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.     

Samuel Tissot’s Traité de l’épilepsie—250 years old

A quarter of a millennium ago, Samuel Tissot (1728–1797), a Swiss physician who had achieved a substantial European reputation, authored a monograph entitled Traité de l’épilepsie. The book was translated into several European languages and appeared in various editions over the following 70 years, although an English-language version was never published. In his Traité, Tissot provided a thorough account and critical analysis of the previous relevant literature concerning epilepsy, added data from his own experience in practice, and raised issues, some of which remain important today. The appearance of the book was propitious, occurring during the period of the European Enlightenment, when medicine was increasingly divesting itself of ancient modes of thinking and veneration for the opinions of great names from the remote past. At least in Western Europe, the Traité de l’épilepsie became an intellectual launching pad for the considerable expansion in knowledge of epilepsy that occurred over the century or longer that followed its publication.     

Biological and Epistemological Models of Localization in the Nineteenth Century: From Gall to Charcot

In the latter half of the nineteenth century, the localizationist doctrines became closely associated with the memory trace paradigm. The analysis of the texts dealing with the localization and the nature of ‘the loss of articulated speech’ (motor aphasia) by Bouillaud, Lordat, Dax, Broca, Trousseau, Baillarger, Charcot and Wernicke shows how the biological paradigm of localization presented by Gall and based on the notion of organ-function correspondence was transformed into a model based on localizable memory traces. This change resulted in the theoretical unification of the mechanisms of motor and non-motor forms of aphasia. These forms, which the earlier authors tended to separate in their analyses of the underlying mechanisms, were now regarded as involving similar mechanisms related to the loss of mnestic images. The crucial step in this development was taken by Broca who presented the hypothesis that the faculty of coordination of speech movements, which according to his predecessors was the faculty lost in motor aphasia, was actually an intellectual faculty and a specific form of memory, and motor aphasia consequently a selective kind of amnesia. Theorists like Charcot and Wernicke generalized this idea into a comprehensive theory of the nature of localization based on the notion of memory traces. Thus, the localization of function was reduced to the localization of representations. Instead of biological paradigms, this model of localization is rooted in the epistemological tradition of psychology represented by Locke and Condillac, who were primarily interested in the problem of representation. In physiology, this approach usually resulted in attempts at localizing representations instead of functions.     

Cortical epileptogenesis and David Ferrier

There was an increasing medical interest in the localization of representation of function in the cerebral cortex after Broca in 1861 identified a cortical area that appeared responsible for expressive speech. By the late 1860s, John Hughlings Jackson—based on clinico-pathological correlations mainly in persons with focal motor seizures—had reasoned that contralateral somatic motor function was represented in another area of the cortex. This localization was supported by Fritsch and Hitzig (1870) in experimental cortical stimulation studies in dogs. These authors also reported producing events resembling contralateral motor convulsing in their animals. Their work, and Jackson’s ideas, prompted David Ferrier, in Great Britain, to begin a program of cerebral cortical stimulation studies in various vertebrate species, trying to locate cortical sites of representation of functions other than expressive speech and motor activity. In his initial report of his investigations (1873), he noted that appropriately sited Faradic stimulation evoked immediate or delayed contralateral focal motor seizures, some of which evolved into generalized convulsions. On this basis he reasoned that focal motor and generalized seizures were expressions of the same disorder; that nearly all epilepsies originated in the cerebral cortex and not in the lower brain stem, as hitherto thought; and that the clinical pattern of epileptic seizure phenomenology depended on the function of the cortical site of origin and the extent and direction of spread of seizure activity in the brain. He not only provided experimental verification for Jackson’s reasoning about epileptic seizure mechanisms but expressed the ideas a good deal more clearly than Jackson ever managed to do. Ferrier’s achievement in this regard has tended to escape notice, lost sight of because of the great importance of his investigations into localization of cerebral function.     

Probable Atretic Cephalocele in an Adult Female from Punta Secca (Sicily,Italy)

Excavations at Punta Secca, Sicily (Italy), in 2008 uncovered a substantially built tomb of ca ad 625/630 inside a private house and accompanying evidence for libations and funerary feasting in honour of the deceased. Inside the tomb were the skeletal remains of an adult female aged approximately 20/25 years and a child aged approximately 3/5 years. DNA analysis showed the child to be female and the adult and child to have been consanguineous. Archaeological and epigraphic evidence demonstrates that they were Christians. The cranium of the adult female showed an enlargement of the central portion of the occipital bone and a circular depression that terminated in a bifurcated foramen (diameter 3.25 mm). The former is likely an instance of occipital bunning; the latter is the first attested example of atretic cephalocele from an archaeological context. Tombs do not normally occur in ancient houses, and the hypothesis is advanced that the individual may have suffered from medical side effects, such as seizures, which caused rejection of the adult female by the local Christian community but veneration of her by her family as a holy woman. Copyright © 2012 John Wiley & Sons, Ltd.     

Perkins’s patent metallic “Tractors”: Development,adoption, and early dissemination of an eighteenth-century therapeutic fad

ABSTRACT

The metallick Tractors were patented by Elisha Perkins, a Connecticut physician, in 1796, for the treatment of various ailments, particularly those associated with pain. They were subsequently rapidly and widely disseminated on the basis of testimonials and aggressive marketing tactics. Dissemination was facilitated by endorsements from prominent physicians, politicians, and clergy, by quasi-theoretical explanations of efficacy based on then-current experiments of Galvani and others, and by the apparent simplicity and safety of the procedure. Abandonment of this ineffective therapy was later prompted by the application of blinded placebo-controlled trials using sham devices.