Was the Father of Modern Neuroanatomy, Neurophysiology, and Clinical Neurology, As Well As Some Parts of Psychiatry
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403 BOOK REVIEW KENNETH DEWHURST: Thomas Willis's Oxford Lectures. x + 182 pp. 19 illustrations. Oxford, Sandford Publications, 1980. £9.00. It is not too large a claim that Thomas Willis of Oxford and London was the father of modern neuroanatomy, neurophysiology, and clinical neurology, as well as some parts of psychiatry. The Cerebri Anatome of 1664 requires little revision in the light of later discoveries. Even though "'animal spirits" have been supplanted by electrical impulses, Willis was the first to recognize that nerves were conductors. He was the first to recognize myasthenia gravis as a clinical entity, and his comments on coma, mental depression (hypochondriasis), mental retardation, and other maladies have a modern ring. He was an astute clinical observer, the first to rediscover the sweetness of the urine in diabetes mellitus, which he distinguished from diabetes insipidus. Yet, during the 18th and 19th centuries his reputation was never so high as those of Sydenham, Heberden, or Bright. Even at the turn of the century Michael Foster was somewhat dismissive of his accomplish- ments-this despite his grave in Westminster Abbey and the permanence in medical nomenclature of the circle of Willis. In recent decades the pendulum of fame has swung. Perhaps Pordage's heavy-handed translation of Dr. Willis's Practice of Physick (1684), a book that is both tedious to read and retranslate into modern usage, did little to make Willis's mind accessible to readers of historical medical texts or to enhance his stature. After 1960 articles by Alfred Meyer and Paul Cranefield, recrudescent interest in science and medicine in the early days of the Royal Society, plus a sensible, readable biography and appraisal by Isler (1968) have combined to restore his reputation to the high level accorded by his contemporaries. The newest contribution to Willisiana is a translation of the lectures he gave at Oxford between 1661 and 1667, when he was Sedleian Professor of NaLural Philosophy. Notes of these lectures were preserved by John Locke, who was in the audience about 1663-1664. Willis incorporated much of this material in his De Anima Brutorum (1672), and partly coextensive notes were preserved by Willis's associate, Richard Lower. Judiciously using these primary sources, Kenneth Dewhurst has provided a coherent and readable text that presents Willis's ideas in their simplest form, essentially as he presented them for didactic purposes. For example, Vol. 57, No. 5, June 1981 40440 W. B.B.OEOBER regarding hysteria, "This passion comes not from the vapours rising into the head from the uterus or spleen, nor from a rapid flow of blood into the pulmonary vessels, but has its origin in the brain itself. "-a blunt anti- humoral definition, quite at variance with generally held theories of the time. (When Willis wrote "brain," he included what we now call psyche.) Dewhurst informs us correctly that "Post mortem examinations were not undertaken solely to reveal the cause of death. They offered Willis and his associates an opportunity of making anatomical observations, of tracing the course of blood vessels, of studying clinico-pathological corre- lations, and assessing the functional significance of various structures in health and disease." In this respect Willis was a precursor of Morgagni who employed the same methods on a wider range of case material. In addition to a clear and usable text, Dewhurst also provides a succinct biography of Willis. Carefully researched, incorporating much original investigation, carefully written (and rewritten more than once, for there are few wasted words), it is a masterful account of the life of one of England's finest physician-investigators. Dewhurst also supplies a brief history of the Sedleian Professorship rich in Oxonian anecdotes. The annotations are superb: accurate, pointed, informative, and scholarly. Two minor cavils: Though most of the illustrations are well chosen and well reproduced, the photograph of entries in the Convocation Register is difficult to read because of the small format of the book; a hand lens is advised. Also, despite an attractive layout and legible type font, the publishers might have used a heavier grade of paper; the print does not actually "bleed through," but it is visible, thereby detracting from the physical appearance of the manufactured product. William B. Ober, M.D. Bull. N.Y. Acad. Med..