The Historical Origin of the Term “Meningioma” and the Rise of Nationalistic Neurosurgery

historical vignette J Neurosurg 125:1283–1290, 2016

The historical origin of the term “meningioma” and the rise of nationalistic neurosurgery

Ernest Joseph Barthélemy, MD, MA, Christopher A. Sarkiss, MD, James Lee, MD, and Raj K. Shrivastava, MD

Department of Neurosurgery, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York, New York

The historical origin of the meningioma nomenclature unravels interesting social and political aspects about the development of neurosurgery in the late 19th century. The meningioma terminology itself was the subject of nationalistic pride and coincided with the advancement in the rise of medicine in Continental Europe as a professional social enterprise. Progress in naming and understanding these types of tumor was most evident in the nations that successively assumed global leadership in medicine and biomedical science throughout the 19th and 20th centuries, that is, France, Germany, and the United States. In this vignette, the authors delineate the uniqueness of the term “meningioma” as it developed within the historical framework of Continental European concepts of tumor genesis, disease states, and neurosurgery as an emerging discipline culminating in Cushing’s Meningiomas text. During the intellectual apogee of the French Enlightenment, Antoine Louis published the first known scientific treatise on meningiomas. Like his father, Jean-Baptiste Louis, Antoine Louis was a renowned military surgeon whose accom- plishments were honored with an admission to the Académie royale de chirurgie in 1749. His treatise, Sur les tumeurs fongueuses de la dure-mère, appeared in 1774. Following this era, growing economic depression affecting a frustrated bourgeoisie triggered a tumultuous revolutionary period that destroyed France’s Ancien Régime and abolished its university and medical systems. The resulting anarchy was eventually quelled through legislation aiming to satisfy Napoleon’s need for qualified military professionals, including physicians and surgeons. These laws laid the foundations for the subsequent flourishing of French medicine throughout the mid-19th century. Subsequent changes to the meningioma nomenclature were authored by intellectual giants of this postrevolutionary period, for example, by the Limoges-born pathologist Jean Cruveilhier known for the term “tumeurs cancéreuses de la dure-mère,” and the work of histopathologists, such as Hermann Lebert, who were influenced by Pasteur’s germ theory and by Bernard’s experimental medicine. The final development of the meningioma nomenclature corresponded to the rise of American neurosurgery as a formal academic discipline. This historical period of growth is chronicled in Cushing’s text Meningiomas, and it set the scientific stage for the modern developments in meningioma research and surgery that are conducted and employed today. http://thejns.org/doi/abs/10.3171/2015.10.JNS15877 Key Words meningioma; Harvey Cushing; Hermann Lebert; history of neurosurgery; history of medicine

he historical origin of the meningioma nomencla- we outline the uniqueness of the term “meningioma” as it ture unravels interesting social and political aspects developed within the historical framework of Continental about the development of neurosurgery in the late European concepts of tumor genesis, disease states, and 19thT century. The terminology itself was the subject of na- neurosurgery as an emerging discipline. tionalistic pride and coincided with the rise of medicine in Continental Europe as a professional social enterprise. Progress in naming and understanding these tumors was The French Enlightenment: Antoine Louis most prominent in the nations that successively assumed The organized advancement of medical science in global leadership in medicine and biomedical science Western Europe has been described as beginning in the throughout the 19th and 20th centuries, namely, France, late 18th century and continuing through the pre-Listerian Germany, and the United States. In this historical vignette, era of the mid-19th century; the French led most of the

Abbreviations ARC = Académie royale de chirurgie. SUBMITTED April 20, 2015. ACCEPTED October 13, 2015. include when citing Published online January 22, 2016; DOI: 10.3171/2015.10.JNS15877.

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Unauthenticated | Downloaded 09/23/21 11:02 AM UTC E. J. Barthélemy et al. advances made during this period.19,23 It was during this tific treatise devoted exclusively to meningiomas: “Sur les time, in the final years of the French Enlightenment, that tumeurs fongueuses de la dure-mère.” This term, translat- the French military surgeon Antoine Louis (Fig. 1) pro- ing into English as “fungoid tumors of the dura mater,” is duced the first known scientific publication exclusively de- therefore acknowledged as the first major attempt at nam- scribing meningiomas. This historical period was marked ing meningiomas.2,29,30 by intense intellectual productivity, creativity, and academic competition during the reign of the relatively weak monarchies of Louis XV and Louis XVI.2,19 19th Century France: Revolution and Jean Born in 1723 in Metz, France, Louis completed his Cruveilhier classical studies with excellence at the Collège des Jé- Following the French Enlightenment, a series of events suites of his native town. He was inspired by the example ushered in social changes. These changes occurred in re- of his father and mentor, Jean-Baptiste Louis, then a re- sponse to a period of economic depression affecting the nowned surgeon at the military hospital. Early on, An- bourgeoisie. Three years later, Louis the XVI was de- toine Louis’s growing reputation and talent in surgery posed, and France entered a politically fractious period was soon recognized by François Gigot de La Peyronie, that was marked by war, revolution, and an evolving edu- who was first-surgeon to King Louis XIV and founder cational structure. During this period of instability for the of the Académie royale de chirurgie (ARC). La Peyro- Ancien Régime, French revolutionaries abolished univer- nie therefore recruited the young surgeon to Paris, where sities and destroyed a fiercely criticized medical system Louis began an illustrious career. In 1746, Antoine Louis that had been characterized by division and rivalry.11,21,22,44 was elected member to the ARC, and in 1749, he success- This unstable period was followed by a decade of eco- fully defended a thesis in Latin on head trauma, called nomic liberalism marked by political and educational an- Propositiones Anatomicae et Chirurgicae de Vulneribus 21,22 26 archy. Eventually, the Napoleonic wars created a need Capitis. In 1764, he was elected perpetual secretary of for the preparation of qualified military professionals, in- the ARC, an event that marked the beginning of the most 25 cluding physicians and surgeons, and as a result, a tiered productive and brilliant period of his life. A decade later, system of medical education was established.1,20,42 The le- Antoine Louis made his key contribution to neurosurgery gal framework for this system was developed at the turn by publishing in the Mémoires of the ARC the first scien- of the century primarily by Fourcroy, an eminent scientist and educator. Fourcroy’s system laid the foundations for the subsequent flourishing of French medicine for the first half of the 19th century.1,8,22,43,44 The next major change in the meningioma nomenclature was authored by Jean Cruveilhier (Fig. 2), a dis- tinguished pathologist and clinician born in Limoges, France, in 1791. Like his predecessor Antoine Louis, Cru- veilhier was the son of a surgeon and was mentored by the leading surgeon of early 18th century France, Guillaume Dupuytren.5,19 Cruveilhier’s work on meningiomas is the subject of a paper by Bakay5 and will be described only briefly here. Cruveilhier devoted a chapter to the description of meningiomas in his magnum opus, L’anatomie pathologique du corps humain, a text whose illustrations are celebrated for their unrivaled beauty in the history of pathology. Sample illustrations from the chapter called “Des Tumeurs Cancéreuses des Méninges” are shown in Figs. 3 and 4.5,14 As noted by Cushing in his 1938 monograph, Cruveil- hier’s work refers to these tumors interchangeably as “tumeurs fongueuses” and “tumeurs cancéreuses internes de la dure-mère.” Cruveilhier also uses the term “tumeurs carcinomateuses de la dure-mère,” asserting his belief, at the time, that these lesions were of a malignant nature.14,17 Cushing notes, however, that when Cruveilhier came to write his Traité d’anatomie pathologique générale in 1856, he began to reconsider whether these fungoid tumors were, in fact, cancerous.16 In this later work, Cru- veilhier writes, “To explain all of my thinking regarding tumors of the dura mater, I will say that we apply rather delicately the term ‘cancerous’ to tumors that can persist for many long years without propagating by continuity of FIG. 1. Portrait of Antoine Louis (1723–1792). Public domain; courtesy of tissue to neighboring regions; such are the tumors born at the National Library of Medicine. the internal surface of the dura mater.”15

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FIG. 2. Photograph of Jean Cruveilhier (1791–1874). Public domain; courtesy of the National Library of Medicine.

One of Cruveilhier’s British contemporaries, the celebrated pathologist Richard Bright, was less committal in FIG. 3. From Cruveilhier, Anatomie Pathologique Du Corps Humain: 8 his own characterization of meningiomas. Born in 1789, Livraison Plate 2 (Cancerous Tumors of the Meninges). Public domain; the son of a wealthy merchant and banker, Bright was courtesy of the University of Iowa Libraries. Figure is available in color broadly schooled in natural philosophy, political economy, online only. and mathematics before completing his medical training at Guy’s Hospital in London and at the University of Edin- initial rise of Napoleon; and the Second Empire of Napo- burgh.34,45 His prolific and artistic contributions to neurol- leon III (1852–1870) and its subsequent collapse during the Franco-Prussian war of 1870 and establishment of a ogy and neuropathology nearly rival the work in nephrol- 11 ogy for which he is primarily remembered.24 In his most Third Republic in the same year. well-known publication, Bright offers, regarding menin- Innovations in clinical and experimental medicine were giomas, that the tumors were of a “…fungoid character, of similarly dynamic. Early doctrines such as the bloodletting slow growth and lobulated in structure”; he further pro- practices of François-Joseph-Victor Broussais, also known posed that they originate from the dura mater, “…or rather as “le vampire de la médecine,” were slowly supplanted by perhaps from the arachnoid lining the dura mater.” Bright more logical, scientifically grounded approaches such as avoids, however, explicitly naming these tumors.17 the statistics-driven medical reasoning of Pierre-Charles- Alexandre Louis.19,25 The work of François Magendie in 1822 on functional divisions of the spinal cord and the The Period of French Leadership in Medicine later work of his illustrious pupil, Claude Bernard, on The tumultuous political and sociocultural backdrop autonomic physiology, marked the dawn of experimental to the ensuing era of the 19th century did not curtail the medicine and laid the foundations for modern French neu- innovations in intellectual life that continued throughout rology and biomedicine.11 Pioneers of French neurology this period. The political ruptures of this epoch included and neurosurgery who also thrived during this period in- the following: the first and second Bourbon Restorations, cluded the great surgeon and anthropologist Paul Broca briefly interrupted by Napoleon’s Hundred Days in 1815; (1824–1880), the father of neurology Jean-Martin Charcot the Revolution of 1830, followed by the July Monarchy of (1825–1893), Charcot’s protégé Charles-Joseph Bouchard King Louis-Philippe (1830–1848); the Second Republic, (1837–1915), and Bouchard’s neurological rival Joseph named in honor of the revolutionary era that followed the Babinski (1857–1932).12

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ambitious in promoting cellular analysis by means of microscopic technology.3 Franco-Prussian Influence and Hermann Lebert The aforementioned shifts laid the foundation for the histogenic era in the meningioma nomenclature. As Fran- co-Prussian tension was mirrored by the growing competition between French and German schools of histopatho- logical and biomedical thought, it is interesting to note how these camps were scientifically linked in the personality of Hermann Lebert (Fig. 5). Born in 1813 in the formerly Prussian city of Breslau, Lebert’s parents lived primarily in Berlin but fled to Lebert’s birthplace to temporarily escape conditions caused by one of the Napoleonic wars (1813–1814). Besides receiving a medical doctorate in Zu- rich in 1834, Lebert researched and received a doctorate in botany before spending 18 months practicing medicine. In Paris, he was a student of the aforementioned surgical giant Guillaume Dupuytren and the physician-pathologist Pierre-Charles-Alexandre Louis, and he also attended the microscopy courses of a prominent French clinician named Alfred François Donné. Lebert’s close friends and colleagues included the French clinicians Charles Robin and Paul Broca. Additionally, during a brief stay in Berlin in the winter of 1845–1846, he also made the acquaintance of the great German pathologist, Rudolf Virchow (Fig. 6), before returning to Paris in 1846.37

FIG. 4. From Cruveilhier, Anatomie Pathologique Du Corps Humain: 8 Livraison Plate 3 (Cancerous Tumors of the Meninges). Public domain; courtesy of the University of Iowa Libraries. Figure is available in color online only.

Perhaps the most notable medical scientist of the 19th century was the French microbiologist Louis Pasteur (1822–1895), who was born in in the city of Dole, near the Swiss border. After early schooling in Arbois and Be- sançon, Pasteur earned admission to the prestigious École normale supérieure where he completed graduate training in physics and chemistry before shifting his interests in crystallography toward the problems of biomedical science. His pioneering work on fermentation led to his con- ceptualization of the germ theory of disease.40 The impact of Pasteur’s work on medicine, microbiology, and the post- Listerian era of surgery is, perhaps, incalculable. More- over, Pasteur and his archrival, Robert Koch (1843–1910), personified a bacteriological feud between the scientific institutes of France and Germany that made the micro- scope an instrument of growing importance in experimental medicine.3 The emerging focus on microscopy marked a shift from autopsy-based gross anatomical knowledge toward the emerging disciplines of histology and histo- FIG. 5. Portrait of Hermann Lebert (1813–1878). Public domain; courtesy pathology. Germany, in particular, became increasingly of the National Library of Medicine.

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perspective, dividing the tumors into two groups: those with a more benign behavior and those with a propensity for malignancy.17,28 As noted by Cushing, Lebert’s contribution to meningioma nomenclature and neuropathology in the mid-19th century was immortalized by the citations of his work in the publications of Cruveilhier and, more significantly, Virchow.15,17,42 Virchow and German Leadership in Medicine As a pioneer of foundational principles of biomedicine such as the modern concept of the cell theory, pathophysi- ological foundations of venous thromboembolism, and the structure and function of neuroglia, Rudolf Ludwig Karl Virchow (1821–1902) is easily considered the most prominent German physician of the 19th century and one of the most prominent physicians in the history of medicine.35 William Osler, a lifelong teacher and mentor of Cushing, said the following of Virchow: “The lesson which should sink deepest in our hearts is the answer which a life, such as Virchow’s, gives to those who today, as in past gen- erations, see only pills and potions in the profession of medicine, and who, utilizing the gains of science, fail to appreciate the dignity and the worth of the methods by which they are attained.”7,32 Virchow’s contributions to the meningioma nomenclature included description of the granules seen in some specimens, for which the Greek term for sand was bor- rowed to label these tumors as “psammoma”: “One can therefore describe the tumor as, ‘brain sand tumor,’ for which the name, ‘Psammoma,’ is suggested (Psammos = 6 FIG. 6. Photograph of Rudolf Ludwig Karl Virchow (1821–1902). Public Sand).” Virchow’s voice of authority in pathology drew domain; courtesy of the National Library of Medicine. attention away from other contemporaneous attempts to name and describe the tumors, such as the suggestion by British surgeon and pathologist Sir James Paget, that the In his 1851 treatise on cancer histopathology, Lebert tumors were of a “myeloid” nature,17,33 or the term “acer- offers the term “…tumeurs fibro-plastiques intracrâni- vuloma,” proposed by Virchow’s compatriot, Heinrich ennes” in the chapter describing tumors of the CNS.27 His Meckel.17,36,41 Other terminology proposed by Virchow is descriptions are notable for their striking detail in both evident in the fourth quote, introducing Cushing’s Menin- gross and microscopic observation: giomas monograph: …The intracranial fibroblastic tumors demonstrate, in most It’s worth mentioning a so-called “Fungoid durae matris”— cases, a rather intimate connection to the meninges. They which has often been written about, but generally remains sometimes take their origin from the dura mater, sometimes unclear in literature. This brings me back to the question from the arachnoid, and they are marked by the particular- of cancer, since it’s undoubtable, that a certain amount of ity of practically no adherence to neighboring regions…. the described patient cases are in fact, cancer. But it’s also They can compress the brain, the cerebellum, the nerves undoubtable that there is Sarcoma of the Dura Mater. This and the bones, invade neighboring organs creating casts and sarcoma however usually sits internally, in the direction of the cavities, but without bringing about the slightest fibroblastic skull space...and not externally, on the side of the bone.17,36 change…27 In this manner, Virchow asserted his belief that the tumors Lebert’s microscopic description of one specimen ex- were of a sarcomatous nature, despite lending support to plains his choice of nomenclature: “…it was a flat tumor, Lebert’s earlier claims regarding the benignity of these le- with a sarcomatous redness and a scattered osseous lattice, sions.17,36 devoid of cloudy liquid and upon microscopic examina- The Franco-Prussian war and confusion over the most tion, demonstrating properties found only in fibroplastic appropriate term for meningeal tumors, dubbed “nosolog- tissues.”27 Further assertions about the nature of Lebert’s ical hairsplitting” by Cushing, spread throughout Central “tumeurs fibro-plastiques” follow, such as the complete de- and Western Europe throughout the rest of the 19th cen- limitation of the lesion relative to neighboring structures, tury.17 Lebert’s “tumeurs fibro-plastiques” was supplanted the meningeal origin, and the microscopic observations by terms such as “epithelioma” proposed by Charles- that suggest an absence of malignant or cancerous ele- Philippe Robin and “endothéliome” proposed by Charles- ments; Lebert therefore concluded that the tumors are be- Joseph Bouchard.9,16,17,38 The term “endothelioma,” which nign.27 Several years later, however, Lebert refines his own Cushing attributed to an 1869 article by the preeminent

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Italian physician Camillo Golgi, began to earn growing Cushing acknowledged the usefulness of Golgi’s term recognition and support; it was the term retained as an “endothelioma”; nonetheless, as Cushing nurtured a habit alias for “meningioma” in Cushing’s 1922 Cavendish lec- of closely scrutinizing the research of his peers and prede- ture in London.16,17 cessors, he noted the limitation of this term: “…even this [term “dural endothelioma”] is now of questionable advan- The Rise of America and American tage, for it seems quite probable that, though attached to the Neurosurgery dura, the tumours do not arise from this membrane proper, but rather from elements of the arachnoid which project Harvey Cushing’s principal neurosurgical predeces- into it; nor are they, in the parlance of some embryologists, sor in the United States was William W. Keen (Fig. 7), tumours which, strictly speaking, actually originate from considered by many to be America’s first brain surgeon.4 what are to be considered endothelial elements.”27,29 Keen spent 2 years in postgraduate study in Europe, first Harvey Cushing’s familiarity with 19th-century Euro- with one of the French founders of neurology, Guillaume pean scholarship on meningioma nomenclature and clas- Duchenne, and then in the laboratory of Rudolf Virchow sification is evident both in the 1922 Cavendish Lecture, 4,10,13 in Berlin. Keen’s European training likely influenced where he coined the enduring name for this tumor, and in his choice of the term “endothelioma” to describe these le- 16,17 18,39 his seminal 1938 monograph. Having lived in an era sions. His most celebrated neurosurgical procedure was in which Europe was the professional finishing school for the resection of a convexity meningioma from a patient on 4 thousands of America’s elite medical graduates, Cushing’s December 15, 1887, in Philadelphia, Pennsylvania. This early exposure to neurological surgery naturally included was the first brain tumor successfully removed in Amer- an apprenticeship in the Old World at the turn of the cen- ica, and the patient went on to live without recurrence 7 4 tury. He observed and studied with British surgeons such of the tumor for more than 30 years. In spite of Keen’s as Victor Horsley, before moving on to France to observe, known use of the term “endothelioma,” Cushing noted that among other things, brain tumor removal and decompres- regarding this convexity lesion extirpated by Keen in 1887, sive surgery for cranial trauma by Eugène-Louis Doyen.7 both the surgeon and his patient described the lesion as a Cushing noted, at this time, that the state of surgery “fibroma” and not necessarily as a “dural endothelioma”; in France was superior to what he had observed in Great “…We evidently were no further along at this time than 17 Britain; however, he was generally disappointed with were the French writers half a century before.” these early examples of Western European neurosurgery.7 A later apprenticeship with Theodor Kocher in Germany proved somewhat more gratifying. Nevertheless, it became clear to Cushing that global leadership in medicine and surgery was shifting from Europe to America, and in neurosurgery, Harvey Cushing (Fig. 8) was the protagonist of this transition.7 Cushing was determined to eliminate the confusion caused by over a century of disagreement among patholo- gists concerning the histology and nomenclature of tumors that, from a surgical standpoint, appeared to share a com- mon origin. He sought an uncomplicated term, “except insofar as it indicates that the growths in question arise from the meninges.”2,16,17 The term would be applied to all tumors appearing to take their origin from the pachy- meninges, regardless of the histological elements that pre- dominate, the presence or absence of calvarial thickening, or other such varieties of what he considered to be a single neurosurgical entity.16,17 Discussing his ultimate choice of the term “meningioma,” Cushing clarifies his reasoning in the following comments on tumor designation: Their cellular composition being in dispute, an “histogenic name” was likely to be misleading; a simple “place-name,” comparable to acoustic tumor, was inadequate since the tumors were widely distributed and took their origin from the leptomeninges almost anywhere; a “tissue-name” was therefore sought which, like osteoma, myoma and lipoma, would at least give an unmistakable connotation. Mesothelioma was discarded as requiring explanation, meningothelioma and leptomeningioma as being needlessly cumbersome. And since primary tumors indubitably of pachymeningeal origin and leptomeningeal tumors other than those under consideration are so rare as to cause little if any confusion, the simple and FIG. 7. Photograph of William Williams Keen (1837–1932) of Philadel- non-committal designation Meningioma as a catchword was phia. Public domain; courtesy of the National Library of Medicine. thought to be suitable and all-embracing.17

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growth is chronicled in Cushing’s text Meningiomas, and it set the stage for the modern scientific developments in meningioma research and surgery that we employ today.31 Acknowledgments We acknowledge the Academic Informatics and Technology resources of the Gustave L. and Janet W. Levy Library, Icahn School of Medicine at Mount Sinai, for material support provided throughout the preparation of this manuscript. We thank Marie- Andrée Barthélemy for her assistance in the translation of original German texts referenced in this manuscript. References 1. Ackerknecht EH: Medical education in 19th century France. J Med Educ 32:148–153, 1957 2. al-Rodhan NR, Laws ER Jr: Meningioma: a historical study of the tumor and its surgical management. Neurosurgery 26:832–847, 1990 3. Allan K: Microbial medicine in 19th century Europe. Br J Healthc Manag 19:420–421, 2013 4. Anene-Maidoh TI, Yeo CJ, Maxwell PJ IV: William Wil- liams Keen, MD: ‘Marshall’ of American surgery and pioneer of neurosurgery. Am Surg 77:649–651, 2011 5. Bakay L: Cruveilhier on meningiomas (1829–1842). Surg Neurol 32:159–164, 1989 6. Beigel H: Recidiv eines papillösen Cystokarkoms der Bauch- höhle. Arch Pathol Anat Physiol Klin Med 44-45:111, 1869 7. Bliss M: Harvey Cushing: a Life in Surgery. Toronto: Uni- versity of Toronto Press, 2005 8. Bloch H: Medical education in 19th century France: impact FIG. 8. Photograph of Harvey Cushing (1869–1939). Public domain; on American physicians in Parisian hospitals. South Med J courtesy of the National Library of Medicine. 80:1036–1038, 1987 9. Bouchard C: Traité de Pathologie Générale. Paris: Masson, 1900, Vol 3, pp 820–821 Cushing’s Meningiomas Text 10. Campbell ED: The achievement of Duchenne. Proc R Soc Med 66:18–22, 1973 The first chapter of Cushing’s seminal monograph,Me - 11. Caradonna JL: The Enlightenment in Practice, Academic ningiomas (1938), lays the foundation for a literary master- Prize Contests and Intellectual Culture in France, 1670– piece in modern neurosurgery. Coauthored by Cushing’s 1794. Ithaca, NY: Cornell University Press, 2012, 14–117 trusted pathologist, Louise Eisenhardt, and bearing the 12. Clarac F, Boller F: History of neurology in France, in Ami- name that Cushing himself gave to the class of tumors in noff MJ, Boller F, Swaab DF (eds). Handbook of Clinical question, the text has been praised as a layered, historical Neurology, Series 3: History of Neurology. Amsterdam: bricolage that presents the final published words of Cush- Elsevier, 2009, Vol 95, pp 629–656 7,39 13. Collins J: Duchenne of Boulogne: a biography and an appre- ing as a neurosurgeon. Cushing’s labor and scholarship ciation. Med Rec 73:50–54, 1908 were manifold by the end of his career and most descrip- 14. Cruveilhier J: Anatomie Pathologique du Corps Humain. tive in this text. In this book, Cushing writes in a more Paris: J.B. Ballière, 1842, pp 379–390 anecdotal and casual style, reflecting not only on surgery 15. Cruveilhier J: Traité D’anatomie Pathologique Générale. but also on his theories of tumor origins and clinical pre- Paris: J.B. Baillière, 1856, Vol. 3, pp 645–646 sentation. 16. Cushing H: The meningiomas (dural endotheliomas): Their Most American and European neurosurgeons were in- source, and favoured seats of origin. Brain 45:282–316, 1922 17. Cushing H, Eisenhardt L: Meningiomas: Their Classifica- debted to Cushing for their basic operative techniques and tion, Regional Behaviour, Life History, and Surgical End procedures and for much of their knowledge of meningio- 7 Results. Springfield, IL: Charles C. Thomas, 1938, pp 2–18 mas and other tumors of the CNS. The founder of modern 18. Dercum FX, Keen WW, Spiller WG: Endothelioma of the neurosurgery in France, Clovis Vincent, said the following gasserian ganglion; two successive resections of the gan- of Cushing: “…he is the man who has left the greatest im- glion; first, by the extradural (Hartley-Krause) operation, and, pression on me….the impression made by a master is not secondly, by an intradural operation. JAMA 34:1026–1033, only measured by time; it is measured by the strength of 1900 his ideas, by his example, and also by the receptiveness of 19. Garrison FH: An Introduction to the History of Medicine: 20 with Medical Chronology, Bibliographic Data: Fourth he who wishes to learn.” Edition. Philadelphia: WB Saunders Co, 1929, pp 1-407 20. Giroire H: [The birth of French neurosurgery.] Sem Hop Conclusions 48:3, 43–49, 1972 (Fr) 21. Haine W: The History of France. Westport, CT: Greenwood The final development of the meningioma nomencla- Press, 2000, pp 55-142 ture corresponded to the rise of American neurosurgery 22. Heller R: Officiers de santé: the second-class doctors of as a formal academic discipline. This historical period of nineteenth-century France. Med Hist 22:25–43, 1978

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23. Horrax G: Neurosurgery: An Historical Sketch. Spring- vey Cushing’s Meningiomas text and the historical origin of field, IL: Charles C. Thomas, 1952 resectability criteria for the anterior one third of the superior 24. Kepes JJ: Presidential address: the histopathology of me- sagittal sinus. J Neurosurg 99:787–791, 2003 ningiomas. A reflection of origins and expected behavior? J 40. Toledo-Pereyra LH: Louis Pasteur surgical revolution. J In- Neuropathol Exp Neurol 45:95–107, 1986 vest Surg 22:82–87, 2009 25. Kirk RGW, Pemberton N: Re-imagining bleeders: the medi- 41. Virchow R: Die Krankhaften Geschwülste. Berlin: August cal leech in the nineteenth century bloodletting encounter. Hirschwald, 1865 Med Hist 55:355–360, 2011 42. Virchow R: Zur Entwickelungsgeschichte des Krebses. Arch 26. Kolopp P: [Antoine Louis, surgeon, his Messin connections Pathol Anat Physiol Klin Med 1:94–204, 1847 and memories.] Mémoires l’Académie Natl Metz A173:73– 43. Weisz G: The medical elite in France in the early nineteenth 82, 1992 (Fr) century. Minerva 25:150–170, 1987 27. Lebert H: Traité Pratique des Maladies Cancéreuses: Et 44. Weisz G: The politics of medical professionalization in des Affections Curables Confondues avec le Cancer. Paris: France 1845–1848. J Soc Hist 12:3–30, 1978 JB Baillière, 1851, pp 755–760 45. Yarmohammadi H, Dalfardi B, Ghanizadeh A, Feili A: Rich- 28. Lebert H: Ueber Krebs und die mit Krebs verwechselten Ge- ard Bright (1789–1858). J Neurol 261:1449–1450, 2014 schwülste im Gehirn und seinen Hüllen. Arch Pathol Anat Physiol Klin Med 3:463–569, 1851 29. Louis A: Mémoires sur les tumeurs fongueuses de la dure- mère. Mémoires de l’Académie Royale de Chirurgie Disclosures 5:9–46, 1774 30. Okonkwo DO, Laws ER: Meningiomas: historical perspec- The authors report no conflict of interest concerning the materi- tive, in Lee JH (ed): Meningiomas: Diagnosis, Treatment, als or methods used in this study or the findings specified in this and Outcome. London: Springer, 2009, pp 3–10 paper. 31. Osler W: A note on the teaching of the history of medicine. BMJ 2:93, 1902 Author Contributions 32. Osler W: Rudolf Virchow—the man and the student. Boston Conception and design: Shrivastava, Barthélemy. Acquisition Med Surg J 125:425–427, 1891 of data: Barthélemy. Drafting the article: Barthélemy. Critically 33. Paget J: Lectures on Surgical Pathology: Delivered at the revising the article: all authors. Reviewed submitted version of Royal College of Surgeons of England. London: Longman, manuscript: Barthélemy. Approved the final version of the manu- Brown, Green and Longmans, 1853 script on behalf of all authors: Shrivastava. Administrative/techni- 34. Pearce JMS: Richard Bright and his neurological studies. cal/material support: Lee. Study supervision: Shrivastava, Sarkiss. Eur Neurol 61:250–254, 2009 35. Pearce JMS: Rudolf Ludwig Karl Virchow (1821–1902). J Supplemental Information Neurol 249:492–493, 2002 Previous Presentations 36. Pendleton C, Olivi A, Brem H, Quiñones-Hinojosa A: Harvey Cushing’s early treatment of meningiomas: the untold story. Portions of this work were presented in abstract form to the World Neurosurg 80:217–221, 2013 Annual Meeting of the Congress of Neurological Surgeons, New 37. Pickel H, Reich O, Winter R, Young RH: Hermann Lebert Orleans, LA, September 26–30, 2015. (1813-1878): a pioneer of diagnostic pathology. Virchows Arch 455:301–305, 2009 Correspondence 38. Robin CP: Recherches anatomiques sur l’épithélioma des Raj K. Shrivastava, Department of Neurosurgery, Mount Sinai séreuses. J l’anatomie la Physiol Norm Pathol l’homme Medical Center, Icahn School of Medicine at Mount Sinai, 1468 des animaux 6:239–288, 1869 Madison Ave., Annenberg 8-35, New York, NY 10029. email: 39. Shrivastava RK, Segal S, Camins MB, Sen C, Post KD: Har- [email protected].

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