Year : 2012 | Volume
: 15 | Issue : 1 | Page : 64--65
Eminent Neuroscientists: Their Lives and Works
Nadir E Bharucha
Department of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai, India
Nadir E Bharucha
Department of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai
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Bharucha NE. Eminent Neuroscientists: Their Lives and Works.Ann Indian Acad Neurol 2012;15:64-65
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Bharucha NE. Eminent Neuroscientists: Their Lives and Works. Ann Indian Acad Neurol [serial online] 2012 [cited 2020 Feb 24 ];15:64-65
Available from: http://www.annalsofian.org/text.asp?2012/15/1/64/93287
Kalyan B. Bhattacharyya, Academic Publishers, Kolkata, Jan. 2011 in collaboration with Assn. of Neuroscientists of Eastern India Academic Publishers.
ISBN: 978-93- 80599-28-1, Price: Rs.750/-
The current approach to clinical neurology consists of history taking, eliciting physical signs, formulating a diagnosis, investigating and, finally, managing the patient. "Eminent Neuroscientists, Their Lives and Works" by Kalyan B. Bhattacharyya is a timely publication for the clinician of today, as through the lives of the neuroscientists of the past, we may better understand the art and science of current clinical neurology. Beginning from the second half of the nineteenth century, other discoveries pertained to neuroanatomy, physiology, pathology and chemistry thus enabling concurrently the elucidation of the nature of neurological disorders themselves.
Chapters on the anatomists, such as Bell, Broca, Golgi, Cajal, Willis and others, together trace the development of neuroanatomical knowledge. Charles Bell studied the path of the seventh cranial nerves. Broca described the cerebral lesion producing aphasia. Golgi developed the silver nitrate and osmic acid stain that clarified the microanatomy of synapses, dendrites, intracellular inclusions, termed "Golgi Bodies," and the branching network of the central nervous system. Although his nerve net theory was erroneous, he demonstrated that localisation of function was difficult as the nervous system acted as a whole. Cajal used Golgi's stain, wrote a treatise on the histology of the nervous system and stated the doctrine of the neurone. Willis, the first to use the term "neurology" in 1664 wrote "Cerebri Anatome," for which Sir Christopher Wren drew the sketches. Willis described a large number of anatomical structures including the arterial circle at the base of the brain, the Circle of Willis and the classification of the cranial nerves.
Of the neurophysiologists, Hans Berger first recorded the electrical activity of the brain, called it the electroenkephalogram and noted the α-wave. Claude Bernard is most remembered for his concept of the "milieu interieur." Pavlov devised and studied the chronic fistula, preserving the vagus nerve and thereby formulating the concept of the conditioned reflex. Sherrington's classic of Neurophysiology, "The Integrative Action of the Nervous System," describes patterns of excitation and inhibition that happen when the knee jerk is elicited - the quadriceps contracts and the hamstrings are inhibited, something which every student should know.
Pathologists of note described in the book include Aloïs Alzheimer, who first described the pathological changes of amyloid plaques and neurofibrillary tangles in a woman with dementia. Kraepelin termed the condition "Alzheimer's Disease." Von Economo, who carried out cytoarchitectural studies, described encephalitis lethargica. Greenfield wrote a textbook of neuropathology, classified spinocerebellar degenerations and developed stains that allowed him to identify late infantile metachromatic leukodystrophy or Greenfield's Disease. Franz Nissl used aniline dyes to identify components of nerve cells, "Nissl granules." Weigert devised a stain for myelin. All the above pathologists developed new and invaluable staining techniques and, with painstaking methodology, established pathological features.
Notable chemists mentioned are Walter Cannon, who worked on the sympatho-adrenal system and its role in maintaining "homeostasis," the steady state of the milieu interne. Two other physiologists mentioned, Henry Dale and Otto Loewi, showed that electrical nerve impulses travel from one neurone to another via the chemicals acetylcholine and noradrenaline.
Clinicians simultaneously developed a system of examination of the nervous system and described and classified neurological diseases. Clinical neurologists, in addition to those above, were many. Romberg, a German, was among the earliest clinicians who made the distinction between motor and sensory disturbances. Duchenne, the first to use electrical current both to study and to treat muscle disturbances, also described progressive bulbar palsy, spinal muscular atrophy and pseudohypertrophic muscular dystrophy, which he studied by muscle biopsy. Jean Martin Charcot, the great neurologist who developed the Salpetriere in Paris into a combined psychiatric and neurological center, also introduced case demonstration. He also induced "seizures" in hypnotized "hysterical" patients. Indeed his student, Joseph Babinski, felt that he had invented rather than discovered the term "hystero-epilepsy." He had innumerable other famous students and assistants, including Axel Munthe, Charles-Joseph Bouchard, Sigmund Freud and William Osler, who further extended the body of both neurological and psychiatric knowledge.
Noted British neurologists have been well covered. These include John Hughlings Jackson, who described epilepsy as "sudden excessive ……… discharge" of nerves. With Gowers, he introduced the concepts of lesions producing either a loss of function or excessive function. He incorporated ophthalmoscopy into clinical neurology. Sir William Gowers, the first Registrar at the National Hospital for the Paralyzed and Epileptic, wrote the well-known Manual of Diseases of the Nervous System, in addition to introducing examination of the knee jerk in clinical neurology.
Other chapters describe numerous other neurologists of note of this period. For the student of medicine, the chapter on Sir William Osler is well worth reading and his aphorisms worth imbibing.
The neurosurgeons who made significant contributions are also well documented. Victor Horsley, "the Father of British Neurosurgery," Harvey Cushing, "the Father of Modern Neurosurgery" and Walter Dandy, who introduced the technique of pneumoencephalography. Dandy was Cushing's clinical assistant, who disagreed with Cushing's aim "to remove as little as possible," whereas Dandy aimed to cure "by removing as much as possible" - a difference of opinion still much alive!
My listing of some of the "Greats" in this book clearly demonstrates the enormous debt current knowledge owes to the past. It is well worth remembering and the enjoyable reading of this book is a suitable start. I found it difficult to put the book down once I started to read it. It makes easy reading. The prose is straightforward and uncomplicated. Serious historians will, of course, go to primary sources. As a well-produced, hard cover book with good-sized print and a photograph of each of the neurologists and neuroscientists mentioned, it is easily affordable at Rs. 750/-. A future edition would benefit from dividing neuroscientists by their respective specialities, as done in this review, thereby providing a tighter framework of organisation. On a personal note, I feel pioneering neuroepidemiologists such as Kurland, Kurtzke and Schoenberg should be included.
I can heartily recommend this volume to all interested.