11th Annual Meeting of the International Society for the History of the Neurosciences (ISHN)
Go to Meeting Program
Von Economo: An inspiring figure in van Bogaert's neuroscientific career
The epidemic of encephalitis lethargica began in the winter of 1916 in Austria, and by 1919, cases had been reported throughout the world. The clinical and pathological findings of this condition were thoroughly described in 1917 by Constantin von Economo (1876-1931), an internationally respected neurologist and brain scientist. Over several years, he studied the disease in his evolution, natural history, and sequelae and in 1929, he presented a synthesis of these studies which was translated to English 2 years later. In 1922 and 1923, the Belgian Ludo van Bogaert (1897-1989), was in Paris, training in neurology and neuropathology, with Pierre Marie, Marcel Labbé, Charles Foix and Joseph Babinski. It was precisely in Pierre Marie's department that Tretiakoff developed his thesis emphasizing for the first time the significance of lesions in the locus niger both in Parkinson's disease and in the parkinsonian form of encephalitis. Deeply impressed by the pandemic, van Bogaert visited von Economo in Vienna. This grew up to rich scientific exchanges in the fields of cerebral architectonics and encephalitis. In 1924, van Bogaert dedicated one of his first publications to a case report of encephalitis lethargica with respiratory and hepatic syndrome. During the following decade, several of his publications dealt with various aspects of the disease, particularly the late dramatic complications characterized by a gamut of involuntary movements observed in survivors. In 1979, van Bogaert , then 82 year old, returned to his first interest and to his old friend. With Theodorides, he wrote a monograph dedicated to von Economo and his achievements. It was one of his last publications.
Session IV. Movement Disorders
Fridtjof Nansen's visit to the Stazione Zoologica in Naples
Marina BENTIVOGLIO1, Fabio DE SIO2 and Christiane GROEBEN2
The multifaceted personality and variegated interests and talents of the Norwegian Fritjof Nansen (1861-1930), zoologist and neurobiologist, pioneer of the neuron doctrine, oceanographer, polar explorer, diplomat and Nobel Laureate for Peace in 1922, have already received attention and praise. Among the many episodes of Nansen’s life, however, it may be less known that a visit to the “Stazione Zoologica” in Naples played a key role in his contributions to neuroscience. In April 1886, Nansen, who had embarked on a continental study tour, spent some days in the laboratory of Camillo Golgi at the University of Pavia to learn the “reazione nera”, Golgi’s silver impregnation. Nansen then applied to a “work-table” at the “Stazione Zoologica” in Naples, that he could finally obtain. He spent two months in Naples, which seemed to have been a very stimulating and productive period. Nansen met there Stephan von Apáthy, whose method to stain fibrils seemed to indicate that fibrils formed a continuous network in the nervous system. In June 1886, Nansen left Naples for a sentimental journey. Back to Bergen, he further developed his independent thinking, denying any direct anastomosis between nerve cells. Correspondence with Anton Dohrn, the founder of the “Stazione Zoologica”, document Nansen’s “respectful and friendly memories” and exchange of (heavy) packages. In April 1888 Nansen defended in Bergen his thesis on “Histological Elements of the Central Nervous System”, richly illustrated by drawings of Golgi-impregnated material (mainly from Myxine glutinosa). Two days after his dissertation Nansen was on his way to Greenland.
Session VIII. The Stazione Zoologica of Naples and the Neurosciences
The study of women's brains in Golgi's times
When Golgi lived and worked, declarations and studies on the brain of women were not exactly encouraging for the female human race. For example, the renowned French psychologist and anthropologist Gustave Le Bon (1841-1931) wrote in 1879: “In the most intelligent of races… there are a large number of women whose brains are closer in size to those of gorillas than to the most developed male brains….All psychologists who have studied the intelligence of women… recognize today that they represent the most inferior forms of human evolution.” Paul J. Moebius (1853-1907) made also strong statements on women being mentally deficient. Golgi’s mentor, the famous neuropsychiatrist Cesare Lombroso (1835-1909) elaborated on mental female inferiority in the book he coauthored with Guglielmo Ferrero on “Criminal Woman, the Prostitute, and the Normal Woman”. Despite such discouraging context, however, Camillo Golgi seems to have been definitely less prejudiced, and accepted women as students in his laboratory. The embarrassing beliefs of those times on the female brain could theoretically be rescued by studies on the elite brains, regarded as a way to unravel brain localization of talents and skills. Needless to say, studies on the brain of famous women were, however, very few. Gustaf Magnus Retzius (1842-1919), examined the brain of the Russian mathematician Sonja Kowaleskaya (1850-1891). James Papez (1883-1958) investigated the brain of Helen Hamilton Gardener (née Alice Chenoweth; 1853-1925), American freethinker , fighter for women’s rights and suffragist, who had also written a book on “Sex in Brain” in 1893. Overall, the opinions and investigations on the brains of women do not really seem to have paved the way to modern studies on gender differences in the brain. They provide, however, an interesting premise to the recent resurrection of gender- and sex-targeted neurobiology, which is nowadays in the forefront of neurosciences.
The broken sword, nominal aphasia and monocular quadrantanopsia: The eve of correlative neuroanatomy
Ronen BLECHER and Moshe FEINSOD
In 1820, a young soldier was injured in a fencing accident as the button of the sword broke and the blade penetrated through the mesh and the roof of the right orbit into the brain. Careful and detailed examination by Baron Larrey disclosed nominal aphasia, right hemiplegia and superior quadrantanopia in the right eye only.
Superb anatomical knowledge enabled Larrey to delineate the course of the blade from the medial chiasmal root of the right optic nerve into the vicinity of the left Sylvian fissure. The clinical diagnosis was verified posthumously.
The association between right hemiplegia, involving mainly the hand, and loss of speech was observe already in Biblical times, but Larrey was the first to describe traumatic aphasia due to left temporal injury already in 1809. He referred ten more patients that he observed to Gall for further studies. It seems that the close association with Gall, of himself and leading academicians like Bouillaud, prevented the identification of the left frontotemporal region as the seat of articulated speech, even though all his patients were injured at that area.
Monocular field defect is a very rare symptom of damage to the intracranial anterior visual pathways. In a study of this entity in twenty-four patients and review of the literature superior quadrantanopia dominated the clinical picture. Most of the patients had various parachiasmal tumors, some had optic disc diversion and nearly a tenth were functional, as was the patient reported as early as 1878. Larrey’s patient is thus singular being most probably the first to be described and unique by being caused by a transorbital penetrating head injury.
The detailed clinical examination and the ensuing conclusions were much ahead of their time. The systematic use of circumscribed cerebral lesions caused by penetrating head injuries for constructing human correlative neuroanatomy lingered till World War I.
Luigi Galvani, Alessandro Volta and animal electricity at the end of the 18th century: A fundamental controversy in the history of (life) sciences
At the beginning of 1792 the Bologna physician Luigi Galvani published the results of his experimental research on the role of electricity in muscular motion. From his experiments on frogs and other animals Galvani concluded that nerve conduction and muscular contraction were due to an electric fluid produced in the brain and flowing through the nerves. He supposed that the muscle fibre was analogous to an electrical capacitor, in which electricity was in a state of unbalance between the interior and the exterior of the fibre; a stimulus, either organic or artificial, would eliminate temporarily the unbalance, producing the contraction of the muscle.
Galvani’s explanation of muscular contraction and his theory of animal electricity were received by most of his contemporaries as a great discovery in natural philosophy (the 18th century term for science), rich of consequences in the field of medicine. Many scientists from all Europe took an intense interest in Galvani’s research and began to repeat and develop his experiments; among them there was Alessandro Volta, professor of physics at the University of Pavia and one of the main scholars of electricity in that period.
In the 1790s Galvani and Volta were the main protagonists of a lively debate on the role of electricity in animal organisms. From this debate originated significant developments leading to the foundation of two new disciplines, electrodynamics and electrophysiology, that were to play a crucial role in the scientific and technological progress of the last two centuries.
The Galvani-Volta controversy has been repeatedly reconstructed, sometimes in the attempt to identify the merits and the errors of one or the other of the two protagonists, sometimes with the aim of demonstrating that the theories elaborated by the two Italian scholars were irreconcilable and reflected completely different ways to look at phenomena and to conceive scientific research. Here a different interpretation is offered, based on the discussion of the scientific issues which were central to Galvani’s and Volta’s research and with reference to the context of science and society of the 18th century.
Session IX. Italian Heritage and the Galvani-Volta Controversy
The neural circulation and the moderns in seventeenth century Spain
Jesús V. COBO
Neural circulation, a hypothesis that explains the functioning of the central nervous system, was developed during the last decades of the 17th and first years of the 18th Century. This hypothesis could not only explain the mechanical muscular movement of the human body, but also the origin of the sensory senses, emotions and thought. In the context of medicine at the Spanish court at the end of the 17th Century, a movement of innovation appears with the name novator. This movement, fed by the scientific revolution (the Moderns) in Europe and supported by medics, surgeons, mathematicians and physicists, grouped the elite of the court scientists at that time.
Describe the hypothesis on neural circulation developed by the novator movement and relate these hypothesis to the historical and medical context of Europe’s neurological science of that time, and specially in the context of the moderns.
The authors of the novator movement follow the modern european interpretation of the functioning of the brain, based on the principles of neural circulation. This interpretation is basically iatrochemical in the first generation of the movement, meaning that it explains the functioning of the brain according to the principles of chemistry of that time. The concept of neural circulation, like blood circulation or iatrochemist, represented the core of the new knowledges and interpretations about the physiology and pathology of the human body. The principal authors of the movement supported the theory. In fact, the circular interpretation of the neurophysiology represented an theoretical and academically point of discussion, linked to the clinical practice of the authors.
Neural circulation is a hypothesis that explains the functioning of the central nervous system. This hypothesis had a remarkable success in Europe at the end of the 17th and beginning of the 18th Century. Spanish medical science at the end of the 17th Century, and more specifically the authors of the novator movement, adopted the new theoretical and therapeutical knowledge of these hypothesis and made several contributions to them.
The neurophysiology of Giovanni Battista Giovannini (Milan 1632 - Madrid 1691) in seventeenth century Spain
Jesús V. COBO
In the context of medicine at the Spanish court at the end of the 17th Century, a movement of innovation appears with the name novator. This movement, fed by the scientific revolution in Europe and supported by medics, surgeons, mathematicians and physicists, grouped the elite of the court scientists at that time. Among them are authors who write neurological works or study the neurophysiologic aspects, specially Giovanni Battista Giovannini (Milán, 1632 – Madrid, 1692) called Juan Bautista Juanini in Spain. Giovannini was a medic surgeon, educated at the Pavia University, and other european universities. Most of his live passed at the spanish court, where represented a main actor in introduccion of modern medicine. He was also author of a monographic work on neurophysiology. This work is conceived as a conversation by letter between several European scientists, mainly the Italian Francesco Redi (1626-1697).
The medic-surgeon Giovanni Battista Giovannini develops an original interpretation of the functioning of the brain, based on the principles of neural circulation. This interpretation was basically iatrochemical, meaning that it explains the functioning of the brain according to the principles of chemistry of that time.
The succus nerveus or intranerveous liquid consists of alkali and acid atoms and circulates through the nerves from the brain towards the periphery. Several kinds of succus nerveus exist, and they all have different functions. The main role of the succus nerveus in the work of Giovannini is a motor function, moved by the impulsive force of a chemical fermentation process. This fermentation takes place in the anterior ventricles of the brain.
Giovanni Battista Giovannini relates the neurophysiology of the brain to macroscopic anatomy and to the results of microscopic anatomy that he carries out personally. Moreover, he links these neurophysiological hypothesis to a number of clinical cases after post-mortem examinations. The seat of the sensitive soul, moreover, was in the front part of the ovale centers. The formulations of Giovannini developed a methodological approach based in his own experiences and observations and devoted on the value of the experiment.
Giovanni Battista Giovannini (1632-1691) develops an original hypothesis about the functioning of the central nervous system, based on iatrochemical concepts and on his own clinical, anatomical and anatomopathological observations of certain patients. Although these hypothesis have their own wordings, they can be framed within the concept of neural circulation, especially the ones related to the role of the brain ventricles, the location of the soul and the functions of the succus nerveus.
The pineal complex and the habenular nuclei in the debate on the origin of cerebral asymmetry
Luigia CRISTINO and Vittorio GUGLIELMOTTI
Neural asymmetry is a peculiarity of vertebrates from cyclostomes to humans. The discovery of an asymmetric organization of the human brain, which dates back to Broca’s observations in 1865 on an area specialized for language, and to the pioneering experiments by Sperry on split brains, has paved the way for the concept of "hemispheric dominance". The frog habenula provides a paradigmatic example of the evolution of brain asymmetry. Habenular asymmetry was first reported by Goronowitsch in 1883 in a bone fish. Pioneering neuroanatomical studies in the early 20th century hypothesized that the development of habenular asymmetry could be viewed in the context of phylogenetic modifications of the pineal complex related to the animal’s survival to environmental changes. Data in support of this hypothesis are far from being complete, but knowledge accumulated since then on diencephalic asymmetries in vertebrates. Ontogenetic and phylogenetic studies on the vertebrate brain indicates that morphological asymmetries evolved very early. Many of these data were reported in investigations carried out in our laboratory (at the Institute of Cybernetics of the National Research Council) on Rana esculenta in the last decades. In the frog, a striking habenular asymmetry was reported for the first time by Kemali and Braitenberg in 1969. In the subsequent decades, studies on the frog brain (e.g. with silver impregnation, electron microscopy, tract tracing, immunohistochemistry), and many other contributions on this theme have been obtained. Findings in the frog compared to recent genetic studies in fish suggest a strict interplay in the epithalamus between the pineal and habenular structures. The comparative analysis of data, from cyclostomes to mammals, suggests that transformation of epithalamic structures may play an important role in brain evolution. Asymmetry of the epithalamus in lower vertebrates occupies, therefore, a special place in the history of cerebral asymmetry.
Neurology in the Bible (Tanach) and the Talmud
The Bible, a major pillar of Western Civilization is made of Hebrew Scriptures of historical lore, sublime prophecies, hymns and aphorisms of wisdom assembled over more than a millennium and accepted as of divine origin, sealed and canonized towards the second century CE. The Talmud, made of the Mishna and the Gemara, is a compendium of Jewish laws, covering every possible aspect of life, collected, analyzed in depth and studied in the Land of Israel and Babylon from 200 BCE to 600CE, becoming the foundation of Jewish way of life.
The Bible and the Talmud have no medical sections and Medicine as a discipline was regarded warily being contaminated by magical attitudes. Still, the all encompassing character of the books brought out numerous medical problems and observations that appear in various connotations. When in need to clarify various dilemmas the Talmudic sages displayed such accurate anatomical knowledge that Vesalius made use of (in Hebrew letters and terms) in his atlas.
Julius Preuss published in 1911 his endeavor to collect and categorize the medical knowledge in the Bible and the Talmud. A special chapter was devoted for neurology. This pioneering work was followed by some books and many articles extracting more observations of neurological significance.
I shall maintain and bring examples that the instances reported in the Bible show very accurate observations but are no sign of knowledge. The many observations of neurological significance reported in the Talmud, expressed as common experience, are evident of a substantial medical knowledge, basically derived from Hellenistic origins, that a large amount of it may have been lost in books that were not included in the canonized Jewish literature.
Luck, the wrong theory, and try it again: A history of the development of phenytoin, lamotrigine, and carbamazepine as anticonvulsants
Edward J. FINE1 and Sarah G. FINNEGAN2
Background: An ideal anti-convulsant should stop seizures, be dosed once or twice daily, have no incapacitating side effects, not interact with other drugs, not cause alteration of endogenous or exogenous hormones, cause no harm to a fetus or be excreted in mothers’ milk. Methodical searches for an ideal anticonvulsant began with phenytoin.
Hypothesis Examining the history of development of phenytoin, lamotrigine, and carbamazepine may provide conclusions about the methods of selection of putative anti-convulsants.
Results: H. Houston Merritt (1902-1979) and Tracy J. Putnam (1894-1975) collaborating at the Boston City Hospital (BCH) Epilepsy Unit recognized that phenobarbital, the leading anti-convulsant in 1930’s, caused side effects of ataxia and sedation. Writing to all drug manufacturers in the USA for potential anti-convulsant drugs, they received samples only from Parke-Davis. They developed a unique method to measure the maximum electrical stimulus (MES) needed to convulse cats. Diphenylhydantoin (phenytoin) raised the seizure threshold from 15 mA to 45 mA. Cats given enough phenobarbital to stop seizures were ataxic or somnolent in comparison with alert cats treated with phenytoin. They discovered phenytoin’s efficacy for generalized, partial simple motor and complex partial human seizures.
Lamotrigine was tested as an anti-convulsant, despite an incorrect theory that an effective anti-convulsant must reduce serum folate. In an open label study, Edward Reynolds demonstrated that about 50% of epileptics who were treated with phenytoin and megaloblastic anemia had increased seizures when treated with folic acid to correct anemia. Lamotrigine, a triazine, reduced serum folic acid. Despite a later double blind crossover study showed that folic acid did not increase seizures, Wellcome Laboratories used the MES test to determine that lamotrigine (LTG) was an anti-convulsant for rodents. Human studies showed LTG had efficacy for partial and generalized seizures and less cognitive impairment than with comparable doses of phenytoin.
Geigy Pharmaceutical developed carbamazepine (CBZ) as an anti-depressant to compete with a rival drug, but CBZ failed. However several patients, co-morbid for seizures, reported fewer seizures during the CBZ trial. CBZ raised the MES threshold in dogs and cats. Lorgé confirmed CBZ controlled generalized and partial seizures. Later studies demonstrated that CBZ produced less cognitive impairment than phenytoin. Both drugs are implicated in causing neural tubule closure defects in fetuses, because they may lower a mother’s serum folate.
Conclusion: These examples demonstrate that luck; illogical reasoning and acting clinical observation have provided some of the current anti-convulsants. Molecular structural analysis of putative anti-convulsants may provide drugs that are closer to the ideal in the future.
Benjamin Franklin and the neurosciences
Benjamin Franklin (1706-1790), who is better known in other fields, especially colonial politics and international diplomacy, was an early, major contributor to the neurosciences from the New World. Among his accomplishments are: experiments on medical electricity as a possible cure for the palsies and hysteria; the first descriptions of how electricity affecting the brain can cause a specific type of amnesia; seeing potential in the new idea that cranial shocks might provide a cure for melancholia; showing that the cures performed by the Mesmerists to remove obstructions, including nerve blockages, rest on gullibility and suggestion, and recognizing the dangers, including those to the nerves, posed by exposure to lead. Franklin’s neuroscience was firmly based on experiments, careful observations, and hard data --- and finding clinical relevance for new discoveries was always on his mind.
Ottorino Rossi Award Lecture
Encephalitis lethargica: A disease which makes criminals
Encephalitis lethargica was an apparently disorder which was widespread in the Western world from about 1916 to the mid-1920s; its cause was never been definitively demonstrated. Some 30% of its victims died during the acute phase of the disorder, but the survivors rarely returned to full health. Best known of the sequelae of this epidemic are the extrapyramidal and other motor symptoms which constituted the so-called ‘post-encephalitic parkinsonian syndrome’. Less well known is the fact that large numbers of victims, especially those under the age of 25 years, exhibited marked personality and other psychological changes which often required involuntary confinement of the ‘patient’. Many of the archived cases are remarkably similar to more recent descriptions of children presenting ‘attention deficit disorders’. This paper will present an overview of the discussions which this phenomenon stimulated, particularly regarding the question of whether such persons required medical care or imprisonment. As an example, the case of Stanley Fletcher, who came to the attention of authorities for petty larceny at the age of 20 years after suffering encephalitis lethargica six years previously, will be discussed. Fletcher’s situation, brought to the attention of the British Parliament by Lord Ammon, ultimately contributed to changes in the British Lunacy Act as well as in the manner in which ‘moral defectives’ were treated.
Session IV. Movement Disorders
Lethargia, lethargus, nona, encephalitis lethargica: The long history of a mysterious malady
Disorders of sleep have always aroused curiosity and fear, and most cultures record incidents of preternatural sleep, often associated with innocence or preservation of virtue. Hippocrates was probably the first to produce a rational medical account of such disorders (lethargos), but there has been a great deal of debate as to whether this disorder can be reconciled with any known to modern medicine. Lethargus was a difficult term even for classical authorities, and its meaning shifted with time and author, and by early modern times had been joined by related concepts of impaired consciousness, including cataphora, coma and carus. Discussions of such phenomena, both as autonomous entities and components of other disorders, occupied a great deal of space in medical textbooks until the 19th century, at which point lethargy as such began to disappear from medicine, although never completely. In 1890, a mysterious disorder known as nona appeared in Central Europe; it was temporally associated with the great influenza pandemic of the early 1890s. This was followed in 1916 by the appearance in Europe of encephalitis lethargica, similarly associated with an influenza epidemic (although a causal link was never unambiguously established), and which apparently disappeared as an epidemic disease in the mid-1920s. This overview of historical sleep disorders will address the question of what such prominent (apparently) neurological disorders may have represented, and whether they have actually disappeared or rather been re-defined.
Session V. Movement Disorders
The Galvani-Volta debate on animal electricity: The roles of complexity, causality and reductionism
The Galvani-Volta debate on animal electricity is one of the most complex episodes in the history of science. Through various intricate phases, the debate led to polarised positions, with Volta denying Galvani's animal electricity and Galvani denying the role Volta ascribed to contact electricity in muscular contraction. Each of them was convinced to be right and that the opponent was wrong. This situation points to the difficult status of the notion of truth in scientific research and is therefore very interesting.
An effort will be made in this paper to identify the basic elements upon which Galvani and Volta established their own truths. It will be shown how their different pictures resulted from a complex interplay between conceptual representation and experimental inquiry. Stress will be put on the extraordinary complexity of the phenomenological domain and on the way this often led both investigators to focus selectively on smaller empirical areas on the basis of theoretical preconception. Interpretation of how Galvani and Volta constructed their respective systems will be provided by taking into account the positions they took with regard to central issues like causality, reduction of phenomena to hidden structures and the relationship between physiology and physics. Some new perspectives on the Galvani-Volta debate will be provided on such grounds and a comparison offered with the views put forth by other authors.
Session IX. Italian Heritage and the Galvani-Volta Controversy
Character and caricatures of Camillo Golgi and Santiago Ramón y Cajal
Santiago GIMÉNEZ-ROLDÁN1 and Lorenzo LORUSSO2
The contrasting personalities of the Nobel prize winners, Camillo Golgi (1843-1926) and Santiago Ramón y Cajal (1852-1934), influenced their relationship and was the centre of a debate within the international scientific community.
The Spanish scientist Cajal’s admiration for his Italian counterpart, Golgi, began in 1887 in Madrid when the Spaniard learned of Golgi’s black reaction technique.
The black reaction, later known as Golgi’s method, was discovered in 1873 in the hospital kitchen at Abbiategrasso, a village not far from Pavia. Golgi used this method to make a number of discoveries on the structure of the nervous system. Based on his observations, he drew up a reticularistic theory according to which nerve cells were fused or interlaced in a diffuse nerve network spreading throughout the nervous system.
Conversely, fifteen years later, using Golgi’s method in almost its original form, Cajal became the champion of the neuron theory, according to which the nervous system is composed of individual cells, like any other tissue.
Their radically opposed views of the brain are also reflected by their completely different characters. Golgi was an introvert and quite reserved, while Cajal was proud and self-confident.
Their personalities were the object of various caricatures of the two neuroscientists. Golgi was depicted as a severe, authoritarian man in public life. Cajal was described as a friendly but outstanding character.
How far did the way they were represented reflect their scientific endeavours?
Experimental neuroscience and wax modeling: The collaboration between Anna Morandi and Luigi Galvani
Sherry GINN1 and Lorenzo LORUSSO2
The use of wax medical models to help students learn both the basic and clinical disciplines became increasingly popular by the 18th century. To facilitate this training, a wax modelers’ school, commissioned by Cardinal Prospero Lambertini (later Pope Benedetto XIV), began in Bologna. Anna Morandi (1716-1774) was one of the best of these modelers. Anna Morandi had acquired considerable skill as an anatomist while working along side her husband, Giovanni Manzolini (1700-1755), continuing her modeling following Manzolini’s death. She was particularly interested in neuroanatomy, devoting much research to the various sensory organs. Her famous self-portrait in wax shows her at work on a brain.
Most well known for his experiments on “animal electricity,” Luigi Galvani (1737-1798) actually conducted most of his research in the area of comparative anatomy, studying the kidneys, sinus cavities, and ears of humans and birds. Morandi and Galvani’s interests in neuroanatomy, particularly sensory systems, led to their collaboration, with Galvani studying organ physiology while Morandi modeled the products in wax. Their fruitful collaboration also extended to obstetrics, as Galvani practiced as a physician and surgeon in addition to his position as Lecturer in Anatomy at the University of Bologna.
Owsei Temkin (1902-2002) as a neurohistorian
Samuel H. GREENBLATT
Owsei Temkin of Johns Hopkins was one of the most preeminent historians of medicine in the 20th century. His scholarly work covered a wide variety of subjects and periods in the history of medicine, but he had a particular relationship to the history of the neurosciences because his first major monograph, The Falling Sickness, was about epilepsy. This presentation will be in three parts:
Founding psychiatry in Vienna as a neuroscience
Psychiatry as a medical discipline was established in Vienna relatively late. In mid-nineteenth century the characteristic and essential criterion ascribed to a scientific theory was the pathologico-anatomical orientation as represented by Karl Rokitansky (1804 – 1892).
In line with this approach Theodor Meynert (1833-1892) studied the pathologico-anatomical structures of the brain, also using microscopy. Against the stern resistance mainly stemming from hospital-based psychiatrists, Meynert was nevertheless appointed Head of the Psychiatric Department, founded at the University of Vienna Teaching Hospital in 1870. In 1873 Meynert became “Ordinarius” (professor in ordinary) for Psychiatry. From then on psychiatry as a science was understood by Meynert as a discipline dealing with the diseases of the brain – including neuropathology. Focus was now on the organ and not on the symptoms – applying to psychiatry and neuropathology alike. Psychopathology played a subordinate role, mere observation and description was taken to be non-scientific, also implying that hypnosis was completely rejected.
Meynert´s research concentrated almost exclusively on neuroscience, such as the cytoarchitecture of the brain, the distinction between projective and associative fibres or the explanation of mental diseases based on the contrast between the cortex and the phylogenetically older subcortical centres. As a logical consequence Meynert installed a laboratory for cerebral research and a neurological outpatient department in his clinic.
Meynert was not the founder of neuropsychiatry in Vienna´s Medical School but he established scientific psychiatry as such; however, in his opinion it had to be a neuroscience.
The predominance of neuroscience and particularly of cerebral research in psychiatry as practiced in Vienna had far-reaching effects all the way into the 20th century. This also explains the close connexion between neurology and psychiatry as an inseparable unit and the very modest acceptance of Sigmund Freud (1856-1938) and his psychoanalysis with its contradicting orientation; moreover, it also had a similar effect on other arising dynamic trends.
Semiology of Parkinson's disease in Arthur van Gehuchten's iconographic material
Anne JEANJEAN and Geneviève AUBERT
Today Parkinson’s disease is characterized by a wide range of motor as well as non-motor symptoms and signs. Motor signs are the most conspicuous, even to the layman, and it is no surprise that they were the first to be well characterized by the medical profession. Arthur Van Gehuchten (1861-1914) who was a neuroanatomist and a neurologist of repute recognized the potential of cinematography in capturing the various signs of neurological diseases as a didactic and documentation support. Patients with Parkinson’s disease occupy an important space in his didactic collection of moving pictures gathered before 1914 – and before the epidemics of encephalitis lethargica swept the world in 1916. Rest tremor is well documented, in the hands, the face, mouth and tongue. The typical posture and gait are demonstrated in several patients. The clinical features of bradykinesia, hypomimia and staring expression with decreased blinking, short slow steps and lack of arm swing when walking are remarkably illustrated. Micrographia is shown in a sample of handwriting, photographed on a glass plate. This collection of early twentieth century photographs and films forms a unique thesaurus of patients with a symptomatology unaffected by treatments such as levodopa. Indeed these treatments which have invaluable positive effects are accompanied by a range of motor complications which modify, sometimes considerably, the clinical presentation of patients.
Session V. Movement Disorders
Neurology becoming independent in the 20th century: Illustration by three large multi-authored textbooks
Peter J. KOEHLER1, F.G.I. JENNEKENS2 and D. TROOST3
Specialisation in medicine started during the second half of the 19th century and may be illustrated by several phenomena, including the establishment of specialised journals, societies, university chairs, the invention and application of instruments, and the publication of handbooks. The emancipation of neurology, independent from internal medicine and psychiatry, went slowly and was paralleled by increasingly larger textbooks.
The object of this paper is to describe three large multi-authored neurological handbooks published during the 20th century, notably Lewandowky’s Handbuch der Neurologie (LHN, 1911-4), Bumke & Foerster’s Handbuch der Neurologie (BFHN, 1935-7), and Vinken & Bruyn’s Handbook of Clinical Neurology (HCN, 1968-2002).
Lewandowsky published his series in six volumes within 3½ years, containing 47 chapters in 5595 pages. Approximately 60 authors, 20 of whom from abroad, contributed. As Lewandowsky died young (1918), supplement volumes were published in the 1920s by Bumke and Foerster, who had contributed to previous volumes. In fact they continued LHN in the 1930s (same title, lay-out, and publisher). They invited 102 authors, many of whom from abroad, filling 12.938 pages in 17 volumes (18 books). Vinken & Bruyn were assisted by a third editor and 28 volume editors. They published 78 volumes (44 in the original and 34 in the revised series), written by 2799 authors (40% European, 48% American), in 1909 chapters (46.025 pages).
The increase of knowledge is illustrated by the growing number of pages necessary to describe neurology. In LHN and BFHN basic neuroscience, including anatomy, physiology, and pathology plays a more important role than in HCN. Over the years these publication projects became more complicated and global as is demonstrated by the increasing number of foreign authors. Whereas the first two handbooks were published mainly in German (a few English chapters in BFHN), HCN was published entirely in English. The three handbooks played an important role in clinical practice at the time and testify how neurology became an independent specialty. They may now be considered important historical sources.
Friedrich Schiller, physician, poet and philosopher
Georg W. KREUTZBERG
The fact that Friedrich Schiller, the poet of freedom, studied medicine and practised as a physician is little known to the general public. Even less is known about the influence this education in his formative years had on Schiller's work, his poetry and his thinking. However, it is generally accepted that the knowledge-system in which a young, perceiving and inquisitive mind is brought up has a deep impact on character and further life philosophy. We maintain that this influence left an enduring imprint on Schiller, to be traced in his life.
The thesis that brought him the graduation as field surgeon from the elitist Karlsschule at Stuttgart is entitled "Essay on the coherence of the animalist nature of man with his mental nature". The core of this thesis is the body and mind question, addressed in a surprisingly modern way. Contrasting to the prevailing Cartesian dualism he postulated the unity of human nature: "man is not soul and body, man is the most intimate composition of both substances". He developed psychosomatic concepts and treated a fellow student suffering from depression by an early form of psychotherapy. In his revolutionary drama "Die R?uber" (The Robbers) we can recover insights from his medical thesis, personalised in the hero Karl Moor and his villain brother Franz. Even after his late promotion to a professorship in history at the University of Jena and becoming a "poetus laureatus" he never gave up his interest in the natural sciences and his critical intellect seems to be imprinted by his early education.
Whither withered Golgi? Time for revival
The 100th anniversary of the Nobel Award to Camillo Golgi and Santiago Ramon y Cajal prompts a modern retrospective examination of the fundamental proposition underlying the ‘Neuron Doctrine’. Cajal successfully championed the view that neurons are unique polarized functional units receiving signals via dendrites, in a variety of patterns, and transmitting their output via generally long axons to the dendrite of the next neuron or an effector cell at a synaptic switch. Golgi’s ‘reticular’ view of a nerve fiber web was successfully refuted, but modern findings, largely derived from electrophysiology, suggest that our concepts of the synapse have changed to include recognition of communication via widely distributed gap junctions that act as electrically coupled junctions to form syncytia that functionally synchronize neuronal firing patterns. Strict rules of ‘polarity’ are sometimes defied by axo-axonic synapses, outward conduction in dendrites, neuromodulatory peptide and hormonal influences, extra-synaptic neurotransmitter release and participation of glial cells in information processing by chemical signals and gap junctions. These features could not have been recognized until recently, nor could the participation of the Golgi apparatus as a key component of the neuronal intracellular membranous channel system for synthesis, transport and degradation.
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
Why was psychosurgery prohibited in the USSR?
The classical frontal leucotomy of Moniz and Lima was used for treatment of schizophrenia and severe pain in psychiatry and neurosurgery clinics of Soviet Union since 1944. On December 9, 1950 a special decree of the Ministry of Health of the USSR prohibited the use of prefrontal leucotomy for the treatment of neuropsychiatry disorders as «contradicting the basic principles of Pavlov’s physiological theory». It was preceded by a publication in “Pravda” (the Communist Party newspaper) an article entitled “Against one pseudoscientific method of treatment” in “letters to the editor” section. The letter was signed by two provincial doctors who labeled leucotomy as “an example of impotence of bourgeois medicine”. The next day after receiving this publication the Ministry of Health of USSR arranged a special meeting of presidium of Ucheny Meditsinsky Sovet (Scientific Medical Council). My presentation is based upon the unpublished stenograph of this meeting available at the State Archive of Russian Federation. It shows the arguments of proponents and critics of psychosurgery belonging to different schools of psychiatry as well as political (anti-Western and anti-Semitic) context of this discussion. The former (A.S.Shmar’yan, Yu.B. Rozinsky, B.G.Egorov etc.) advocated leucotomy as a method of last resort which is justified by an increasing number of hopeless chronically ill mental patients. The critics (V.A. Gilyarovsky, A.G.Galach’yan, M.V.Solov’eva etc.) compared the results of leucotomy to “ideas of American imperialists, who are looking for robots”. After the decree was published, several leading psychiatrists and neurosurgeons of Jewish origin were fired from their jobs on the pretext of performing leucotomy. It happened less than two years before the so-called “delo vrachei” (“doctors’ affair”, when a group medical doctors mostly of Jewish origin were accused of deliberate putting to death leaders of the Soviet Union).
Memory, regression and multiple languages in the works of Ribot (1881) and Rush (1812)
Marjorie Perlman LORCH
The short passage contained in Théodule Ribot's book on Diseases of Memory (Les maladies de la memoire, 1881; English translation, 1882) on the language abilities of second language learners in later life forms the foundation of our modern understanding of the neurolinguistics of bilingualism. The book presents a detailed investigation of memory impairments of various sorts and offers a number of axiomatic principles derived from the pathological cases to explain the workings of memory in general. The 'law of regression', now referred to as Ribot's Law, predicts the gradient of forgetting from the most recent to the oldest memories. Ribot's Law has been formatively applied to a variety of phenomena in neuropsychology in the past century, notably influencing Freud (1915). Within the field of aphasia, his formulation of selective recovery of languages in multilingual speakers with language disturbances is still employed today. However, in Ribot's work a significant distinction was drawn between disorders in monolingual and multilingual speakers which appears to have been lost. Impairments in language which he classified as aphasia are discussed under the classification of "partial amnesia". However, impairments in language with respect to those who had learned multiple languages were classified as "exaltations of memory, or hyperamnesias". Examination of Ribot's writings reveals a distinct conceptual approach to memory, learning and aging from that assumed today.
This paper will critically examine these ideas and analyse the sources of Ribot's conceptualization by placing his work in its historical context, and tracing the antecedents of his theories through the authors he cited, in particular, those of Benjamin Rush (1812). Detailed consideration of Ribot's original thesis provides a new the perspective on current research on bilingual speakers which is predicated on a different set of theoretical assumptions.
Lorenzo Tenchini (1852-1906): Neuroanatomy and society
Lorenzo LORUSSO1, C. CRISTINI2, R. TRALLI3 and A. PORRO3
At the end of the 19th century Phrenology was very popular in society and in Medicine. However, the correlation between skull conformation and personality was not further developed owing to its lack of scientific bases. In Italy at the same time, Cesare Lombroso (1835-1909) proposed a new approach to the study of cranial conformation and its influence on society, particularly between the morphology of the brain and criminality. An important role was played in this context by the anatomist Lorenzo Tenchini (1852-1906), who studied the relationship between neuroanatomy and society.
Lorenzo Tenchini was born in Brescia and studied Medicine in Pavia. He became a lecturer of Anatomy in 1880, at which time he wrote a book on the doctrine of Gall. In 1881 he published a volume on cerebellar anatomy. In the same year, at the age of 29 years, he was conferred the Chair of Anatomy at the University of Parma. In this city Tenchini began to study the morphology of the brains of criminals, later founding the “Museum of Criminal Anthropology”. He collected the brains of delinquents and wax masks of their faces. He studied the relationship between neuroanatomy and criminality and promoted the building of a lunatic asylum in the province of Parma. He was also interested in social medicine, including the pellagra scourge in Northern Italy.
He illustrated the Anatomy with microscopy research, particularly on the nervous system and its embryogenesis, and discovered anatomical variations in the cerebellum.
He wrote books for students including a monography on the brain, published by Vallardi, and his compendium of descriptive anatomy was very successful in Italy, confirmed by the fact that the first edition was sold out in a short space of time.
His main research works were important in the field of neuropsychiatry and anthropology. Tenchini was one of the founders of criminal anthropology in Italy and sought to explain criminal behaviour through the study of neuroanatomy.
Session IX. Italian Heritage and the Galvani-Volta Controversy
Nets without nodes and vice versa: The paradoxical Golgi and Cajal story
In 1873 Camillo Golgi wrote to a friend these words: «I spend long hours at the microscope. I am delighted that I have found a new reaction to demonstrate even to the blind the structure of the interstitial stroma of the cerebral cortex. I let the silver nitrate react with pieces of brain hardened in potassium dichromate. I have obtained magnificent results and hope to do even better in the future». This was the first reference to the discovery of the brain reaction which allowed the staining of single nerve cells. By applying this method to different part of the brain and spinal cord, Golgi elaborated a reticularist theory of brain structure and function also named diffuse nervous net, according to which the axons prolongations of nerve cells were fused or interlaced in a diffuse web along which the nervous impulse propagated. Even if the idea of a net of mutual relationship among the nervous elements, was not absent before Golgi, the novelty of his model was his functional penchant. According to Golgi, in fact, the diffuse nervous net was a physiological organ, in which the nervous impulse travels diffusely, establishing a not-selective communication system linking together every part of the encephalon and the spinal cord. The direct consequence of this model was that, according to Golgi, large part of the brain could function in an ensamble, i.e. in a holistic way. In fact he affirmed that brain activity was due «not to the isolated action of individual cells but to the simultaneous activity of large group of cells».
Golgi’s model was probably the first, in the history of science, that clearly related a complex function to a concept of net, i.e that related a web of relationship among nerve cells to the astonishing complexity and flexibility of nervous activity.
Towards the end of the nineteenth century this concept developed in polemical opposition to the neuron theory championed by the Spanish histologist Santiago Ramón y Cajal which affirms that the nervous system is anatomically and functionally composed of individual cells, like any other tissue, and that nerve cells act to each other through points of contact subsequently named synapses. In advocating this theory Cajal assumed an anti-reticularist view as a general epistemological approach to the brain function. It is obvious to say that the net of Golgi was wrong and that the neuronal concatenations of Cajal, at synaptic level, are a fairly good approximation to reality. But if we consider these models from a general “neurophilosophical” point of view we can see that both deal with one of the two fundamental aspects of neurosciences. In fact if there are two words that can epitomize more than any others, the basic pillars of neurosciences these two words are: net and nodes. Net means that the basic elements of the nervous system are related through a diffuse web of circuital relationships working both in a series and parallel to each other, accounting for the complexity of the nervous function. But they must also be targeted specifically. This second requisite is assured by specific nodes, i.e. synapses.
Now, from a historical point of view, if we look at the origin of the neurosciences, we find a paradoxical situation. Golgi advocated the idea that the functional level accounting for the activity of the encephalon and the spinal cord has to be searched in a net of mutual relationship among nerve cells. On the contrary Cajal assumed that this fundamental functional level has to be found at the synaptic level and the idea of a net conceived as physiological element is substantially absent from his writings.
Thus we reach the paradoxical conclusions that the two fundamental concepts of brain organization, the net and the nodes, were endorsed with mutual exclusion by the two champions of early neurosciences.
A Nobel pursuit: Celebrating 100 years of excellency in experimental brain research, 1906-2006
Joseph M. McKEDDIE
For their research concerning the structure of the nervous system, Camillo Golgi (1843-1926) and Santiago Ramon y Cajal (1852-1934) were jointly awarded the 1906 Nobel Prize in Physiology or Medicine. Today, one-hundred years later, the Royal Carolinian Institute of Stockholm has awarded more Nobel Prizes for experimental brain research than any other field of medicine. This paper, a centennial commemoration of this achievement, invites the reader to embark on a journey into the discoveries that have defined twentieth-century neuroscience. From the controversial histology of Golgi and Cajal to the fascinating neuropsychology of Roger Sperry (1913-1994) and beyond, the period 1906-2005 has been one of increasing diversity and growth for the neurosciences as we celebrate in retrospect what may truly be defined as "the century of the brain".
Those strange mental constitutions: The theoretical patriotism of Camillo Golgi
Joseph M. McKEDDIE
In 1873 Camillo Golgi (1843-1926) discovered the riazione nera or black reaction, a silver nitrate impregnation technique that revolutionised neuroanatomical knowledge and legitimated a new field of scientific endeavour - neurohistology. On the basis of results obtained with the new method Golgi reasoned that nerve cells formed an anastomotic reticulum defined by axo-axonic continuity. At the time the idea of a nerve-net was not without support but became increasingly scrutinised with improvements in methods of fixation, embedding and staining of neurological tissue using the Golgi method. Led most notably by Wilhelm His (1831-1904) and Santiago Ramon y Cajal (1852-1934), the initial capriciousness of the black reaction gradually yielded to a new perspective on the nature of cellular relations which was to manifest in a competing theory, the neuron doctrine. This theory, which held the cerebrum to consist of anatomically distinct cellular units, or neurons, triggered a protracted debate between the so-called "reticularists" and "neuronists" during the late nineteenth and early twentieth centuries that was highly polemical and which attracted many leading figures of anatomy, pathology and histology. A decisive moment in the history of the neuron doctrine came in 1888 when Cajal first applied his modified staining technique to embryonic neural tissue. By allowing Cajal to trace the prolongation of Deiters and protoplasmic expansions in their entirety during embryogenesis, this novel methodological approach revealed the free termination of axonal arborisations. Coupled with subsequent research into the nature of peripheral nerve regeneration by Cajal and Ross Harrison (1870-1959) among others, these investigations did much to empirically validate the neuron doctrine. Today the idea of the independence of the nerve cell represents a fundamental tenet of the neurological sciences. However, throughout his intellectual life Golgi, paradoxically, never accepted the neuron doctrine favouring instead the existence of the nerve-net. The reasons are here analysed.
Cajal, S. R. y (1995). Histology of the nervous system of man and vertebrates. (trans. N. Swanson and L. W. Swanson). Vol. I: General principles, spinal cord, spinal ganglia, medulla and pons. New York: Oxford University Press.
Golgi, C. (1975). On the structure of the Gray Matter of the Brain. (trans. M. Santini). In Santini, M. (1975). Golgi centennial symposium. New York: Raven Press.
Jones, E. G. (1999). Golgi, Cajal and the neuron doctrine. Journal of the History of the Neurosciences. Vol. 8, No. 2, 170-8.
Katz-Sidlow, R. J. (1998). The formulation of the neuron doctrine. Archives of Neurology. 55, 237-40.
Galileo and the senses: "Sensory physiology" and "visual psychophysics" in the work of Galileo Galilei
Marco PICCOLINO1 and Nicholas J. WADE2
In spite of the great interest among historians of science in Galileo’s work at the dawning of modern science, there have been relatively few studies concerned with his reflections on sensory physiology. This has occurred even though Galileo’s great perceptiveness in interpreting the astronomical images obtained with his telescope depended to a large extent on these reflections. Galileo’s interest in the physiology of the senses, and particularly of vision and hearing, is explicitly documented in a letter written in 1610 to the secretary of the Grand Duke of Tuscany; in it he spoke of his plan to write a book entitled De visu et coloribus and another entitled De sono et voce. Although these books were never published (and probably never written), the senses and perception feature in many of Galileo’s letters and published works. For example, in the Saggiatore (1623), there are some well-known passages concerned with the so-called “primary” and “secondary qualities”: Galileo seemed to anticipate the epistemological and physiological approaches to sensory mechanisms that we associate with modern studies. As a founder of the scientific method, Galileo pointed out the importance of both experimentation and direct observation of the “book of the universe” as a better source of scientific truth than the “books of men”. However, at the same time he had clear grasp of the fact that senses are adapted to the basic needs of life and are not by themselves a sure path to scientific knowledge of the world. This is particularly evident in his interpretation of structures on the moon’s surface and of “secondary light” of the moon, of the appearance of Venus, of his study of sunspots, and of the visibility of “fixed stars” (where Galileo’s science reaches some of its highest points). We examine the foundations upon which Galileo built his perceptive sensory physiology and how it was embedded in his published and unpublished texts.
Session IX. Italian Heritage and the Galvani-Volta Controversy
Vision and vexillology
Marco PICCOLINO1 and Nicholas J. WADE2
Designs on flags and in other heraldic figures have not been accorded the recognition in the history of visual science that they warrant. We wish to draw attention to the ambiguity of the vase/face type evident in an Islamic flag hanging in the Chiesa dei Cavalieri di Santo Stefano in Pisa. In this flag, which dates at least from the mid-seventeenth century, the face components are displayed through a skilful use of decorative elements and the vase counterpart can be identified as a helmet or a dome of a mosque (both in an inverted position). The design on the flag represents one of the earliest examples of figure/ground ambiguity involving facing profiles. The ambiguity is surprising because the unknown artist has flown in the face of the Islamic prohibition on representing human figures in religious decorations; this would certainly have applied to flags of the Islamic army and navy. In addition, the overall image appearing inside the chequered border of the flag is highly suggestive of the forked sword, the dhû-l-fikar, the ‘perfect sword’ of divine origin and of religious symbolic value, an important emblem of Islam. It also bears some similarity with a geometrical instrument – the compass. There is likely to be a symbolic meaning in this resemblance of a sword with a compass because the latter was becoming an instrument of great military importance. At that time, battles were becoming less dependent on the individual courage of proud knights fighting with their swords and more on a series of geometrical calculations of which the military compass was an emblem. On the one hand, the visual (and material) ambiguity present in an instrument that could be both a geometrical and military tool is perhaps an illustration of the potential ambiguity present in any human progress. On the other hand, the beautiful, but neglected, examples of perceptual ambiguity evident in the Islamic flag might be taken to reflect a certain arrogance in visual science. Phenomena disclosed to the scientist’s eye are considered as discoveries. In many cases, those practitioners of vision, artists, have discovered and manipulated the same phenomena often centuries before they came under scientific scrutiny, and often with greater subtlety.
A surgically-induced childhood: Construction of the post-operative lobotomy
Lobotomy, a surgical intervention which involves severing brain tissue with no organic evident pathology, was commonly preformed in order to treat mental illness, reaching its zenith in the United States in the 1940s. This paper will present the perceptions of members of the medical community of post-operative prefrontal lobotomy patients. It will focus on the relations between American neurologist and pioneer of psychosurgery, Walter Freeman, and his patients. It will evaluate how he perceived his patients, and what methods of training and discipline were advocated by Freeman and his colleagues. It will focus only on the post-operative situation of patients who had undergone prefrontal lobotomy, rather than transorbital, and will analyze the usage of the metaphor of childhood when referring to post-operative patients. This metaphor was used to describe the convalescence period directly following the prefrontal lobotomy, and patients were expected to undergo this period and continue on with their recovery process. The perception of lobotomized patients as being temporary children framed the manner in which the results of the lobotomy were perceived, and enabled both physicians and families to empathize with the patients. Reconstructing Freeman’s perception of his post-operative patients as children, which he also tried to instill amongst the patients’ families, is essential in understanding how the initial results of lobotomy could be interpreted in such an overwhelmingly positive manner, both by Freeman, his patients’ and their families.
Camillo Golgi and his Nobel Prize in philately
Plinio RICHELMI1, Paolo ANGELINI2, Roberto PIZZALA3 and Paolo MAZZARELLO3
In 1906 Camillo Golgi, together with Santiago Ramón y Cajal, was awarded the Nobel Prize in Physiology and Medicine for the recognition of the work concerning the structure of the nervous system. It is only in 1962, however, that the first stamp commemorating the achievements of Golgi was issued by Cuba (Scott #757). The red Cuban stamp depicts the intra-erythrocytic forms of Plasmodium, showing that malarial paroxysms coincide with the release of parasites from red cells. It is to stress out, however, that it was not Italy, i.e. Golgi’s country, to issue the first Camillo Golgi stamp. In fact stamps featuring the 1906 Nobel Laureate were issued by Sweden in 40 øre value in 1966 (Scott #711) and Comore Islands in 1977 (Scott #A52). It is only in 1994 that Italy issued the stamp “Portrait of Camillo Golgi and cerebral cells” (Scott #1976). This stamp is interesting, since it represents one of the major scientific achievements of Camillo Golgi, the black reaction, i.e. the histological technique that allowed Golgi to describe the structure of cells in the nervous system. This is, however the only Italian stamp dedicated to Camillo Golgi. More recently, Togo issued “100° Nobel Prize Laureates” in 1995 (Scott #A361), Dominica issued “Nobel Prize Laureates” in 1997 (Scott #2003), and finally Buthan issued “100 Years of Modern Medical Discoveries” in 2000 (Scott #A171). The other major finding by Camillo Golgi, the discovery of the Golgi apparatus in mammalian cells was never featured in any stamp. This is going to be represented this year in a First Day Cancel issued at Pavia for the commemorations of the Golgi Nobel prize centennial.
Acknowledgements: We thank Mr. Maurizio Misinato for the First Day Cancel and Filateliaefrancobolli Forum for bibliographic and iconographic support.
The debate on human automatism in mid-Victorian England
During the 1830s, Marshall Hall carried out innumerable experiments on a great variety of animals to establish the concept of a ‘reflex arc’. In France F.L.Goltz showed that decerebrate frogs were still capable of complex behaviours. Thomas Laycock in England and Ivan Sechenov in Russia sought to apply the reflex idea to the brain. This paper follows the debate in the periodical literature of mid-Victorian England and discusses the contributions of WB Carpenter, Herbert Spencer, TH Huxley, W Clifford and others. The previous outing of this issue in the post-Cartesian seventeenth century had been largely suppressed by ecclesiastical authority. In the nineteenth century ecclesiastical power had waned, at least in England, and the debate could take a more open form. As neurophysiology and behavioural science developed, with the widespread acceptance of Darwinian evolution, it became more and more difficult to deny that brain and mind were part of the natural world and subject to the usual laws of cause and effect. This, of course, had powerful implications for the human self-image and for jurisprudence. These implications are still with us and the work of neurophysiologists such as Benjamin Libet have only reinforced them. Should humans be regarded as ‘automata’ and, if so, what becomes of ‘free will’, ‘responsibility’, and the rule of law? The Victorian debate is still useful and relevant.
Session VI. Movement Disorders
Catalysing neurobiological research: Jacques Loeb (1859-1924), the Stazione Zoologica di Napoli and a growing network of basic neuroscientists, 1900-1930
Frank W. STAHNISCH
Already after his medical studies at the universities of Berlin, Munich and Strasburg and his M. D.-graduation - 1884 - under Friedrich Goltz (1834-1902), the experimental biologist Jacques Loeb had become interested in de- and regenerative problems of the brain. It is likely that he addressed these questions out of a growing dissatisfaction with leading perspectives on cerebral localisation as they were advocated by the Berlin physiologists. Instead he followed Goltz and late Gustav Theodor Fechner (1801-1887) in developing a dynamic model of brain function in perception and coordinated motion.
To further pursue his scientific aims, Loeb moved to the Naples Zoological Station between 1890 and 1891, where he conducted various experimental series on regenerative phenomena in sea animals. And he deeply admired the Italian marine station for its overwhelming scientific liberalism as well as for its technical and intellectual support. Here, he hoped to advance his research investigations on tropisms as basis for clarification not only of the behaviour of lower animals, but as a mechanism for space perception and general intellectual capacities. He sought to show a tight interdependence of the centres of the brain and he was convinced of regenerative phenomena as being a general mechanism for neural plasticity in animal and human behaviour. This new perspective and his astonishing successes in the experimental research on hydroids brought him into close contact with a number of contemporary neuroscientists. Yet, it is impossible to conceive of Loeb's groundbreaking experiments without taking the wider scientific network of teachers, colleagues as well as local milieus into account, in which he worked in, as they also exerted a strong influence on a growing group of collaborators, neuroscientific peers and research pupils.
The proposed paper shall explore various intellectual and organisational influences, which developed out of Loeb's early experiences at the Naples Zoological Station in Italy. The main focus will be laid on questions of the structure of scientific institutions, the development of research networks of basic neuroscientists as well as on the establishment of an interdisciplinary research style, which later exerted a strong influence on the make-up of a number of research units of the German Kaiser-Wilhelm-Gesellschaft and on the American Rockefeller Institute for Medical Research.
Session VIII. The Stazione Zoologica of Naples and the Neurosciences
Leaving trails for historians, or "Using the Lancet to explore the incorporation of cardiac theories into the causation of stroke"
It is taken as established fact that diseases of the heart are important in the causation of Stroke. The international journal Stroke is published by the American Cardiac Society. There is clearly a well recognised relationship between the two. The question posed in this paper is whether there are methods available to examine when this relationship developed and how these theories were accepted into clinical practice.
In this paper I will demonstrate that the pages of the Lancet, first published in 1823 and available in weekly format since that time, offer some insight into contemporary medical practice with which to explore these issues. A review of the case reports, proceedings of medical societies, letters to the editor as well as formal lectures provides a glimpse into medical controversies that surrounded the incorporation of theories into practice for the medical community of Lancet readers.
I will demonstrate that the Lancet, whose pages are now exposed in electronic format, makes great reading and offers lots of trails for the medical historian. The question will also be posed as to whether in our modern literature we leave enough trails for the historian of the future to identify the contemporary controversies that often surround the incorporation of medical theories.
Physiological and biological psychology textbook references rated for biological importance: A preliminary report
To evaluate the historical importance of neuroscience knowledge for the students in my psychology course, I collected data from references found in physiological psychology textbooks (1942-1990) and those of biological psychology (1984-2002). Since I was interested in literature selected by the author(s) who described the broad spectrum of the physiological or biological psychology, I chose only general and introductory books written by a single author or limited number of authors, and thus, excluded more specialized books written by multiple authors and those compiled by editors. From 25 textbooks (22 in English, 2 in Japanese, 1 in German) there were over 23,000 references. Since most of the literature (ca. 46%) was cited within a decade after a study’s original publication, I used a weighted scoring method with a logarithm-based categorization, which included the span between the years of publication and citation. For example, if an article was cited within a decade after the original publication, it was counted as 1.0 point; if an article was cited 35 years after publication, it was counted as 1.6 points. The total score of each reference and the number of citation were analyzed. The detailed results will be shown in tables.
Warts and the kings of Parthia: An ancient representation of hereditary neurofibromatosis depicted in coins
This study of the portraiture on coins of Parthian Kings demonstrates the feature of a nodule or wart on several monarchs. Evidence will be presented that these lesions may represent the cutaneous tumours of hereditary Neurofibromatosis. Examples of coins from several monarchs will be illustrated in this paper as well as coins of Phraates IV for examination.
The Parthians were a nomadic people originally from central Asia who moved into the region of Persia (Iran) in the 3rd century BC and established an eastern superpower that rivalled Rome's hegemony in the west. Parthian coins depict what has been described as a wart on the face of the king. The wart is first seen in the image of Orodes II (57-38BC) though an earlier coin of Mithradates II (123-88BC) shows a nodule below the left eye. The wart is shown on the foreheads of succeeding kings including Phraates IV (38-2BC), the son of Orodes II. They appear on the faces of many but not all of the subsequent kings up to Vologases I (51-78AD) and Vardases II (55-58AD).
The nodules do not appear on all the coins of a particular monarch though they were evident in different parts of the face suggesting a notable facial characteristic. It is unlikely that they were purely symbolic. The familial occurrence in successive generations suggests a hereditary condition. Such rounded nodules are of a size and shape which resemble hereditary Neurofibromatosis type 1(NF-1, von Recklinghausen's Disease). Multiple cutaneous and subcutaneous tumours are the principal feature of this disease. The cutaneous lesions are situated in the dermis and form discrete nodules ranging in size from a few millimetres to a centimetre or more (molluscum fibrosum). The disfiguring lesions may number in the hundreds and being visible at a distance would constitute an identifying characteristic on coin portraiture.
Historiography of research in the field of memory and intelligence: A scientometric approach
Computer-aided historiography represents a valuable method for identification and prognostication of the essential international communication patterns of science development. The capacity of a complex scientometric methodology to outline the specific role of the components of published research in a given field of rising socio-medical importance, i. e. of memory-related intelligence, was illustrated. A set of bibliometric indicators (Tomov, 1998) was used to comparatively study the historical development of the world publication output as reflected in MEDLINE (1955-2004) and in EMBASE (1980-2004). Several parameters were dynamically followed-up: journal titles (number; thematic profile; belonging to this specific field, to certain disciplines or sciences; mono-, bi-, inter- or multidisciplinary as well as national or international journals; country belonging); authors’ names and affiliations; types of journal publications, and rate of appearance of new specialized journals and scientific institutions. There were 1128 relevant documents in EMBASE and 1215 ones in MEDLINE. In the 1980s, both data-bases contained similar amounts of abstracted publications while in 2000-2004 EMBASE sharply predominated (with 513 vs 234 papers, 93 vs 45 journals from 20 vs 11 countries). In MEDLINE in 1963-1965, there were 34 relevant papers by a total of 61 authors in 29 journals from 8 countries; in 1980 in both databases - 27 papers by 59 authors in 24 journals from 9 countries and in 2004, 182 papers by 793 authors in 116 journals from 29 countries. In 2004, there were 15 mono-, 22 bi-, 8 three-disciplinary and 14 problem-oriented thematic journal profiles. The relative share of single-author’s articles gradually decreased. Institutionalization of research presented with permanent diversification, differentiation and integration. The thematic non-coincidence between institutions and journals proved the continuous emergence, interdisciplinary and international dissemination and exchange of ideas and methods. This scientometric approach to the historiography of narrow-topic research could further improve science planning and management.
Lina Stern: Science and fate
Lina Stern (1878-1968), an outstanding neurophysiologist and biochemist, was born in Russia and studied at the University of Geneva, Switzerland. After her graduation she did original research in biochemistry together with Frédéric Batelli. In 1918 Stern was the first woman to be awarded a professional rank at the University of Geneva. In 1921, she published her pioneering research on the hemato-encephalic barrier and continued this study in the Soviet Union to which she returned in 1925 because of her ideological convictions. In Moscow she turned to university teaching, which she combined with scientific research and public activities. In 1929, Stern founded the Institute of Physiology of the USSR Academy of Sciences, of which she was director until 1948, when it was discontinued. Under her leadership multidisciplinary groups of colleagues worked on the problems of the hemato-encephalic and histohematic barriers. The results of this work were later implemented in clinical practice and saved thousands of lives at the fronts of World War II. Among the many problems Stern and her scientific group worked on were longevity and sleep. In 1939, she became the first woman full member of the Academy of Sciences.
When World War II broke out Stern was chosen as a member of the Women Anti-Fascist Committee and the Jewish Anti-Fascist Committee (JAC). The JAC was wiped out in January 1949. All members of the JAC were sentenced to death, including the 74-year-old Stern. Her verdict was later changed into a term in prison followed by a 5-year-exile. She was the only member of the JAC to survive, out of the fifteen who were arrested. After Stalin's death she was allowed to return to Moscow and to establish a laboratory to continue her research work. Until her death in 1968 Stern headed the Department of Physiology at the Biophysics Institute.
Movement disorders associated with encephalitis lethargica
Joel A. VILENSKY1, Christopher G. GOETZ2 and Sid GILMAN3
Encephalitis lethargica (EL) was a highly polymorphic neurological epidemic disease that occurred primarily from 1916 to 1925 and killed as many as 500,000 people worldwide. Although initial reports of the disorder focused upon extreme lethargy, later reports emphasized the highly variable nature of its signs and symptoms and that the disease often presented with a movement disorder. The most significant sequela of EL, postencephalitic parkinsonism (PEP), was characterized by a mixed movement disorder, including parkinsonism with festination, bradykinesia and rigidity, but also a variety of dystonic, tremorous, catatonic and myoclonic movements. We have collected a series of largely forgotten films from the US, England and Germany that depict the polymorphic manifestations of EL and PEP, and edited them into four video sequences:
Because no diagnostic test was developed for EL, clinical recognition of the typical features of the disorder was the only in vivo means to identify the condition during the epidemic period. Recently (2003), 20 new cases of EL were identified in England. Our films help determine whether these recent patients resemble the classic cases of epidemic EL. The ability to diagnose EL accurately may become important if the expected bird-flu epidemic does become manifest because EL was probably epidemiologically and/or etiologically associated with the 1918 bird-flu pandemic. These films provide objective documentation of epidemic EL and may help clinicians to be aware of the unusual constellation of signs that could herald another epidemic of this disease.
Session IV. Movement Disorders
The visual neuroscience of Golgi and Cajal
Nicholas J. WADE1 and Marco PICCOLINO2
Camillo Golgi’s silver staining procedure (resulting in a black reaction – reazione nera) for nerve fibres, published in 1873, was used to good effect in the study of the visual pathways. First in 1887, Golgi’s student, Ferruccio Tartuferi, presented beautiful diagrams of retinal structure, with its vertical and horizontal connections. In the same year, Santiago Ramón y Cajal learned about Golgi’s staining technique and soon after applied it to the retina. Where Tartuferi’s representation emphasised the lateral connections of the horizontal and amacrine cells, Cajal’s positted more importance to the verticalorganisation of receptor, bipolar and retinal ganglion cell connections. This reflected the differences in the conceptions of the nervous system adopted by Golgi and Cajal (reticular and neuronal, respectively). Cajal took the dissimilarity between the rods and cones to support duplicity theory. He also sought to retain the distinction for the fibers in connection with the receptors. The presence of lateral connections from the horizontal and amacrine cells presented a problem for Cajal’s conception of the manner in which vision operated, and he tended to exclude these two classes of cells from the operative visual network of the retina. The principle of point to point projection featured strongly in Cajal’s analysis of vision and it is also a fundamental feature of photography, with which he was involved for much of his life. It is mainly due to his study of retinal architecture (culminating in 1893 with his monumental memoir La rétine des vertébrés), that the projective model dominated physiological investigations of the retina for the first half of the 20th century. Thus, the functional paradigm of retinal and visual physiology adopted by Cajal was clearly inspired to the process of photography. Not only did he develop great skills as a photographer but he also applied them to stereoscopic vision: he devised a technique not unlike the principle of random dot stereograms, with the intention of encrypting messages. Modern conceptions of retinal function perhaps owe more to Golgi’s network model than to Cajal’s point projection principle.
Movement symptomatology in melancholia and the legend of "Le Tristi Reyne di Napoli"
David A.J. WIDMER
At the church of Sant'Anna dei Lombardi, a statue of one of the last queens of an independent Naples stands frozen in a cry of grief. Giovanna IV mourns over the body of Christ, with members of her family, but the queen, along with her mother, (Juana d'Aragona or Giovanna III) was also marked as solidly with a sorrowful sobriquet as the marble of the retable. Both Giovannas are known as "le tristi reyne di Napoli" "the sad queens of Naples" and this presentation will explore the personal events associated with their title as well as the physical symptomatology and political powerlessness suggested in the nickname.
When Juana de Aragona (1455-1517) married King Ferrante I of Naples in 1478, she took the name Giovanna III, numbering herself after the two Neapolitan Queens-regnant of the previous 100 years. For the next 30 years, through deaths in the family, wars, invasions, and exiles, she acted as advisor to her husband, served as chief lieutenant of the kingdom for her step-son and for her son-in-law, and was politically active in ousting their successor from the throne in the hopes of installing her daughter there. This daughter, when married to King Ferrandino, was titled as a joint monarch to support her claim and when her husband was sick and dying, she was paraded through Naples as Queen Giovanna IV in the hopes of gaining the crown in her own right. Yet after all this involvement in the politics of the realm, suddenly in 1508, Giovanna III was removed as regent for the Spanish crown and both women disappeared into royal palaces where their court remained in seclusion for the next decade of their lives and where the legend of the "tristi reyne di Napoli" began. Melancholia's awkward and slowed movements along with other aspects of psychomotor retardation in states of chronic sadness create a specific portrait of the classic melancholic. In reviewing the familial history of the Aragonese house, I hope to show that, in Spain's attempt to discredit the ousted dynasty, labeling the two Giovannas as "sad" queens of Naples may have been a use of melancholia's associated physical immobility as a tool to render the women politically powerless and to justify their close confinement.
Session VI. Movement Disorders
The Hughlings Jackson Collection of the Rockefeller Library, Institute of Neurology
George K. YORK1 and Louise SHEPHERD2
Henry Head writes of visiting the elderly Hughlings Jackson at 3 Manchester Square and finding him surrounded by stacks of papers and notebooks. Unfortunately for posterity, Hughlings Jackson instructed his executor to destroy all his personal papers upon his death, an instruction that was carried out. As a result, little autograph material from this seminal neuroscientist remains.
While collecting material for a catalogue raisonné, we came across five boxes of material on Hughlings Jackson in the Rockefeller Library of the Institute of Neurology, Queen Square, now part of University College London. Inspection of this material revealed a large number of very rare or unique items, and we have prepared a catalogue of the collection. The Rockefeller Library Collection includes off-prints and tear-sheets from contemporaneous journals, some of which show autograph evidence of having belonged to Hughlings Jackson. It contains the largest known collection of pamphlets printed by Hughlings Jackson for private circulation. Hughlings Jackson’s handwriting is notoriously illegible, so he and James Taylor arranged for the preparation of typescripts of his writings. A number of these items show evidence of being Taylor’s preparatory material for Selected Writings of John Hughlings Jackson; and there is clear evidence that Hughlings Jackson participated n the selection of articles for these volumes. There is a typescript of the monograph Neurological Fragments. The Collection also contains the only one of Hughlings Jackson’s notebooks known to have survived.
The most important items in the Collection are 45 unpublished manuscripts, the authorship of which can be reliably attributed to Hughlings Jackson. They are the only unpublished manuscripts of Hughlings Jackson known to exist, and consist mainly of typescripts prepared in collaboration with Taylor between 1898 and 1910. However, two are hand-written. These manuscripts are in various stages of completion; most contain marginal comments and corrections in Hughlings Jackson’s hand. The Rockefeller Library Collection’s unpublished material treats the full range of Hughlings Jackson’s scientific interests, including epilepsy, aphasia, localization and evolutionary neurophysiology. Historical analysis of this unpublished material will add a new dimension to the story of the birth of modern neuroscience.
A glimpse at the teaching of G.F. D'Acquapendente (1533-1619) on the nervous system
Giorgio ZANCHIN1 and Monica PANETTO2
Despite the fact that neither a systematic description nor an iconographic record regarding the brain, the spinal cord, and the peripheral nerves were found to be published by Fabrici, if we exclude the 21 coloured paintings of neurological subject matter stored at St. Mark’s Library in Venice, two lists of manuscripts, respectively contained in the testament of 1615 and in a letter of 1622 written by the Rettori to the Riformatori dello Studio di Padova, demonstrate that Fabrici had composed neurological works. In the first list, three manuscripts that deal with neurological subjects are cited: De Capitis facultatibus, earumdemque actionibus, et proprio ac praecipuo actionum organo; De communibus Instrumentis, ut puta Venis, Arteriis, et Nervis in totus corpus discurrentibus; and De instrumento Odoratus. In the latter one, five are cited: De Cerebro, et Anatomia Cerebri; De fantasia; De Intelectu; De memoria; and De nervis. None of these manuscripts have been found, until now.
During research conducted six years ago on Gabriele Falloppia at the Municipality Library of Siena, a manuscript from the XVI century attributed to Fabrici was found, containing 85 leaves; it bears on page 1 the title De methodo anatomico Excellentissimi Aquapendentis anno 1585, and on page 22 that of De anathomia quaedam excerpta sub excellentissimo Aquapendente anno 1584. Under this title are 4 chapters: “De nervis”, “De nervis brachii”, “De nervis cruris”, and “De capite”, illustrated with 13 anatomical sketches.
It does not appear to be a manuscript by Fabrici, but instead a collection of notes taken by an unknown pupil; however, its interest remains noticeable. It allows us to appreciate, at least partially, the teaching method of d’Acquapendente; moreover, it constitutes the only written description, although indirect, of neuroanatomical structures by the renowned anatomist of Padua University.
Session IX. Italian Heritage and the Galvani-Volta Controversy
ISHN 2006 Annual Meeting -- Abstracts
Last updated 17 July 2006
Last updated 17 July 2006