Thomas Willis?s Practice of Paediatric Neurology and Neurodisability

Abstract

Thomas Willis (1621-1675) is regarded as a founder of modern clinical neuroscience. He conceived the word "neurology" and left a body of work that defined mid-seventeenth-century medicine. Recent interpretations of Willis's work have led to a growing appreciation of his significant contributions to paediatric neurology, a speciality founded properly some three centuries after his death. This paper presents abstracts and plates taken from Willis's major published works, together with student notes by John Locke (1632-1704) and Robert Boyle (1627-1691) taken from lectures delivered by Willis in Oxford in the 1660s. The material embraces a wide variety of conditions now managed within modern paediatric neurology and neurodisability. In several cases, these are the first descriptions recorded in the medical literature. Willis fused astute history taking and clinical observation (sometimes supported by subsequent post-mortem studies) into a structured medical intervention. Willis's practice was state of the art, being based on acceptance of Harvey, a traditional Galenic infrastructure, iatrochemistry and Gassendi's "psychology". Although Willis's discoveries became a cornerstone of modern medical science, his medical practice did not lead to any therapeutic advances. However, up to the mid-eighteenth century his works were internationally accepted for their practical usefulness. The corpus of material left by Willis affords a fascinating insight into the clinical rationale of a seventeenth century physician in his management of paediatric cases.

Historia de la Epilepsia II: desde el Renacimiento a la actualidad

“…William Harvey (1585-1657) (Figura 38) será el primero que hará importantes avances para el establecimiento de la neurología como especialidad clínica con sus descripciones de varios trastornos neurológicos, incluida la epilepsia. Una teoría interesante sobre las convulsiones epilépticas es la de omas Willis (1621-1675) (Figura 39) que asumió la existencia de una "cópula explosiva espasmódica" 48 . Para Willis "la enfermedad convulsiva en su mayor parte, tiene su origen en la cabeza (Willis, 1684).…”

“…En su De morbus con ulsivis (Con ulsiones mórbidas), Willis ubicó la causa de la epilepsia en el cerebro, pero di ere con sus predecesores que apuntaban al centro del cerebro mismo o a las meninges. Su hipótesis sugería que como el cerebro es de constitución débil, una cópula espasmódica fuerte destila de la sangre al cerebro conduciendo a los espíritus animales que se encuentran en el medio del cerebro a explotar 48 . La explosión de los espíritus aniónicos causa todos los síntomas mentales de la crisis epiléptica, y una serie de explosiones similares ocurren a lo largo del resto del sistema nervioso para provocar las convulsiones del cuerpo (Willis, 1682).…”

Children in Hospitals Before There Were Children’s Hospitals

“…[12][13][14] Most notably, 17th-century English physician and neuroanatomist Thomas Willis described childhood epilepsy, palsy, coma, and mental retardation in the context of clinical histories and postmortems. 15 Willis made a distinction between adult and pediatric epilepsy, with different causation, treatments, and outcome. Willis considered adult seizures to have started when puberty had finished, which he took to be 25 years of age.…”