Vladimir Mikhailovich Bekhterev

V.M. Bekhterev (1857-1927) was an outstanding Russian neurologist, psychiatrist, psychologist, morphologist, physiologist, and public figure, who authored over 1000 scientific publications and speeches. At the beginning of the twentieth century he created a new multidimensional multidisciplinary scientific branch - psychoneurology, which included the objective knowledge of the anatomy and physiology of the nervous system, psychology, psychiatry, neurology, philosophy, sociology, pedagogy, and other disciplines. Psychoneurology in V.M. Bekhterev's understanding has furthered the introduction into the idea of a "biosocial" essence of man of a third - psychological - component, thus having created a "biopsychosocial" model in the interpretation of human diseases.     

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.     

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.     

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.     

Neurognostics Answer

Although many individuals contributed to the development of the science of cerebral localization, its conceptual framework is the work of a single man—John Hughlings Jackson (1835–1911), a Victorian physician practicing in London. Hughlings Jackson's formulation of a neurological science consisted of an axiomatic basis, an experimental methodology, and a clinical neurophysiology. His axiom—that the brain is an exclusively sensorimotor machine—separated neurology from psychiatry and established a rigorous and sophisticated structure for the brain and mind. Hughlings Jackson's experimental method utilized the focal lesion as a probe of brain function and created an evolutionary structure of somatotopic representation to explain clinical neurophysiology. His scientific theory of cerebral localization can be described as a weighted ordinal representation. Hughlings Jackson's theory of weighted ordinal representation forms the scientific basis for modern neurology. Though this science is utilized daily by every neurologist and forms the basis of neuroscience, the consequences of Hughlings Jackson's ideas are still not generally appreciated. For example, they imply the intrinsic inconsistency of some modern fields of neuroscience and neurology. Thus, “cognitive imaging” and the “neurology of art”—two topics of modern interest—are fundamentally oxymoronic according to the science of cerebral localization. Neuroscientists, therefore, still have much to learn from John Hughlings Jackson.     

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.     

A biography of James Ramsay Hunt (1874-1937)

James Ramsay Hunt (1874-1937) was a pre-eminent twentieth-century American neurologist. The name of Ramsay Hunt is known today because several neurological disorders bear his name, including the herpetic geniculate ganglion syndrome and a form of ataxia and myoclonus. Despite his importance in the field of neurology, few biographical details have been recorded about Hunt's life. One of the authors of this report recently located Hunt's daughter. This biographical sketch was based on interviews conducted with her and review of documents in her possession, including letters written by Hunt. Details are depicted about Hunt's family background and childhood, medical education and early professional development, courtship and marriage, wartime experiences, family and social life, daily routine and professional development, as well as illness and death.     

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.     

Vincenzo Neri and His Legacy in Paris and Bologna

Italian neurologist Vincenzo Neri was able to discover cinematography at the beginning of his career, when in 1908 he went to Paris to learn and improve his clinical background by following neurological cases at La Pitié with Joseph Babinski, who became his teacher and friend. While in Paris, Neri photographed and filmed several patients of famous neurologists, such as Babinski and Pierre Marie. His stills were published in several important French neurological journals and medical texts. He also collaborated with Georges Mendel, who helped Doyen film the first known surgical operation in the history of cinema. In 1910, when he came back to Bologna, he continued in his clinical activities and, for 50 years, slowly developed a huge archive of films, images, and prints of neurological, psychiatric, and orthopedic cases. This archive was extremely helpful to Neri, who especially needed to analyze neurological disorders and to differentiate them from functional conditions in order to understand clinical signs, rules, and mechanisms.     

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.     

Three Twentieth-Century Multiauthored Neurological Handbooks – A Historical Analysis and Bibliometric Comparison

The emergence of neurology as a separate specialty from internal medicine and psychiatry took several decades, starting at the end of the nineteenth century. This can be adequately reconstructed by focusing on the establishment of specialized journals, societies, university chairs, the invention and application of specific instruments, medical practices, and certainly also the publication of pivotal textbooks in the field. Particularly around 1900, the German-speaking countries played an integral role in this process. In this article, one aspect is extensively explored, notably the publication (in the twentieth century) of three comprehensive and influential multivolume and multiauthor handbooks entirely devoted to neurology. All available volumes of Max Lewandowsky's Handbuch der Neurologie (1910–1914) and the Handbuch der Neurologie (1935–1937) of Oswald Bumke and Otfrid Foerster were analyzed. The handbooks were then compared with Pierre Vinken's and George Bruyn's Handbook of Clinical Neurology (1968–2002).

Over the span of nearly a century these publications became ever more comprehensive and developed into a global, encompassing project as is reflected in the increasing number of foreign authors. Whereas the first two handbooks were published mainly in German, “Vinken & Bruyn” was eventually published entirely in English, indicating the general changes in the scientific language of neurology after World War II. Distinctions include the uniformity of the series, manner of editorial involvement, thematic comprehensiveness, inclusion of volume editors in “Vinken & Bruyn,” and the provision of index volumes. The increasing use of authorities in various neurological subspecialties is an important factor by which these handbooks contrast with many compact neurological textbooks that were available at the time.

For historiographical purposes, the three neurological handbooks considered here were important sources for the general study of the history of medicine and science and the history of neurology in particular. Moreover, they served as important catalyzers of the emergence of neurology as a new clinical specialty during the first decades of the twentieth century.     

Gabrielle Lévy and the Roussy-Lévy syndrome

In 1934, Gabrielle Lévy died at the age of 48. She became well known for an article she published on a hereditary polyneuropathy in cooperation with Gustav Roussy, resulting in the eponym Roussy-Lévy syndrome. Not much is known about this extraordinary neurologist/neuropathologist. Her family declared that she died from the disease she was studying. She was a pupil of Pierre Marie, with whom she worked at the Salpêtrière in Paris and wrote on war neurology. In cooperation with Marie, she published a number of articles on postencephalitic syndromes, which also became the subject of her 1922 thesis. Three years later, she became associate physician at the Paul-Brousse Hospital in Paris, where the study of brain tumors became one of the subjects of her scientific work. Remarkably, Lévy was first author in a few of her many articles, although Roussy confirmed that she often initiated the study and even wrote the main part. In this article her career is considered in the context of the struggle of women physicians to improve their position during the early-twentieth century. She probably died from a brain tumor or a postencephalitic syndrome.     

A Biography of James Ramsay Hunt (1874–1937)

James Ramsay Hunt (1874–1937) was a pre-eminent twentieth-century American neurologist. The name of Ramsay Hunt is known today because several neurological disorders bear his name, including the herpetic geniculate ganglion syndrome and a form of ataxia and myoclonus. Despite his importance in the field of neurology, few biographical details have been recorded about Hunt’s life. One of the authors of this report recently located Hunt’s daughter. This biographical sketch was based on interviews conducted with her and review of documents in her possession, including letters written by Hunt. Details are depicted about Hunt’s family background and childhood, medical education and early professional development, courtship and marriage, wartime experiences, family and social life, daily routine and professional development, as well as illness and death.