Sir Charles Bell (1774−1842): contributions to neuro‐ophthalmology

Abstract

. Sir Charles Bell (1774–1842) was a Scottish anatomist, physiologist, neurologist, artist and surgeon, who enjoyed a distinguished career in teaching and clinical practice in London between 1804 and 1836. In 1814, he was appointed to the surgical staff of the Middlesex Hospital. In 1824, he was elected Professor of Anatomy and Surgery at the Royal College of Surgeons of England, and shortly afterwards was elected Professor of Physiology at the University of London. In 1831, he was knighted on the accession of William IV. In 1836, he was elected to the Chair of Surgery in the University of Edinburgh, and remained there until his death in 1842, at 68 years of age. During his career, Bell was a prolific medical author, a brilliant medical researcher and a skilled artist. In 1811, he discovered the distinct functions of the motor and sensory nerves, findings that were initially published in a pamphlet entitled ‘Ideas of a New Anatomy of the Brain’. In 1821, Bell described the long thoracic nerve, which supplies the serratus anterior muscle, and which now bears his name. In the same paper he showed that lesions of the seventh cranial nerve produce facial paralysis (now termed Bell's palsy). He also demonstrated that the fifth cranial nerve is of sensory importance to the face and controls the muscles of mastication, whereas the seventh cranial nerve principally controls the muscles of facial expression. Bell published research on a number of ophthalmological subjects. This paper reviews some of these latter achievements.

The role of external eyelid weights in acute facial palsy: functional and aesthetic considerations

“…Diagnosing lagophthalmos in the primary care setting can be difficult as one must consider and eliminate the more sinister aetiologies of this condition. The most prevalent diagnosis is that of Bell’s palsy, however, as a clinical diagnosis of exclusion, physicians in the primary care setting with limited immediate access to diagnostic resources may feel uncomfortable making this judgement without further investigation [ 3 , 4 ]. Referral to specialist tertiary services should always be considered however many practical steps can be taken to prevent damage to the cornea during this vulnerable time.…”

The neurologist’s dilemma: A comprehensive clinical review of Bell’s palsy, with emphasis on current management trends

“…Bell later studied the function of the facial nerve in animals [ 2 ]. While practicing surgery in London, he encountered many cases of unilateral facial nerve paralysis and published his first report in 1821 [ 4 ]. Interestingly, his most famous and widely quoted account of facial paralysis was published in 1828, in which he told the story of a man who had been tossed by a bull.…”

“…Although Bell’s initial publication on facial paralysis came after Friedreich’s account by 23 years, Grzybowski argues that Bell deserves the credit for differentiating peripheral from central facial nerve paralysis [ 4 ]. Today, the term Bell’s palsy is synonymous with idiopathic peripheral facial paralysis .…”

Charles Bell as an illustrator of military trauma (1809 and 1815)

“…Bell is said to have inherited his talent as an artist from his mother. Growing up, he learnt drawing and painting from well-known painter David Allen (Grzybowski and Kaufman 2007).…”