The Genesis of Neuroscience

A Earl Walker (eds Edward R Laws, George B Udvarhelyi)

American Association of Neurological Surgeons, £50, pp 371

ISBN 1 879284 62 6

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Rating: ★★

T he Genesis of Neuroscience reflects the growing interest of neurosurgeons in the roots of their specialty. For 25 years, its author, Arthur Earl Walker, was a professor of neurosurgery at the Johns Hopkins University School of Medicine. In 1951 he edited A History of Neurological Surgery, which was, for decades, the only comprehensive book on the subject. After retiring from his professorial post, he continued his historical research. During the last decade of his life he was invited to give a series of lectures on the history of neurology and neurosurgery. He began collecting these notes into a manuscript, a task that was completed after his death by his wife, Agnes Marshall Walker, and it was edited into The Genesis of Neuroscience.

The book is a popular account of the origins of neurology and neurosurgery from prehistoric times until the end of the 19th century, when, according to the editors, “there was probably no way that anyone . . . could have predicted the developments in molecular biology that dominate the field of neuroscience today.” The book's central message is that we should resist the impersonal direction of current scientific methodologies and return to the importance of careful clinical observation.

The chapter on the evolution of neurosurgery is one of the most interesting. The head was shaved, we are told, because surgeons believed that removal of thick hair reduced body temperature and allowed the application of an ice cap. Medieval illustrations show the scalp being incised in a standing position in order to reduce the bleeding.

The main strength of the book is its concise and lively style. It is full of rather dry witticisms. For example, the author says that neuropathology “was born as a bastard offspring of neuropsychiatrists.” It is a useful reference book for understanding the origins of modern medical and surgical neurology and is rich in primary sources.

The editors could have increased the text's value by adding recent secondary literature on the history of neuroscience. There is also much repetition and many errors in names and dates. There are some obvious omissions—the book fails to mention some of the “giants” of neurophysiology, such as Ivan Sechenov and Ivan Pavlov, and in the chapter on neurological examination there is nothing about the history of the tendon hammer.

The book has several appendices, one of them discussing the role of the arts in the evolution of neurology. “Is it possible,” asks the author, “that appropriate soothing musical tones could so dull the algetic centers of the brain that the current pain-killers will no longer be necessary?” Another fascinating appendix deals with medical fees throughout the ages. It turns out that Galen charged the equivalent of $2000 for attending an illness, and Louis XIV of France gave the equivalent of $200 000 to his surgeons and assistants for a fistula operation.

The Genesis of Neuroscience is a fascinating historical introduction to the art and science of neurology.