The development and evolution of “cerebral thermometry”: The physiology underlying a nineteenth-century approach to cerebral localization and neurological diagnosis

ABSTRACT

Surface thermometers were developed in the latter half of the nineteenth century. From the 1850s through the 1880s, collaborations between physicians, research scientists, and instrument makers produced clear improvements in the technology to measure cranial surface temperatures, with development of self-registering mercury surface thermometers resistant to pressure and little influenced by ambient temperature, apparatus for recording cranial surface temperatures from multiple stations simultaneously, and development of thermoelectric apparatus. Physiologic studies of cranial surface thermometry were conducted over a quarter century from 1861 to 1886. Beginning in the 1860s Albers in Bonn, Germany, and Lombard at Harvard and later in England systematically investigated surface temperatures on the head using surface thermometers and thermoelectric apparatus; they demonstrated that head temperatures were variable over time and across individuals and were not clearly influenced by thinking or muscular contraction but were influenced by ambient air temperature. In 1880 Amidon in the United States claimed that cranial surface thermometry during exertion produced localized increases in surface temperature on the contralateral scalp in a specific pattern (“external motive areas”) indicating underlying brain areas responsible for each movement. Amidon’s results were not reproduced by experienced physiologists in England or France. Contemporaries recognized that significant technical and practical problems limited the accuracy and reliability of cranial surface thermometry. Physiological studies of cranial surface thermometry ended in the mid 1880s, although some clinicians who were early advocates promoted its use in clinical contexts into the early twentieth century.     

The Sherrington–Cushing connection: A bench to bedside collaboration at the dawn of the twentieth century

ABSTRACT

British physiologist Charles Sherrington (1857–1952) and American neurosurgeon Harvey Cushing (1869–1939) were seminal figures in the history of neuroscience. The two came from different worlds, one laboratory-based and the other largely clinical. Their scientific intersection, beginning in July 1901, provides a glimpse into a nascent form of “bench to bedside” collaboration, which carried with it the potential to extend the arm of neurophysiological experimentation from Sherrington’s laboratory to Cushing’s operatory. I reviewed extensive primary source materials archived at Yale University School of Medicine Library. Sherrington viewed Cushing’s bedside work as an opportunity, in humans, to extend his bench-side physiological observations on higher primates, at times almost directing Cushing in the clinic. Cushing would indeed take Sherrington’s observations on apes and extend them to his patients, and the work would eventually overturn the prevailing notion that the motor and sensory cortex were intermixed across the Rolandic fissure.     

Did Herbert Spencer Have Reading Epilepsy?

Herbert Spencer, the nineteenth-century philosopher, has frequently been dismissed as a “fantastical hypochondriac” (as his most recent biographer, Mark Francis, terms him). Yet he left a record in his Autobiography of symptoms that suggest a very different diagnosis. Abruptly at age 35, he found that the activity of reading, previously indulged in without difficulty, triggered paroxysmal episodes of disturbing “head-sensations” including “giddiness” (so Spencer described them); these severely curtailed his ability to carry out his philosophical studies. Of all possible explanations for such episodes, none seems as likely as reading epilepsy. Enduring preconceptions about Spencer's presumed neurosesmay have kept modern historians from appreciating that Spencer suffered from a legitimate, if esoteric, neurological malady.     

Georg Friedrich Handel's strokes*

Abstract

Although there is no definite proof, it seems most likely that Georg Friedrich Handel suffered from cere‐brovascular disease, which caused two or three minor strokes and weakness of his eyesight in his last years. His etiologically important risk factors and the symptoms of Handel's strokes are presented and evaluated by primary sources; various diagnoses are discussed. In Handel's musical work, no direct impact from his illness can be found, but there are some indirect outflows of Handel's pathography on his compositions, especially the Messiah.     

Making Distinctions: The Contribution of Hector Landouzy to Differential Diagnosis in Relation to Hysteria and Epilepsy

Hector Landouzy (1818-1864) is known for his Traité Complet de l'Hystérie (1846), which was crowned by the Académie de Médecine, but this work is not given much importance in historical accounts. It deserves more attention because it was more than an orthodox statement about the nature of hysteria. In the context of the diagnostic confusion between epilepsy and hysteria, it introduced a method of presenting criteria to facilitate diagnosis. An examination of French authors on epilepsy and hysteria in the second half of the nineteenth century suggests that this method probably set the example which was to be followed by later clinicians, including Charcot at the Salpêtrière.