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The Neurological Founding Fathers of the National Society for Epilepsy and of the Chalfont Centre for Epilepsy

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The Neurological Founding Fathers of the National Society for Epilepsy and of the Chalfont Centre for Epilepsy 3'ournal ofNeurology, Neurosurgery, and Psychiatry 1993;56:599-604 599 REVIEW J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.56.6.599 on 1 June 1993. Downloaded from The neurological founding fathers of the National Society for Epilepsy and of the Chalfont Centre for Epilepsy J W A S Sander, J Barclay, S D Shorvon Abstract agricultural colony where people with epilepsy The National Society for Epilepsy is the could live and work, hence the origin of the largest epilepsy charity in the United Chalfont Centre. The roads and houses at the Kingdom, and administers the Chalfont Chalfont Centre for Epilepsy are named after Centre for Epilepsy. The Society was several British philanthropists from the late founded in London in 1892 and its first 1800s, who were generally perceived as the task was to establish an agricultural Society's founding fathers. Our researches of colony where people with epilepsy could the early history of the Society show, how- live and work; and this was the origin of ever, that neurologists from the National the Chalfont Centre. Recently, details of Hospital, Queen Square, were instrumental in the early history ofthe Society have come its foundation and early running; indeed, it to light showing that neurologists from was their impetus which interested others in the National Hospital, Queen Square setting up the Society. After several years, were instrumental in its foundation. The however, differing opinions on whether meeting in which the society was consti- epilepsy should be viewed as a medical condi- tuted was held in the house of Thomas tion or a social problem led to the premature Buzzard, chaired by David Ferrier, and rupture of the relations between the neurolo- its first resolution was proposed by John gists and lay persons on the executive com- Hughlings-Jackson. Other neurologists mittee, and the resignation of the former. associated with its early history include Only in the last two decades have neurologists William Gowers, Victor Horsley, Howard regained influence in the running and plan- Tooth, and W Aldren Turner. In this ning of the Society's activities so that medi- paper we review the society's history and cine and research flourished. the light it throws on the attitudes to epilepsy and neurology in London in this http://jnnp.bmj.com/ exciting late Victorian period. The National Hospital The National Hospital for the Paralysed and (7 Neurol Neurosurg Psychiatry 1993;56:599-604) Epileptics (now the National Hospital for Neurology and Neurosurgery), the first spe- cialist neurological hospital in the world, was The National Society for Epilepsy (NSE) is opened at Queen Square in 1860. True to its the largest epilepsy charity in the United title, the hospital accepted patients from all on September 27, 2021 by guest. Protected copyright. Kingdom, and administers the Chalfont over the country, the majority of them with Centre for Epilepsy, a specialised epilepsy epilepsy. Its establishment was a great step centre on the outskirts of London. The forward for the sufferers of epilepsy; in the Epilepsy Research Society was founded in the spring of 1892 in 1870s as many of 50% of the inpatients and Group, Institute of Neurology, National London as the National Society for the an even higher proportion of the outpatients Hospital for Employment of Epileptics and it is therefore had epilepsy, and its consumption of brom- Neurology and also one of the oldest epilepsy societies in the ides, then the only effective drug for epilepsy, Neurosurgery, Queen Square, London world. In this paper we review the early histo- was 2-5 tons annually.' John Hughlings WClN 3BG ry of the Society with special emphasis on its Jackson24 was on the staff from 1862 and J W A S Sander connection with the neurological establish- among his colleagues were Thomas Buz- S D Shorvon ment at the National Hospital, Queen zard,56 William Gowers,78 David Ferrier,90 Chalfont Centre for Square, basing our review on historical and Howard Tooth." Epilepsy, Gerrards largely Cross, Bucks SL9 ORJ and archival documents, including a series of These were heady years for the scientific J W A S Sander books of minutes of the Society that were un- study of epilepsy. In the 1870s Ferrier J Barclay covered during the preparations for the Soci- demonstrated that activation of areas S D Shorvon specific Correspondence to: ety's first centenary. This original material of the cortex of animals could induce seizures Dr J W A S Sander, National throws new light on the evolution of epilepsy in corresponding parts of the body. 12 Hospital, Chalfont Centre for Epilepsy, Gerrards societies in late nineteenth century Britain. Hughlings Jackson, whose interest in epilepsy Cross, Bucks SL9 ORJ We have also included as an appendix brief may have been triggered by the fact that his Received 16 June 1992 bibliographical sketches of the neurologists wife had what is now called "Jacksonian and in revised form 25 August 1992. involved in the foundation of the Society. epilepsy,3 made original observations on many Accepted 4 September 1992 The Society's first task was to establish an aspects of the condition. In 1873 he presented 600 Sander, Barclay, Shorvon his definition of epileptic seizures "occasional an institution to be modelled on the establish- J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.56.6.599 on 1 June 1993. Downloaded from sudden excessive, rapid and local discharges of ment in Bielefeld in Germany, visited by grey matter","3 a definition still commonly David Ferrier in the previous year. People in used. Queen Square became the "Mecca of attendance represented three different bodies. neurology"; epilepsy was the condition which The first were the medical staff from the aroused most scientific interest at the hospi- National Hospital represented by Thomas tal, and the large number of patients with Buzzard, John Hughlings Jackson, Howard epilepsy formed the base of Ferrier's, Tooth, William Gowers, Joseph Ormerod,'9 Jackson's, and Gower's great works on the Walter Colman,20 and David Ferrier. The subject. second was the Ladies' Samaritans Society of the National Hospital, Queen Square, which was formed in 1861; some members were the The perception of epilepsy wives of Queen Square physicians (as then, Clinical interest in epilepsy was accompanied the Ladies' Samaritans still do sterling work). by the realisation that people with epilepsy This Society raised money to provide food, also experienced social and economic prob- clothes, seaside holidays, and other comforts lems. Some of these problems were no differ- for poor patients from the National Hospital, ent from those faced by all poor people in Queen Square; employed lady almoners; ran those times, although most arose from pre- a convalescent home at Finchley (now the vailing attitudes to epilepsy. Epilepsy was still National Hospital Rehabilitation Unit); and widely regarded as a demoniac disease, one started a pension scheme for incurable both contagious and hereditary; people with patients. The third was the Charity epilepsy were ostracised and their marriage Organisation Society which had been set up frowned upon.'4 Not only were they often in 1869 by a group of philanthropists, many consigned to poorhouses, asylums, houses of of whom had connections with the Jewish correction, or gaols but words like degen- Board of Guardians, to prevent begging and erate, lunatic, imbecile, idiot, feckless, and the abuse of charity. Its members prided feeble-minded were used almost interchange- themselves on their scientific rather than sen- ably with epileptic.'5 The perceived and timental approach to poverty and both the actual link between epilepsy and lunacy was paid officials and voluntary members strongly particularly important; an association which upheld the work ethic and approved schemes had always overshadowed the life of people that encouraged people to be self-supporting. with epilepsy continued even towards the end The Charity Organisation Society was against of the century when the "sane epileptics" state intervention in social affairs, believing became recognised as a special group for that it would lead to less accountability and whom, in the opinion of many, asylums and expenditure on unproductive schemes for gaols were not appropriate.'6 17 feckless people.21 At this meeting the NSE To a greater extent than with many other was constituted, and its first resolution, pro- diseases, at the end of the nineteenth century, posed by Hughlings Jackson, to create "a those with epilepsy were considered very defi- home for such epileptic persons as are capable of nitely a class apart. The Victorian answer to work but unable to obtain regular employment on problem groups (even if "sane") was to segre- account of their liability to fits" was unanimous- http://jnnp.bmj.com/ gate them and pressure grew for institutions ly accepted (fig 1). The second resolution for epilepsy to provide care and control for proposed by David Ferrier and seconded by life. These should be situated in the country Howard Tooth and also approved unani- away from the bustle of towns; by utilising mously was "that it is expedient to establish in the inmates' work, they might become self- England an industrial colony for epileptics supporting. Enforced idleness and anxiety capable of work, on the same lines, so far as were thought to increase epileptic seizures in circumstances should render advisable, as the on September 27, 2021 by guest. Protected copyright. this feckless subclass and work was seen as a colony near Bielefeld in Germany". panacea.18 The Society was quickly established and by the end of May 1892 the provisional commit- tee (later the executive committee), which The Society included all Queen Square's physicians (fig 2) A number of meetings and other activities present at the inaugural meeting, also co- were held during the late 1880s to discuss the opted into the Society a number of influential needs of people with epilepsy and other hand- medical people.
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