The contributions of Derek Denny-Brown, the Boston City Hospital, and Harvard University to 20th century American neurology
Joel A. VILENSKY1 and Sid GILMAN2
A neurological division at Boston City Hospital (BCH) began in 1876 and ended in 1993. During much of this period the division was a component of Harvard University, and from 1941 to 1967 it was under the direction of Derek Denny-Brown (DD-B). Under DD-B the division became one of the premier neurological training centers in the U.S., transforming American neurology from a previous association with psychiatry into an independent specialty more aligned with internal medicine.
BCH was dedicated on May 24, 1864, with the neurological division established 12 years later under the “electrician,” Dr. Samuel Webber. In 1925 the Rockefeller Foundation offered Harvard $350,000 to establish an associated Neurological Unit (NU) at BCH. The Unit opened in 1930 with a 56-bed ward, library, research laboratories, and conference rooms under the direction of Stanley Cobb, who was followed in 1934 by Tracy Putnam. In 1939 Putnam moved to Columbia and was replaced by New Zealand-born, Sherrington-trained DD-B, who arrived in 1941.
DD-B immediately began an ambitious research program that initially centered on projects begun during WWII such as craniocerebral trauma and peripheral nerve injury, but eventually expanded to include multiple sub-disciplines of neurology, with a concentration on movement disorders. Much of the latter research involved studies of the effects of cerebral and spinal lesions on over 400 monkeys, all of which were filmed, and were charted on a regular basis.
DD-B’s clinical training in London (under Gordon Holmes, Charles Symonds, and MacDonald Critchley) had instilled in him the importance of internal medicine and neuropathology to neurology. In his training program, his residents approached neurological disorders from the perspectives of medicine and pathology, and in 1952 DD-B published an article in the NEJM, “The Changing Patterns of Neurologic Medicine,” that elaborated upon his views and became a model for neurological training across the country. DD-B’s training program was so successful that at one time 50% of the Chairman of U.S. Departments of Neurology had received some training at the NU. Similarly, his program attracted fellows from around the world, including Ian McDonald, Roger Bannister, Ralph Ross Russell, and staff members such as Lahut Uzman, Flaviu Romanul, and Simeon Locke.
DD-B was a self-reliant scientist who made his own equipment, conducted experiments himself, created illustrations and hand-wrote articles. He was described as the “conscience of neurology” because he sharply criticized residents and professors alike whose research reflected less than full scientific rigor. DD-B retired from the NU in 1967 but continued his research at the New England Regional Primate Center almost until his death in 1981. During the 1970s, Harvard was forced to withdraw from the BCH, and the NU became a component of Boston University. A separate Neurological Unit was laterestablished at the Beth Israel Hospital in Boston, which has continued under the direction of Clifford Saper.
Session XI -- The Makers and Shapers of Neuroscience
Montreal, Quebec, Canada