Neurological examination: pioneering authors and their books

Abstract

The objective of this article is to highlight some of the most important pioneering books specifically focused on the neurological examination and their authors. During the XIX Century, Alexander Hammond, William Gowers and Charles Mills pioneered the neurological literature, followed in the XX Century by Aloysio de Castro, Monrad-Krohn, Derek Denny-Brown, Robert Wartenberg, Gordon Holmes, and Russel DeJong. With determination and a marked sense of observation and research, they competently developed and spread the technique and art of the neurological exam.Keywords: neurologic examination, textbooks, semiology. RESUMOO objetivo deste artigo é destacar alguns dos primeiros e mais importantes livros-texto interessados em difundir o ensino do exame neurológico e seus autores. Durante o século XIX, Alexander Hammond, William Gowers e Charles Mills foram pioneiros na literatura neurológica, seguidos por Aloysio de Castro, Monrad-Krohn, Derek Denny-Brown, Robert Wartenberg, Gordon Holmes e Russel DeJong no século XX. Com determinação, grande senso de observação e pesquisa, eles competentemente disseminaram a técnica e a arte de se realizar o exame neurológico.Palavras-chave: exame neurológico, livros-texto, semiologia.Although the case history generally remains as the main source of data for a proper diagnosis, the neurological examination (NE) as we know today is a critical element in clinical practice. The NE is based on a systematic sequence of maneuvers specifically conceived to highlight dysfunctions in various parts of the nervous system. The XIX and the beginning of the XX Centuries were particularly fruitful for the settlement of the NE, when seminal textbooks on the subject were published. We herein highlight some of these pioneer books and comment on their authors. J. M. Charcot (1825-1893), the father of modern neurology 1 , applied the clinical-pathological method by correlating signs and symptoms to morbid anatomy, but there is sparse literature about how he would perform the NE. The lack of documentation is probably related to the fact that the NE was not systematized at the time 2 and rather based on observational analysis of selected phenomena 3 . The NE developed significantly after him as the following generation of physicians incorporated his findings and progressively developed a systematic approach.The written neurologic teaching emerged during the XIX Century. Four books, three published in London and one in Germany, were seminal in the initial development of

Neurological examination: history, problems and facts in the 21st century

“…Nicholl and Appleton 1 concluded, in a recently published article, that even in the modern era wider dissemination of the essential neurological skills is required to ensure more thorough investigation and better care of patients with neurological diseases. In this edition of Arquivos de Neuro-Psiquiatria, Maranhão-Filho et al 6 , from the Neurology Service at the Hospital de Clínicas Clementino Fraga-Filho, Federal University of Rio de Janeiro, present an interesting review of neurological examination, with an emphasis on pioneering authors and their books. They provide a brief introduction to the most important textbooks that seek to disseminate the teaching of neurological examination and their respective authors 6 .…”

“…In this edition of Arquivos de Neuro-Psiquiatria, Maranhão-Filho et al 6 , from the Neurology Service at the Hospital de Clínicas Clementino Fraga-Filho, Federal University of Rio de Janeiro, present an interesting review of neurological examination, with an emphasis on pioneering authors and their books. They provide a brief introduction to the most important textbooks that seek to disseminate the teaching of neurological examination and their respective authors 6 . Among 19 th century works, they discuss the books of pioneering authors in the field of neurology such as Hammond, Gowers and Mills, and in the 20 th century they focus on the books of Monrad-Krohn, Denny-Brown, Wartemberg, Holmes and DeJong, as well that by the only Brazilian author included in the review, Aloysio de Castro 6 .…”

“…They provide a brief introduction to the most important textbooks that seek to disseminate the teaching of neurological examination and their respective authors 6 . Among 19 th century works, they discuss the books of pioneering authors in the field of neurology such as Hammond, Gowers and Mills, and in the 20 th century they focus on the books of Monrad-Krohn, Denny-Brown, Wartemberg, Holmes and DeJong, as well that by the only Brazilian author included in the review, Aloysio de Castro 6 . Jean-Martin Charcot, the founding father of modern neurology, developed the renowned clinical-pathological method based on the studies of Laennec and his famous méthode anatomo-pathologique.…”

“…One of the pioneering books in this field was A Manual of the Nervous Diseases of Man, by Moritz Romberg, which was published in English in 1853 7 . This exerted a great influence not only in Germany, but also in other European countries, particular the United Kingdom as well as a thesis on gait disorders and their semiological value, which was published in 1904 6,8 . The important pioneering contributions of the various authors mentioned by Maranhão-Filho et al 6 in in the field of neurological examination should serve as examples and a stimulus for younger neurologists so that they may constantly improve the clinical examination of neurological patients as well as reduce costs during this period of great technological advances.…”

“…This exerted a great influence not only in Germany, but also in other European countries, particular the United Kingdom as well as a thesis on gait disorders and their semiological value, which was published in 1904 6,8 . The important pioneering contributions of the various authors mentioned by Maranhão-Filho et al 6 in in the field of neurological examination should serve as examples and a stimulus for younger neurologists so that they may constantly improve the clinical examination of neurological patients as well as reduce costs during this period of great technological advances. The correct application of neurosemiology and recognition of its importance can not only be invaluable in reducing "neurophobia" 9 among medical students, but also stimulate a new syndrome characterized by a fascination with neurology, known as "neurophilia"…”