A nineteenth century American sensory-motor controversy
J. Wayne LAZAR
Moses Allen Starr (1854-1932) of New York, Charles Loomis Dana (1852-1935) of New York, and Charles Karsner Mills (1845-1931) of Philadelphia were American neurologists and conspicuous in published articles from 1884 to 1895 that discussed the extent of cutaneous sensory and motor areas. The articles included direct discussions by the three men or direct references to each others’ work. Starr and Dana wrote reviews of the literature in 1884 and 1888, respectively that supported the position that there were cortical sensory and motor areas on either side of the central fissure and that these regions substantially overlapped. Their conclusions were consistent with the findings of Munk, Goltz, Tripier, and Moelli. Mills did not agree with these conclusions. His conclusions supported the views of Ferrier, Horsley, and Schafer that the regions did not overlap and that limbic structures were involved.
They did not reach consensus during this period. Mills stood fast about non-overlapping regions although he refined their localization over the period. Starr was ambivalent switching from overlap to separate depending on clinical or anatomical findings, respectively, and Dana stood fast for overlapping regions. Starr and Dana eschewed the limbic involvement. There were many reasons for controversy: There was conflicting anatomical information and an inability to integrate the new findings of Flechsig, Golgi, and Cajal. Cutaneous sensory phenomena were poorly delimited and measured. There were theoretical biases based on assumed boundaries of the motor area and the strong belief in the sensory-motor model. There may have been a practical bias, as well, introduced by the practical needs of the physician.
Session VI. Movement Disorders
Pavia, Italy, 2006