From the Reflex Hammer to Molecular Biology: Do Clinical Descriptions Still Play a Role in Our Neurological Decision Making? Jorge Luis Borges and the Analytic Language of Wilkins

According to the renowned Argentinean writer Jorge Luis Borges (1899–1986), the 20 lines of biographical data were deliberately expunged from the article about John Wilkins in the 14th edition of the Encyclopedia Britannica. Wilkins, born in 1616, was a priest appointed to the court of a palatine prince, was later endowed a chair at one of the oldest colleges in Oxford, and finally became secretary of the Royal Society of London. A curious man, his interests included theology, cryptography, trajectories of invisible planets, and possible flights to the moon. However, according to Borges, he was guilty of describing the whole world in purely objective terms. It was for this reason that he was purposely excluded from the Encyclopedia Britannica.

In the language that Wilkins envisioned, every word was defined in a purely objective manner. Impossible to describe in this editorial, some examples on classification of rocks can be found in Borges' work. According to the author, this objective description of the universe was not new and probably resembled the numeric classification code proposed by Descartes in 1629. Wilkins divided the universe into 40 categories or genders, subdivided these into differences, and finally classified them in species. In the end, however, all classifications relied on descriptions that were purely subjective.1

The ambiguities, redundancies, and deficiencies of Wilkins' language writings reminded Borges of a certain Chinese Encyclopedia: “The Celestial Emporium of Benevolent Knowledge.” In this century, this classification would sound hilarious; nevertheless, it still reveals the important role of description. When classifying an animal, for example, these were categorized in the pages of the encyclopedia as (1) belonging to the emperor or not, (2) embalmed, (3) tamed, and (4) seeming like pigs, (5) mermaids, or even (6) looking like flies.

The Bibliographic Institute of Brussels divided the universe at that time once again into 1,000 categories, with, for instance, category 262 corresponding to things belonging to the Pope.1

Borges concluded that “there is no classification of the universe that is not arbitrary and speculative” and therefore based on observation. But, the impossibility to penetrate the divine scheme of the universe should not dissuade us from devising our own schemes, even though it is clear that there are provisional”1. Thus, observation is the key.

These short fragments extracted from the essay entitled “The Analytical Language of John Wilkins” written by Borges for his book Other Inquisitions 1 clearly, and perhaps dramatically, underlines the inaccuracy of classifications based on equivocal descriptions and underlined the crucial role of proper descriptions. To know how to describe is an art that has to be exercised and practiced. Just as improper classifications may arise from wrong observations, incorrect diagnosis is the outcome of inaccurate descriptions or careless observations.

This brings us clinicians to the center of the scene. Surely, this sensation must have driven Stan Fahn and David Marsden to publish the very first clinical journal dedicated to movement disorders 28 years ago, which included careful description, supporting figures and pictures, and those big black boxes that our new members may have never even come across in their lives: “videocassettes” (replaced today by digital video libraries and currently easily accessed and viewed on the International Parkinson and Movement Disorder Society [MDS] website). Thus were the beginnings of the Movement Disorders journal (MDJ), today a successful publication we all know well.

To date, in this new century, descriptions, illustrative videos, and teaching cases could barely find publication space with the exponential growth of basic translational sciences, genetic classifications, or molecular discoveries. These appear to ignore, as Wilkins did, that correct observation, documentation, and good description are key. Because of this, and as occurred 28 years ago, a need for continuing documentation and learning from clinical movement disorders was recognized by the MDS and has taken shape as a new online journal—Movement Disorders Clinical Practice (MDCP).

To salute the original journal, the banner colors and design for MDCP were taken from the initial cover of our brother journal, and the MDCP will retain and foster interest for clinical work, careful descriptions, and high standards, as in our original journal.

One difference perhaps is that when MDJ first appeared, 20% of published papers were written by founding editors, unlike MDCP today, in which submission of interesting clinical material has exceeded the capacity of the first issue in less than a month of call for articles. Clearly, sustained interest of clinicians in the field and inordinate amounts of excellent clinical observations will drive translational investigations to produce further advances in the field and a rapid growing of this journal.