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Biomedical subjects

George K York

Publications and source records attributed to George K York.

12 recordsLinked to original sources

Weir Mitchell's observations on sensory localization and their influence on Jacksonian neurology.

BACKGROUND: John Hughlings Jackson (1835-1911) in London was critical in advancing the concept of cerebral localization. Hughlings Jackson, however, did not work in a vacuum. Silas Weir Mitchell (1829-1914), in Philadelphia, published several clinical observations related to localization. OBJECTIVE: To examine Weir Mitchell's clinical observations on sensory localization, to determine whether they influenced Jacksonian neurology, and to elucidate the private relationship between the two men. METHODS: The authors reviewed published (fictional and scientific writings of Weir Mitchell and scientific writings of Hughlings Jackson) and archival sources (Weir Mitchell's unpublished autobiography and Hughlings Jackson's unpublished correspondence with Weir Mitchell). RESULTS: In the 1860s, Weir Mitchell, through his work on phantom limb syndrome and other nerve injuries, made oblique references to the central representation of body parts, specifically with regard to sensation. Hughlings Jackson had an interest in somatotopic representation in the nervous system and repeatedly cited Weir Mitchell's work in support of his ideas. The two shared several patients, met at least once in London, and carried on a friendly correspondence. CONCLUSIONS: Weir Mitchell's observations on sensory localization were well known to Hughlings Jackson, who cited them in seminal articles on cortical localization. Their correspondence provides an example of trans-Atlantic scientific and clinical communication at the time that neurology emerged as a distinct clinical discipline.

Cerebral Cortex↗

Commentary. The diseases of Alexander the Great.

The accompanying articles that speculate that Alexander the Great had a traumatic carotid dissection or congenital cervical scoliosis demonstrate the difficulties in retrospective diagnosis as a historical enterprise. The extant primary sources were written centuries after Alexander's death and are ambiguous in their original languages, and even more so in translation. Thus we cannot be certain what illness Alexander actually had. Furthermore, anachronistic diagnosis removes Alexander from the medical context of this time, telling us little of historical significance about him. Such investigations also illustrate the more general limits that the absence of context imposes on the study of ancient history.

Adult↗

Motor testing in neurology: an historical overview.

Systematic testing of muscle tone, bulk, and strength and analysis of the distribution of abnormal findings is a key element of bedside cerebral localization. A codified neurological examination was developed in the 20th century, but physicians have commented on weakness since antiquity. The ancient Egyptians, Greeks, and Romans described weakness in patients with head injuries and strokes, explaining it in terms of the pathophysiology of their times. Diagnostic principles of lateralization and localization developed in the Enlightenment, alongside an understanding of the anatomy of the motor system. In the 19th century, the work of Romberg, Todd, Charcot, and Gowers popularized the use of motor localization by demonstrating the power of scientific reasoning at the bedside. The concept of the upper motor neuron, as elaborated by Gowers, has enduring clinical utility.

Animals↗

Getting started: objectives and justifications in the history of neurology.

Contemporary historiographical ideas have the potential to enrich the history written by practicing neurologists. Neurology is a science, and historians of neurology might profit from considering the experiences of historians of other sciences. An explicit consideration of the range of possible objectives, justifications, sources and methods of historical research may open new and exciting avenues of inquiry. Any plausible answer to the question, "What does a historian do when he or she sits down to write history" helps an historian to develop the structure of his or her project. The selection of sources for a historical study is improved, if also expanded, by understanding its aims.

Historiography↗