Anthropological Neurology: Symptoms and Their Meanings According to Joseph Prick (1909–1978)

This article describes the life and work of the Dutch neurologist Joseph Prick (1909–1978) and his idea of an anthropological neurology. According to Prick, neurological symptoms should not only be explained from an underlying physico-chemical substrate but also be regarded as meaningful. We present an outline of the historical and philosophical context of his ideas with a focus on the theory of the human body by the French philosopher Maurice Merleau-Ponty (1908–1961) and the concept of anthropology-based medicine developed by Frederik Buytendijk (1887–1974). We give an overview of anthropological neurology as a clinical practice and finally we discuss the value of Prick's approach for clinical neurology today.     

A Brief Exploration of Neurological Art History

The invention of realistic portraiture to reveal "inner life" is attributed by some art historians to Jan van Eyck who worked in Flanders from 1420 onwards. We show, using clinical neurological examination of the gold mask of Agamemnon dating from 1550-1500 BC and of the portraits of Henry III and his son Edward I - important English royals - painted between 1216 and 1307, that realistic portraits were made well before the 15th Century. Thus artists unwittingly used neurology as part of their realistic approach to the presentation of the face. Because neurological diagnosis is often visual, neurology, in turn, has a rich potential to unveil examples of realism in art. We consider the art pieces examined here also pertinent to art historians, as they assess the role of art in documenting history.     

A brief exploration of neurological art history

The invention of realistic portraiture to reveal "inner life" is attributed by some art historians to Jan van Eyck who worked in Flanders from 1420 onwards. We show, using clinical neurological examination of the gold mask of Agamemnon dating from 1550-1500 BC and of the portraits of Henry III and his son Edward I -- important English royals -- painted between 1216 and 1307, that realistic portraits were made well before the 15th Century. Thus artists unwittingly used neurology as part of their realistic approach to the presentation of the face. Because neurological diagnosis is often visual, neurology, in turn, has a rich potential to unveil examples of realism in art. We consider the art pieces examined here also pertinent to art historians, as they assess the role of art in documenting history.     

Founding years of clinical neurology in Berlin until 1933

During the so-called "Gründerjhare" or "founding years" in Berlin it became necessary to build new hospitals because of the rapid growth of population. As a result, several infirmaries, asylums for the insane and institutions for epileptics were build between 1877 and 1912. The new building of the University of Neuropsychiatric Clinic ("Nervenklinik") of the Charité was opened in 1905 according to plans made by Friedrich Jolly (1844-1904), the physician who named myasthenia gravis pseudoparalytica. A "Neurological Central Station", under the direction of Oskar and Cecil Vogt, in existence since 1898, was a research center dedicated more to morphology. There the study of the structure of the cerebral cortex by Korbinian Brodmann (1868-1925) and research into basal ganglia diseases by the Vogts began. The Kaiser-Wilhelm Institute for Cerebral Research, which moved into a new building in 1931, also had its origin here. Hermann Oppenheim (1858-1919) promoted independent clinical neurology, as did his younger contemporary, Max Lewandowsky (1876-1918), who was already advising physician for neurology at the Berlin-Friedrichshain Hospital. Hug Liepmann (1863-1925), the creator of apraxia theory, worked at the asylums for the insane in Dalldorf (Berlin-Wittenau) and Berlin-Herzberge. In 1911, the first neurological unit was established in the large hospital in Berlin-Buch under the direction of Otto Maas. Not until after World War I were further neurological hospital units founded, under the direction of Paul Schuster (1867-1940), Kurt Goldstein (1878-1965), Kurt L?wenstein (died in 1953) and Friedrich Heinrich Lewy (1885-1950). These Jewish physicians, as well as C.E. Benda and Otto Maas, had to leave their posts in 1933 and emigrate. The clinical institutions and scientific achievements of these pioneers of independent clinical neurology will be presented up to the point of its violent dissolution.     

The James Ramsay Hunt case books

James Ramsay Hunt (1874-1937) was one of the pioneers of early-twentieth-century American neurology. The James Ramsay Hunt Case Books, Columbia University, were created by Hunt and chronicle his experience with private patients from 1903 until 1937. This resource is not widely known to scholars and the content of these 30 volumes has not been described in detail. The purpose of this report is to describe this resource in terms of its organization, general contents and special features. The books contain the clinical records of 5,019 consecutive patients. The largest proportion had neurasthenia or psychiatric diagnoses, followed by those with neuropathies, manifestations of neurosyphilis, migraine and epilepsy. The books, through the enclosed correspondence, photographs, and poetry sent by patients, reveal a close relationship between the patients and their physician. Hunt's drawings are a special feature of the early volumes, including his original unpublished drawing of the lesions associated with his herpetic geniculate ganglion syndrome. The Case Books, by providing an indexed and permanent record of cases, would have made it easier for Hunt to cross-reference patients with similar clinical characteristics when he was in the process of describing a new syndrome. These Case Books provide a valuable perspective of the practice of neurology in early-twentieth-century America.     

G.I. Rossolimo (1860-1928) neurologist and public benefactor

G.I. Rossolimo was attracted to neurology as a medical student in the late nineteenth century and remained affiliated with Moscow University most of his life. His training included psychiatry, neuropathology, and laboratory research in his postgraduate years. The domain of his neurological clinical interests was vast. His most enduring efforts were directed toward neurological illnesses and developmental delay. He established a children's institute for neurology and psychology that was the first of its kind in Russia. In addition he developed a neuropsychologic examination for assessing cognitive function. His sustained interests were pursued during and after revolutionary changes in his government.     

Charcot in contemporary literature

Charcot and his medical observations remain an enduring topic of scientific study in neurology, but he is also the topic of modern literary works. This essay examines the depiction of Jean-Martin Charcot (1825-1893) as a character in late-twentieth-century literature as an index of the contemporary nonmedical literary public's interest in neurology and Charcot. It focuses on three contemporary works that involve Charcot as a central figure with comparison between primary source documents and the rendered context, character development, and plot lines of these literary works. The two French novels [Slumbers of Indiscretion and Dr. Charcot of the Salpêtrière] and one American play [Augustine (Big Hysteria)] approach Charcot and neurology with differing levels of historical accuracy. All create a figure of authority, each with a different coloration of the balance between power and its abuse. Two focus almost exclusively on his work with hysteria and inaccurately amplify Charcot's concern with symbolic sexual conflict as the origin of hysteria and fictionalize more extensive interactions with Freud than historical documents support. The three works demonstrate that Charcot retains an enduring fascination with an enigmatic personality, a controversial career, and a pivotal role in the development of studies involving the brain and behavior. Neurologists should not look to these works as replacements for more seriously composed historical studies, but as enrichments anchored in the imaginative possibilities of Charcot and his fin de siècle era.     

Emergence and early development of Russian neurosurgery (1890s-1930s)

This paper is a case study of specialization in clinical medicine - it is a story of the difficult and complicated birth of a neurosurgery clinic in Russia and the Soviet Union. It demonstrates the futile attempt to institute a new specialty as surgical neurology advocated by neuro(patho)logist V.M. Bekhterev (1857-1927) and implemented by his pupils L.M. Pussep (1875-1942) and A.G. Molotkov (1874-1950). However, surgical neurology was gradually replaced by neurological surgery performed by general surgeons N.N. Burdenko (1875-1946), A.L. Polenov (1871-1947), and V.N. Shamov (1882-1962). Part of my paper is dedicated to the institutional history (emergence of the Institute of Surgical Neurology in Leningrad (in 1926) and the Central Institute of Neurosurgery in Moscow (in 1934). The Moscow Neurosurgical School was focused on lesions of the central nervous system whereas the Leningrad neurosurgical school dealt primarily with peripheral nerve surgery. In the 1930s neurosurgical clinics were established beyond the two capitals - in Rostov-on-Don, Kharkov, and Gorky. Similar to the centralized five-year planning in the Soviet economy, a new discipline of neurosurgery was also centralized and planned from Moscow in the 1930s. It was characterized by kompleksnost' - concentration of several auxiliary disciplines (neuroradiology, neuroophthalmology, neurophysiology, etc.) within neurosurgical research institutions in Leningrad and Moscow. Particular stress was made on the experimental nature of a new discipline, which was viewed as a sort of applied neurophysiology.     

The James Ramsay Hunt Case Books

James Ramsay Hunt (1874–1937) was one of the pioneers of early-twentieth-century American neurology. The James Ramsay Hunt Case Books, Columbia University, were created by Hunt and chronicle his experience with private patients from 1903 until 1937. This resource is not widely known to scholars and the content of these 30 volumes has not been described in detail. The purpose of this report is to describe this resource in terms of its organization, general contents and special features. The books contain the clinical records of 5,019 consecutive patients. The largest proportion had neurasthenia or psychiatric diagnoses, followed by those with neuropathies, manifestations of neurosyphilis, migraine and epilepsy. The books, through the enclosed correspondence, photographs, and poetry sent by patients, reveal a close relationship between the patients and their physician. Hunt's drawings are a special feature of the early volumes, including his original unpublished drawing of the lesions associated with his herpetic geniculate ganglion syndrome. The Case Books, by providing an indexed and permanent record of cases, would have made it easier for Hunt to cross-reference patients with similar clinical characteristics when he was in the process of describing a new syndrome. These Case Books provide a valuable perspective of the practice of neurology in early-twentieth-century America.     

Louis Muskens: A Leading Figure in the History of Dutch and World Epileptology

In the history of Dutch neurology Muskens has a place in his own right. Elderly neurologists still attest to the special fame of Muskens. He held a strong opinion on developing the specialty of neurology independent of psychiatry. At the same time he maintained that surgery of the nervous system also should be included in the realm of neurology. These views met with considerable opposition from colleagues and led to Muskens’ isolation. To the field of epileptology he contributed both clinical and experimental neurological studies. With Donath he was the co-founder of the International League Against Epilepsy in 1909. In addition he held a lifelong interest in the pathophysiology of forced movements, which he studied both in human pathology and in experimental studies throughout the vertebrate series. This resulted in his magnum opus on the supravestibular system in 1935. His scientific work was well received in scientific societies all over Europe.     

Louis Muskens: a leading figure in the history of Dutch and world epileptology

In the history of Dutch neurology Muskens has a place in his own right. Elderly neurologists still attest to the special fame of Muskens. He held a strong opinion on developing the specialty of neurology independent of psychiatry. At the same time he maintained that surgery of the nervous system also should be included in the realm of neurology. These views met with considerable opposition from colleagues and led to Muskens' isolation. To the field of epileptology he contributed both clinical and experimental neurological studies. With Donath he was the co-founder of the International League Against Epilepsy in 1909. In addition he held a lifelong interest in the pathophysiology of forced movements, which he studied both in human pathology and in experimental studies throughout the vertebrate series. This resulted in his magnum opus on the supravestibular system in 1935. His scientific work was well received in scientific societies all over Europe.     

Armand Trousseau--some of his contributions to neurology

Trousseau made a remarkably large number of original clinical contributions to medicine and neurology. Best known are Trousseau's syndrome, the combination of venous thrombosis with visceral carcinoma; tache cérébrale, the red streak seen on scratching the skin in acute meningitis; and Trousseau's sign, the cardinal physical sign in tetany. His pioneering work in tracheostomy in diphtheria, haemochromatosis, Parkinson's disease, aphasia and chorea are but a few of his outstanding clinical studies. Based on his famously comprehensive text, Clinique Médicale de l'H?tel Dieu, this paper highlights a few of his discoveries. The name of Armand Trousseau must stand alongside those of Charcot, Oppenheim, Jackson and Gowers in the annals of neurology.     

William Alexander Hammond: The Centenary of His Death

In the United States, the field of clinical neurology began within the medical practice of a single physician, William Alexander Hammond. In the 1870s, this New York medical practitioner became the first American physician who limited his practice to patients who suffered from symptoms potentially due to dysfunction of the nervous system. From the experience of his huge practice, Hammond wrote the first American textbook of neurology. With Silas Weir Mitchell, he founded the American Neurological Association. The year 2000 marked the 100th anniversary of Hammond's death and stimulates this brief survey of his life.     

The first career of William Alexander Hammond

Neurology in its modern sense was first studied in the well-known neurological institutions of France and England. In America, however, this new field of medicine was developed by a physician in a private practice, Dr. William Alexander Hammond. This article addresses the question how Hammond was able to limit his practice to neurology. It is argued that Hammond was a famous military physician before becoming the first practitioner of clinical neurology in America. This fame translated into a large referral base.