Neurology from 1900-1909

Kenneth L. Tyler, MD

         The first decade of the 20th Century (1900-1909) saw dramatic changes and advances in virtually every aspect of neurology. The basic science framework for neurology was solidified by fundamental advances in neurophysiology, led by Sir Charles Sherrington and his collaborators.

Sir Charles Scott Sherrington Sir Charles Scott Sherrington shown as a young man was a pre-eminent neurophysiologist of the first decade of the 20th Century. The Integrative Action of the Nervous System, published in 1906, was a landmark in the history of science. Sherrington received the Nobel Prize in 1932 for physiology.

Santiago Ramón y Cajal (1852-1934) This photograph of Santiago Ramón y Cajal was taken in 1899 at the time of his visit to the United States to lecture a the Decennial Celebration of Clark University in Worcester, Massachusetts. Cajal shared the Nobel Prize in 1906 with Golgi for his work on the structure of the nervous system. He was instrumental in providing clear histological proof that nerve cells were discrete cellular units whose processes were interconnected at synapses ("neuron doctrine") rather than through a continuous reticular net. Cajal's illustration of the giant pyramidal cells (A,B) from the motor cortex of a 20 day old infant shown here are from his lecture at Clark University in 1899.

         The clinical spectrum of neurology was broadened and enriched by many contributions still remembered by eponyms today. International recognition of neuroscience during this decade included Nobel Prizes being awarded to Pavlov in 1904 on digestive physiology and to Golgi and Cajal in 1906 for their work on the neuron theory.

         Few neurodiagnostic tests were available to clinicians in the first decade of the 20th century. One of the most important of those available was the examination of the CSF, first attempted by Corning (1855), and introduced in modern form by Quincke (1891). Several contributions related to CSF and its physiology and pathology appeared during this decade with studies authored by Cushing, Froin, Sicard and Wasserman. Arteriography, ventriculography, myelography, and electroencephalography were all still in the future.

Famous Eponyms Famous Eponyms developed from works of the first decade of the 20th Century.

         A quick world tour of leading neurological centers in the first decade of the 20th century would have shown that American neurology largely revolved around Philadelphia, New York and Boston. Leading neurological figures included such giants as: Silas Weir Mitchell (elected for the second time to the ANA's presidency in 1909), Charles K. Mills (ANA President in 1924) and William Spiller (ANA President in 1905) in Philadelphia, and James Jackson Putnam (ANA President in 1888) in Boston. A notable landmark during this decade was the creation of the New York Neurological Institute (1909). English neurology was in the midst of a generational change as William Gowers, Hughlings Jackson, Charles E. Beevor, and Henry Bastian were entering the end of their active careers, and a new generation of leaders that included Henry Head, Gordon Holmes, and S. A. Kinnier Wilson was emerging. French Neurology was dominated by Charcot's successors including Vulpian's student, Dejerine, Pierre Marie, and Joseph F. F. Babinski. In Germany, William Erb and Hermann Oppenheim were leading figures.

Prominent International Neurologists Prominent International Neurologists of the first decade of the 20th Century. Top row: William Gibson Spiller (1863-1940), United States of American; Gordon Holmes (1876-1965), United Kingdom. Bottom Row: Joseph FF Babinski (1857-1932), France; William Erb (1940-1921), Germany.