the specious claim for discovery by British neurologist, Armand de Watteville (ADW) and elucidate the physiology of this reflex.

BACKGROUND: ADW (1846-1925) is commonly but incorrectly credited with discovery of the human jaw jerk reflex (JJR) in 1886, based on his note in Brain 8:518-519, 1886. ADW stated that the JJR was increased in a case of amyotrophic lateral sclerosis (ALS). A reference in Charles K. Mills' The Nervous System and its Disease to a paper by written by Morris J. Lewis (MJL) in 1885 (1) could cast doubt upon de Watteville's claim for discovery of the JJR.

DESIGN/METHODS: Reviews of American text books of neurology from 1884 to 1898, Surgeons' General Index, files on MJL at College of Physicians and Wistar Institute Philadelphia, USA. Recording the JJR in several normal subjects using modern EMG equipment.

RESULTS: ADW elicited the JJR, by introducing "a tongue depressor or paper knife in the mouth" and striking "either object with a thin bound book or best of all with a percussion hammer". The index patient was a woman with ALS who exhibited an increased JJR. Dr. Charles Beevor published details of her clinical course in a companion article. ADW stated that the JJR had been observed "in a case in America", but offered no reference. A bibliographic reference by Charles K. Mills (1) established that MJL observed the JJR before May 9, 1885. Lewis described the JJR as "the elevation of the lower jaw immediately following a blow upon the lower teeth or chin" and elicited the JJR by "striking these parts in downward direction with a rubber plexor." The patient's "mouth is open and the muscles should be relaxed." MJL observed the JJR in two patients with spastic paralysis, patient with cerebral tumor and another patient with "congested spinal cord." Lewis elicited the JJR "occasionally from perfectly healthy individuals." (1) He noted that contraction of the masseter or temporalis muscles contributed to the closure of the mouth during JJR. Currently the JJR is obtained by striking the chin with a percussion hammer containing a pressure actuated electric switch to trigger an electromyography (EMG) machine. Electrodes placed on both masseter muscles pick up efferent action potentials in response to afferent activation of stretch receptors by hammer strikes. To obtain the JJR, mandibular muscles must be relaxed. The 7-10 ms average latency and 200-400 [micro]V amplitude were measured from the oscilloscope display of an EMG machine.

CONCLUSION: MJL discovered the JJR, based on earlier publication and description of more patients than ADW.

REFERENCE: (1) Lewis MJ. Med Surg Reporter. 52:591, 1885.

Providence, Rhode Island, USA

Otto Soltmann's pioneering work of 1876 on stimulation and development of the motor cortex, and recovery after brain damage

Stanley FINGER¹, Timothy BEYER¹, and Peter J. KOEHLER^2
1St. Louis, Missouri 63130 USA; and ²Heerlen, The Netherlands

In 1870, Fritsch and Hitzig employed electrical stimulation and ablation techniques to show that the dog has a motor cortex. In relatively overlooked chapter published six years later, Otto Soltmann, a pediatrician in Breslau with a strong interest in basic science, described the functional development of the motor cortex, and argued that it must play a role in willed movement. Soltmann became the first experimenter to show when the dog's motor cortex becomes electrically excitable (at about 10 days in dogs), and how the contralateral forepaw area appears prior to the hindpaw or face. He also studied the effects of ablating the cortical motor regions, and encountered a remarkable degree of sparing of function in those animals operated upon as newborns, but not in older dogs. He turned to the theory of vicariation or "functional take-over" to explain the relative absence of deficits in his young operated animals, and specifically mentioned how only dogs with unilateral lesions continued to show bilateral movements to remaining (opposite) motor cortex stimulation. Soltmann concluded with parallels between his experimental results and clinical observations made on children with early brain damage.

Providence, Rhode Island, USA

A century of vision mapping in the human cerebral cortex

Ronald S. FISHMAN
St. Ingoes, Maryland USA

By 1990, a consensus had arisen that the primary visual projection area was in the region of the calcarine cortex. E.A. Schaefer's textbook of physiology in 1900 was confident of this, but less confident of the exact representation of the visual field in this region. His "probable scheme" included an erroneous placement of central vision anteriorly and peripheral vision posteriorly, and made no mention of the magnification factor whereby the area devoted to central vision expands greatly in the projection for retina to cortex.

What was needed was a way of producing small discrete lesions in the human calcarine cortex and then studying the visual field defects that were produced. This was accomplished by World War I. The unprecedented use of artillery and the relatively exposed position of the head of soldiers huddling in the trenches made head wounds account for a quarter of all wounds. Instances where the wound was minor enough to allow survival and examination of the visual fields were reported by American, British, French and German authors. The most influential studies were that of Gordon Holmes, whose mapping of the visual field projection on the cortex was reproduced in textbooks virtually without change for 70 years.

In the 1990, the Holmes map was finally modified by Horton and Hoyt, who were able to apply modern brain imaging technique to the study of small calcarine lesions. This showed the magnification factor to be much greater than previously thought. They also make the case that the small quadrantic scotomas thought by Holmes to extend to the horizontal meridian represented wounds to V-2 in the peri-striate area outside of the calcarine cortex proper.

Application to the human of the laboratory finding of a multitiude of visual areas in the cat and monkey are still in an exploratory phase, but is leading to rethinking the vague and indefinite concept of "association" cortex.

Providence, Rhode Island, USA

Sigmund Freud's place in the history of the neuronal cytoskeleton

E. FRIXIONE <frixione@cell.cinvertav.mx>
Departamento Biología Celular; and Departamento Fisiología, Biofísica y Neurociencias, Centro de Investigación y de Estudios Avanzados del IPN, Mexico City, 07000 MEXICO

Freud's seldom remembered and unfairly overlooked important investigation on the internal structure of nerve fibers and cells, carried out in the summers of 1879-1881 while he was a students at Ernst Brücke's laboratory in the Vienna Institute of Physiology, is examined in the context of the contemporary debate regarding the existence of neurofibrils, and of present views on the cytoskeleton.

The controversy as to whether the protoplasm of nerve fibers and cells should be considered either structureless and homogenous throughout, or rather containing a finely fibrous texture, was then a hot though hardly new issue. It originated nearly 40 years earlier, since Robert Remak's 1843-1844 pioneer descriptions of bundless of labile fibrils within the microscopic "tubes" and "globes" found constituting the nerve cord of the crayfish. Further work by other microscopists --including such acknowledged masters as Max Schultze and Albert von Kölliker --on nervous tissues of both vertebrate and invertebrate species had either supported, questioned or ignored Remak's claim. But even many of those who succeeded in finding internal fibrils attributed them to artifacts. As recently as 1880 the influential Thomas H. Huxley, in an exhaustive treatise on the crayfish as an example of a thorough zoological study, stated that the contents of the tubes seen in fresh nerves are "perfectly pellucid, and without the least indication of structure". Thus Huxley implicitly denied the existence of fibrils in nerve elements of the same animal in which Remak sustained to have discovered them. It was at a bout this time when Freud decided to analyze such a contentious matter by himself, selecting also the crayfish for his observations.

Taking special care to work almost exclusively with fresh specimens, Freud inspected the inner structure of nerve fibers and nerve cells independently, as well as processes extending from the latter. He was able to resolve separate fine fibrils following straight courses within the fibers, and concentric loops of striae or thick threads surrounding the nucleus and converging towards the outgrowths of the cell bodies, where they seemed to become continuous with the fine fibrils. Furthermore, he followed the progressive breakdown of these delicate structures as minutes elapsed after dissection. The conclusions in his 1882 extensive paper on the subject were unambiguous: "The nerve cells in the brain and in the ventral ganglionic chain consist of two substances, one of which arranged as a network in the fibrils of the nerve fibers, and the other is homogeneously continuous in between." He then discusses cautiously but favorably the probable general validity of those conclusions for the nervous tissues of other animals. Some of his comments may perhaps be taken as harbingers of the soon to rise neuron theory.

Current knowledge of the fine structure of the crustacean nervous system has confirmed Freud's main points, which in turn vindicated and expanded those of Remak. Both researchers were looking at small bundles of axonal and somal microtubules, and thus they were among the first to picture the lacy intracellular framework that later on would be called the cytoskeleton. Not long after Freud's paper appeared the neurofibrils became widely accepted as true cellular components, the dispute shifting then to their physiological significance, as in the writings by Stephan von Apáthy, Albrecht Bethe and Santiago Ramón y Cajal, among other. Nevertheless, in contrast to the often cited Remak's work, Freud's contribution to cell biology went largely unnoticed. Except for an occasional mention in biographical accounts, it still remains neglected by the specialized scientific literature.

Providence, Rhode Island, USA

Carl Wernicke's contribution to theories of conceptual representation in the cerebral cortex

Nicole GAGE and Gregory HICKOK
University of California, Irvine, California USA

In his 1874 monograph The Aphasia Symptom Complex: A Psychological Study on an Anatomic Basis, Carl Wernicke related neuroanatomical information to behavior following brain damage and formulated a description of sensory aphasia that remains in wide usage to this day. Wernicke's model for language processing - outline in this monograph - has formed the basis for the classical connectionist language processing model which serves as an integral part of the theoretical framework for current language research. Less well known are Wernicke's ideas regarding conceptual representations, originally described in the 1874 monograph and extended in later works. A contemporary description of conceptual representation in the brain includes two central ideas: i) the anatomical substrate of a concept is comprised of distributed sensory memory traces associated with that concept, and ii) this association is formed through the simultaneous occurrence of sensory event. Wernicke's notions about the neural substrates of conceptual representation foreshadowed contemporary theory and are stikingly similar to present views. In the Grundriss de Psychiatrie (Outlines of Psychiatry)¹, published in 1900 and never translated into English, Wernicke describes the neural substrate of a concept: "In conclusion, then, we would have explained a memory trace as an acquired association of perceptual elements...Since these different sensations occur simultaneously, their memory traces remain associated with each other. In this way, every tangible object is related to an acquired association of memory traces of different sense, and this association is stronger the more frequently the object is perceived by our senses. We have in this manner arrived at the anatomical substrate for what psychology has long called a "concept" (1900, 1999; p.7). In this present paper, we provide a translation of relevant sections of the Grundriss der Psychiatrie, set it into context with earlier work as well as with contemporary work in the field, and present Carl Wernicke's ideas regarding conceptual representation in the cerebral cortex to the neuroscience community.

Session I -- Commended Papers
Monday, 12 June 2000, 9:30 - 10:00 am

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

Providence, Rhode Island, USA

Women in Neuroscience: The first twenty years

Laurel L. HAAK¹, Andrea ZARDETTO-SMITH², and Russell A. JOHNSON^3
1Lab for Molecular and Cellular Neurophysiology, NIH, Bethesda, MD 20892-4095; ²Department of Physical Therapy, Creighton University, Omaha, NE 68178; ³Neuroscience History Archives, Brain Research Institute, UCLA, Los Angeles, CA 90095-1761 USA

Women in Neuroscience (WIN) was created in 1980 during the annual Society for Neuroscience (SFN) meeting. Despite major changes and advances in 'equal opportunities', women were still not achieving a proportionate level of success in neuroscience. In 1980, women made up 40-50% of entering classes in medical schools or graduate programs, but often comprised only 5-15% of leadership in respective organizations. While there had been women elected to serve as SFN Presidents, Council and committee members, women were not well-represented in other positions of the society, such as symposium and session chairs. There was even a lesser degree of representation in leadership positions at universities and medical schools in terms of full professorships, chairs, and program directors, as well as on editorial boards, advancement of women neuroscientists, to facilitate contacts and communication among women working in neuroscience and to organize appropriate activities at the SFN meeting.

In this presentation, we will discuss what role WIN can and should serve in increasing the participation of women in neuroscience. WIN has a long history of activism, from providing travel awards, to hosting symposia and mentoring programs, to providing an arena for women to learn and practice leadership skills. The historical relationship of WIN with SFN and the SFN Committee on the Development of Women's Careers in Neuroscience will be examined. In addition, we will discuss the importance to the field of neuroscience of documenting the role of individual women scientists and organizations such as WIN.

Providence, Rhode Island, USA

Ross G. Harrison (1870-1959) and the Nobel Prize for Physiology and Medicine in 1917

Duane E. HAINES
Department of Anatomy, The University of Mississippi Medical Center, Jackson, Mississippi 39216 USA

In the period of 1906-1912 Ross Granville Harrison developed methods to culture and assure the longer-term survival of tissues outside the organism. While Harrison was not the first to attempt to culture tissue, nor the first to succeed, he was the first to get tissues to survive in culture conditions for long periods of time. His ability to achieve survival times, of up to four weeks, were considered a remarkable achievement for the time and his techniques (hanging drop method) and results acclaimed as an important discovery. Harrison noted the development of contractions in muscle, growth of neurites to muscle cells and, most importantly, the fact that the processes of neurons were the result of outgrowth of the neuron cell body. Some scientists of the period believed that Harrison's discoveries were the ultimate proof of the neuron doctrine.

Harrison was nominated for the Nobel Prize in 1913, 1914 and 1917. The Nobel Committee for Physiology and Medicine met, deliberated and by majority vote recommended that the prize for 1917 go to Harrison for "...his discovery of the development of the nerve fibers by independent growth from cells outside the organism...". However, for reasons that remain enigmatic, even to this day, the prize was never awarded. After 1917 Harrison was repeatedly nominated for The Prize, including once by Hans Spermann who would receive The Prize in 1935. In 1933 the Nobel Committee again considered Harrison. However, in a decision that, in retrospect, was profoundly short-sighted the award could not be given because of "...the rather limited value of the method and age of the discovery..."!

This paper explores the hanging drop method, its revolutionary nature at that time, the persons and events surrounding the nomination of Harrison for the Prize, and the events which may have resulted in the award not being made.

Providence, Rhode Island, USA

RETICULUM: An Internet gateway to neuroscience history resources

Russell A. JOHNSON
Neuroscience History Archives, Brain Research Institute; and History and Special Collections Division, Louise M. Darling Biomedical Library, UCLA, Los Angeles, CA 90095 USA

During the past five years, the Neuroscience History Archives (NHA) at UCLA has developed tools--from listservs to World Wide Web sites--to assist neuroscience historians in harnessing the chaotic and ever-changing Internet to supplement and in some cases replace other forms of communication and information distribution and retrieval. This presentation will concentrate on RETICULUM: Neuroscience History Resources <http://www.medsch.ucla.edu/som/bri/archives/RETICULM.htm>. This website complements Neil Busis' Neurosciences on the Internet utility (which focuses on information sources supporting contemporary neuroscience research, development, policy, and teaching), serving as a meta-site or gateway that organizes pointers or links to the burgeoning pool of individual Internet resources that may be of interest to historians of neuroscience. We will report on progress in collecting, evaluating, selecting, add verifying links to existing sites as well as generating content--such as announcements, directories of repositories, images and texts--which might not otherwise be available on the Web. RETICULUM's array of links presently connect to various professional societies, Internet forums, placement and funding opportunities, image databases, online exhibitions, and antiquarian dealer and book searching utilities. Some upcoming features will link to or improve upon resources offered by other history of science, medicine, and technology websites and gateways. For this project to be useful and flourish, however, we must also rely on input from established as well as potential users whose expertise and familiarity with specific topics, individuals and eras gives them the appropriate perspectives from which to evaluate the quality of RETICULUM's structure and relevance of its contents. Prioritized suggestions of additional Internet resources to procure, refine, or even create--such as history of recent science portals which the Sloan Foundation is funding through various professional societies, including the Society for Neuroscience--will be appreciated, as we continue to identify the concerns and expand efforts to meet the information needs of the neuroscience history community.

Providence, Rhode Island, USA

Pick's Disease: The tedious career of a 'new' neuro-psychiatric disorder

A. KARENBERG
Institute for the History of Medicine and Medical Ethics, University of Cologne, Germany

Between 1892 and 1906 Arnold Pick, Professor of Psychiatry at Charles University in Prague, published a series of four case reports on localized atrophy of the temporal and frontal lobes of the brain. It took more than twenty years before the new syndrome was named after him and another two decades until it gained a wider acceptance within the scientific community. In contrast to this slow evolution, the peculiar type of dementia outlined by Alois Alzheimer in 1906 was recognized as a specific disease only a few years after the first description and quickly considered as a nosological entity.

Using a wide selection of primary sources, the paper will discuss the differing reasons for the lengthy early "career" of Pick's disease: for neurologists and psychiatrists of the 1910's and 1920's its rare occurrence, the heterogeneity of clinical symptoms as well as its course, the variability of macroscopic morbid anatomy, and the absence of reliable histological findings interfered with the "construction" of a "new" brain disease. Political factors such as the support of Alzheimer by the most eminent psychiatrist of the time, Emil Kraepelin, may also be regarded as an important factor. From this perspective, the early history of Pick's disease can be used to describe and analyze the process of neuropsychiatric research and its context at the beginning of the 20th century.

References

Berrios GE, Porter R (1995): A History of Clinical Psychology, London: Athlone.
Kertes A, Kalvach P (1996): Arnold Pick and German neuropsychiatry in Prague, Arch Neurol 53: 935-938.

Providence, Rhode Island, USA

From symmetry to complementary in hemisphere function: A long delayed conceptual transition

Marcel KINSBOURNE
Department of Psychology, New School University, New York, New York 10003 USA

When first proposed, cerebral localization was presented a uniformly symmetrical (Gall). The irrefutable violation of this principle in the case of aphasia (Dax, Broca) did not lead to it being abandoned. Instead, the symmetry principle was patched along "exception proves the rule" lines by unilaterally superimposing language on an otherwise symmetrically organized cerebrum, rendering one hemisphere "dominant". Sporadic nineteenth century objections, both with regard to specific functions (Jackson) and to the right hemisphere as a whole (Wigan) left the dominant left hemisphere unscathed. Skilled observers, the early neuropsychologists nonetheless failed to recognize right hemisphere syndromes were attributed to bilateral cortical damage, even if there was no evidence of bilateral involvement.

Right hemisphere dominance was belatedly recognized after World War II (Duensing, Paterson and Zangwill). Even then, lateralization (right and left) was circumscribed. It was denied all animals, and denied human infants. Lateralization became an accolade to human exceptionality (of adult males in particular).

The tables were turned as of the sixties. Hemisphere differences, on an equal footing, or ever tilting toward the right (Galin, Ornstein) became acceptable. The inventory of lateralized functions continues to grow, to the point that it might be questioned whether any cognitive operation has a bisymmetric (rather than bicomplementary) cerebral base (Doty, Ringo). Infants, and species as modest as the mouse, have been conceded their lateralization, and minimal morphological asymmetries have been endowed with surplus meaning. Significant but minuscule laterality effects are interpreted as guides to what one hemisphere, and not the other, does.

I propose that it required a change in Zeitgeist (from autocratic/hierarchical to democratic/egalitarian) before the dogma of symmetry could be discarded. Does the current Zeitgeist, in turn, blind us to still more promising ways of conceiving cerebral function?

Providence, Rhode Island, USA

The contributions of Edward Tyson to brain anatomy in 17th century England

Lawrence KRUGER
Department of Neurobiology, Brain Research Institute; and 17th and 18th Century Study Center, UCLA Medical Center, Los Angeles, CA 90095 USA

Edward Tyson (1650-1780), the son of a mayor of the City of Bristol, was proposed as a member of the Royal Society by Robert Hooke the year before receiving his M.D. degree at Corpus Christi College, Cambridge in 1680; the same year in which Tyson published the first comprehensive account of the anatomy of a single animal, Phocaena, Anatomy of a Porpess, etc. (London). This milestone work in comparative anatomy correctly enumerates the "land Quadruped" features of this "fish" and provides a description of the brain as well as the auditory system of this cetacean, remarkable for its accuracy and insight. He soon published anatomical papers in the Philosophical Transactions (1682-83) and was active in the Royal Society but became a busy and prominent medical practitioner in London.

His contributions to the comprehensive, huge two volume Systeme of Anatomy (London, 1685) by Samuel Collins_is generally unrecognized, although acknowledged by Collins, and includes dissections of the human brain and some insights that guided the development of comparative neurology. He subsequently became the founding pioneer of Physical Anthropology with the publication, under the auspices of the Royal Society, of a treatise entitled Orang-Outgang, sive Homo Sylvestris; or, the Anatomy of a Pygmie compared with that of a Monkey, an Ape, and a Man (London, 1699), containing an account of the dissection of a chimpanzee (correctly identified by Tyson despite the misleading title), including a description and depiction of its brain. The significance of cerebral gyral variation in different animals and in humans of various background and intellectual capacity was considered in anatomical and philosophical contexts that were largely ignored until the Darwinian era.

Providence, Rhode Island, USA

The birth of a neurosurgery clinic in Europe: three case studies

Boleslav L. LICHTERMAN <licht@aha.ru>
Russian Postgraduate Medical Academy, Moscow, Russia

The aim of this paper is to trace the emergence of a new specialty of neurosurgery in Great Britain, France and former USSR and put it in into a broader cultural context. The process of its birth lasted for several decades but it was in the interwar period when first full-time neurosurgeons appeared, professional societies were formed, university chairs and academic institutions founded, neurosurgical periodicals launched. Due to its links with basic neuroscience, neurosurgery was experimental in its nature. It was often viewed as a kind of applied neurophysiology which, according to Nikolai Burdenko (1876-1946), has to follow three basic principles: anatomical availability, technical possibility and physiological permissibility.

There are several levels of studying neurosurgical history: technical (introduction of electrocoagulation, new instruments, cerebral angiography, etc.), organizational (structure of neurosurgery clinics, referral and research policies) and political (a shift of interest to head injuries in the late 1930's due to impending war with Germany, for example). A comparative history of neurosurgery in three European states in the 1920's and 1930's reveals striking similarities and sharp contrasts between them which reflect the impact of social and economic factors.

Providence, Rhode Island, USA

John Martyn Harlow: An obscure country physician?

Malcolm MACMILLAN
School of Psychology, Deakin University, Burwood, Victoria, Australia

If John Martyn Harlow is known at all in the neurosciences, it is because he was the Cavendish, Vermont, physician who attended Phineas Gage and then followed up his case. Although Harlow's skill in treating Gage and his insightful accounts of the changes in Gage's personality are fairly well recognized, Harlow himself is usually the shadowy figure caught by the self-depreciatory characterization of my sub-title.

Harlow, born in 1819, in Whitehall, New York of Puritan and farming stock, trained and worked as a teacher before he was graduated MD in 1844 from Jefferson Medical College. At Jefferson he was exposed to phrenological doctrine, the influence of which is evident in his appreciation of the Gage case. Cavendish was his first practice but we know nothing other than Gage about his medical work there. In 1857 Harlow gave up his practice on health grounds but resumed it in 1861, in Woburn, Massachusetts, where he spent the rest of his life. He was very active in medical, political, church, business and educational affairs. On his death in 1907 the New York Times said he was one of the "most prominent surgeons of New England" and "the wealthiest man in Woburn."

In this paper I will use manuscripts, illustrations, and other little known material to evaluate Harlow's contributions to medicine and to Massachusetts' medical, political, and civic life.

Providence, Rhode Island, USA

The human central nervous system on Jacques-Fabien Gautier Dagoty's anatomical plates

R. OLRY
Department of Chemistry-Biology, University of Québec at Trois-Rivières, Québec, Canada

Jacques-Fabien Gautier (or Gautier-Dagoty: he added his mother's name from 1756, probably to be told from Gautier de Montdorge, one of Le Blon's sponsors) is one of the pivotal figures in the history of eighteenth century anatomical illustration. Like Jan Ladmiral, who signed plates for Bernard Siegfried Albinus and Frederik Ruysch, Gautier-Dagoty was an assistant to Jacob Christoph Le Blon, but after only six weeks, he was already thinking of taking over his master's color printing procedure. He was granted the copyright in 1745, and produced then a succession of anatomical, surgical, and natural-history coloured plates, some life-sized.

The aim of this presentation is to study the evolution of neuroanatomical illustration in Gautier-Dagoty's plates from 1748-1776. Plate IV of the Anatomie de la tête en tableaux imprimés (Paris, 1748) shows a midline sagittal section of adult head and neck. It was drawn and engraved after dissections by Pierre Tarin, who succeeded Jacques François Marie Duverney. Plates XI, XVII and XIX of the Exposition anatomique du corps humain (Marseille, 1759) include many neuroanatomical accessory figures in the margins. Plate XI shows the parieto-occipital cortex, both cerebellar hemispheres and the septa of the cerebral dura mater (falx cerebri and tentorium cerebelli). Plate XVII depicts the base of the brain with its vessels and the spinal cord. Plate XIX includes the 1748 sagittal section of the head (but of much poorer quality) and a horizontal section of the brain dissected to remove the roofs of the lateral ventricles. One unnumbered plate of the Supplement à l'atlas sur le cerveau (1770) shows a standing man from behind. His head was transversely sawed so that the brain, cerebellum and brain stem become visible. However, the brain area is rather small and reminds one of similar illustrations by Charles Estienne (1545). Plate VI of the Exposition anatomique des organes des sens (Paris, 1776), Gautier-Dagoty's last achievement, shows the base of the brain with cranial nerves which have been spread. This plate seems to have been inspired by many authors, Andreas Vesalius (1543), René Descartes (1662) and Clause Nicolas Le Cat (1740), among others.

The accuracy of plates depicting the central nervous system never achieved that one of the wonderful plates of the human muscles contained in his Myologie complette en couler et grandeur naturelle (Paris, 1746). As the years went by, Gautier-Dagoty introduced more and more confusing and conflicting emotions into his plates, and cared less and less about their scientific accuracy.

Providence, Rhode Island, USA

Howard Knox (1885-1949): Pioneer of performance tests

John T.E. RICHARDSON
Department of Human Sciences, Brunel University, Uxbridge, Middlesex UB8 3PH, United Kingdom

Howard Andrew Knox served as an assistant surgeon in the United States Public Health Service between April 1912 and May 1916, working for most of this period at the immigration station at Ellis Island, New York. In response to public disquiet that the physicians at Ellis Island were failing to prevent mentally retarded people from entering the country, and also in response to their own dissatisfaction with Binet's recently developed intelligence scale, Knox and his colleagues assembled a collection of "performance" tests which did not rely upon verbal skills and which could thus be administered to potential immigrants with little knowledge of the English language. In a series of papers published between September 1913 and April 1914, Knox described these tests and advocated their use as a single scale. The tests were subsequently used both in clinical practice and in educational, psychological, and social research. In this paper, I shall discuss the nature of Knox's work with the Public Health Service and briefly describe what is known about his life before and after his time at Ellis Island.

Providence, Rhode Island, USA

Galen's Brain

Julius Rocca
Liding, Sweden

If only at second hand, Galen's pioneering work on the nervous system is widely known. This knowledge, however, is, to an appreciable extent, focused on his considerable work on the spinal cord and nerves. Perhaps less well appreciated is Galen's anatomical demonstrations of the brain itself. The purpose of this paper, illustrated by relevant slides, is to enumerate Galen's contributions to the anatomical science of the brain.

Providence, Rhode Island, USA

A concept of Hughlings Jackson: "The Physiological Bottom of the Mind"

C.U.M. SMITH
Vision Sciences, Aston University, Birmingham B4 7ET, United Kingdom

The young John Hughlings Jackson had to be dissuaded from giving up medicine in favor of 'a literary life' by Jonathan (later Sir Jonathan) Hutchinson. Hutchinson is nevertheless on record as believing that 'it might have been a yet greater gain for the world at large if Hughlings Jackson had been left to devote his mind to philosophy' (1). In this contribution I examine the philosophical position Jackson expressed in scattered passages in his writings. In particular I discuss the metaphysics implied by his term 'the physiological bottom of the mind' (2). Although it is clear that his major philosophical debt is to Herbert Spencer it is also clear that he had more than nodding acquaintance with the philosophical literature of the nineteenth and earlier centuries. His concept of the 'physiological bottom of the mind' combines Kantian, Darwinian, Spencerian and other philosophical influences. It also looks forward to some of the existentialist analyses of the twentieth century (3). This paper will consider these influences and discuss how far Jackson was able to square his everyday observations on the neurological ward with a philosophy of mind.

References

1. Hutchinson, J., 1911, British Medical Journal, vol. 2, p. 952
2. Selected Writings, ed. J. Taylor (New York: Basic Books, 1958), vol. 2, p. 111
3. Smith, C.U.M., 1982, "Evolution and the problem of mind: part 2, John Hughlings Jackson", J. Hist. Biol., 15, 241-62

Providence, Rhode Island, USA

Magendi and the chemists: early chemical analyses of the cerebrospinal fluid

Theodore L. SOURKES
Department of Psychiatry, McGill University, Montreal, Quebec, Canada

Shortly after 1825, when François Magendie (1783-1855) described the cerebrospinal fluid (CSF), he solicited the aid of chemists to analyze it. This was consonant with his view, a reflection of the philosophy of the Paris ideologues that evolved at the end of the eighteenth century, that physics and chemistry have a legitimate place in physiological research, but without dominating it. Magendie's interest in the composition of CSF stemmed from his concern as to whether this fluid is derived from serum, or if it is a fluid sui generis. The chemists he approached were P J Pelletier (1788-1842) and J P Couerbe (1805-1867) of the School of Pharmacy; M E Chevreul (1786-1889) of the Museum of Natural History; and J L. Lassaigne (1800-1859) of the Veterinary School of Alfort. References in the literature indicated the results obtained by two of these men. Lassaigne analyzed CSF collected by Magendie from a horse (1826). Couerbe, who in 1834 had published an extensive report on the chemical composition of human brain, provided Magendie with some data on human CSF (1836). Their analyses showed that CSF differed from serum chemically. But even before their work the chemist-physician J F John (1782-1847), of the University of Berlin, had published a brief paper on "the internal hydrocephalic fluid of a child" (1818). From his study of this material John concluded that the hydrocephalic fluid is different from the "moisture of the brain of slaughtered calves." The comparison was valid, because he had already shown that calf brain is very similar in composition to that of humans. He concluded that the hydropic fluid originated as an exudate of the water of the blood.

Research aided by a grant from the National Parkinson Foundation, Miami, Florida.

Providence, Rhode Island, USA

When harmine was tested in Parkinson's disease: An historical episode circum 1930

Theodore L. SOURKES
Department of Psychiatry, McGill University, Montreal, Quebec, Canada

Harmine is an indole alkaloid that had been identified in two plants: a Southern American vine, Banisteria caapi, and Asian rue, < i>Peganum harmala. Both plants have been used in indigenous medicine, in some cases for their reputed hallucinogenic action; whether harmine is the active agent is not clear because other ingredients have always been present. Pharmacological studies of harmine began in Munich in 1895, and were later pursed elsewhere. Since 1911 the firm of E. Merck (Darmstadt) had an active programme of research in their department of alkaloid chemistry. Their source of harmine at that time was the Asian plant, but in 1926 they received some "yagé drug" from South America, from which they obtained a supply of harmine. Some of this went to Louis Lewin (1850-1929), the outstanding Berlin pharmacologist and toxicologist, and to Kurt Beringer (1893-1949), a privat-Dozent at the neurologic-psychiatric clinic of the University of Heidelberg, and an authority on hallucinogenic agents. Lewin's analysis of the pharmacological actions of harmine on the nervous system led him to try it in patients with Parkinson's disease. His apparent successes induced Beringer to test the compound also. Lewin filmed his results with three patients. The E. Merck Company made a film illustrating the chemistry and pharmacology of harmine, along with its effects in three Parkinsonian patients at the Heidelberg Clinic. The latter historic film will be shown. Harmine had a rapid rise to fame in the treatment of Parkinson's disease in Germany, and an equally rapid demise, the reasons for which will be discussed.

Research aided by a grant from the National Parkinson Foundation, Miami, Florida.

Providence, Rhode Island, USA

Edward Albert Schäfer (Sharpey-Schafer) and his contributions to neuroscience: A tribute on the 150th Anniversary of his birth

Elizabeth P. SPARROW and Stanley FINGER
Washington University, St. Louis, Missouri 63130 USA

The year 2000 marks the 150th anniversary of the birth of Edward Albert Schäfer, later to become Sir Edward Albert Sharpey-Schafer. Affiliated during the last three decades of the 19th century with University College and afterward with Edinburgh University, Schäfer made monumental contributions to the fields of histology, physiology, endocrinology, and practical medicine. Yet he has never been the primary subject of a book or even lengthy paper.

The first part of this presentation will be biographical and will review Schäfer's training and professional life. The second part will deal with his seminal contributions to the neurosciences, which include his: (a) histological research that led him to neuron doctrine a decade before Cajal; (b) stimulation and ablation studies on monkeys that corrected some of Ferrier's faulty cortical localizations and opened new vistas; (c) experiments on adrenal extracts that led to the discovery of chemical transmission; and (d) personal observations on recovery after sensory nerve damage, which revealed serious confounds in the earlier work of Head and others.

Author of many esteemed histology and physiology books, founder of the Quarterly Journal of Experimental Physiology, and mentor to many students who achieved great fame in the neurosciences, Schäfer remained committed to a better medicine based on laboratory science until his death in 1935.

Providence, Rhode Island, USA

The influence of fermentation theory on Newton's hypothetical neurophysiology

Wes WALLACE
Department of Neuroscience, Brown University, Providence, Rhode Island, USA

Newton published statements in later editions of both of his major works which advanced a quasi-electrical hypothesis of nervous transmission. In these passages, Newton described the nerves as "solid, pellucid and uniform capillamenta" permeated with a subtle aether. He proposed that vibrations in the aether are transmitted along the capillamenta just as light is transmitted through transparent glass, and they cause muscular contraction by altering the density of aether in the muscle. Newton arrived at this hypothesis through the influence of Willis, who in his treatise De cerebri anatome (1664), proposed all of the principal ingredients of Newton's hypothesis: solid nerves, a vibratory mechanism of transmission, and a luminous or light-like nervous fluid. Both models hinge on a vibratory transmission mechanism, which was made possible by a fermentation-based mechanism of muscular contraction. If the muscle contracts due to ebullition produced by fermentation, then the nerve need only deliver a tiny droplet of fluid in order to cause contraction. This frees the nerve to transmit commands by vibation, a much faster method than direct inflation of the muscle with a spirit, as was supposed by the Cartesians. Newton's use of fermentation concepts indicates that his theory of nervous transmission was indebted to the nascent science of iatrochemistry, a borderline discipline whose conceptual foundation was quite foreign to that of Renaissance anatomy or physics.

Providence, Rhode Island, USA