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Biomedical subjects

M Macmillan

Publications and source records attributed to M Macmillan.

At least 19 recordsLinked to original sources
PubMed2001

John Martyn Harlow: "Obscure country physician"?

If John Martyn Harlow is known at all in the neurosciences, it is because he was the physician who attended Phineas Gage and followed up his case. Although Harlow's brief but insightful accounts of the changes in Gage's personality are fairly well recognized, and his skill in treating Gage often acknowledged, Harlow himself is, for the most part, the shadowy figure caught by the self-depreciatory characterization of the subtitle of this paper. Although his contribution to the neurosciences was singular, literally and figuratively, he deserves a place in the history of the subject. Harlow's training in antiphlogistic therapy can be seen in his treatment of Gage and in his evaluation of its results. As a medical student, he was also exposed to phrenological doctrine, the influence of which can also be seen in his appreciation and explanation of some aspects of Gage's behaviour. Manuscript materials, newspaper reports, and other little known material are used here to evaluate Harlow's contributions to medicine and to the medical, political, and civic life of Cavendish, Woburn, and the Commonwealth of Massachusetts.

Bloodletting↗
PubMed2000

Nineteenth-century inhibitory theories of thinking: Bain, Ferrier, Freud (and Phineas Gage).

The theories of thinking of Alexander Bain, David Ferrier, and Sigmund Freud are examined and their relation to Phineas Gage explored. During the 19th century Ferrier derived an inhibitory-motor theory of thinking from a similar theory of Bain's, and aspects of Freud's theory of thinking resemble both. All 3 theories were modeled on the sensory-motor reflex, and all proposed that thinking was inhibited action. Ferrier used his theory to explain the behavior of monkeys whose frontal lobes were ablated and the disinhibited behavior Phineas Gage exhibited after massive damage to his frontal lobes. I show there is some possibility that Freud knew the Bain-Ferrier theory of thinking and its application to Gage.

Behavior↗
PubMed2000

Restoring Phineas Gage: a 150th retrospective.

September 13 1998 marked the 150th anniversary of the accident to Phineas Gage, one of the most famous cases of survival after massive injury to the brain, and certainly the most famous case of personality change after brain damage. For this article a sample of the current literature about Gage was examined. It was found that although his case is mentioned in about 60% of introductory textbooks in psychology, there is a good deal of inaccuracy in what has been written about him. Similar inaccuracy was found in a smaller sampling of the psychiatric, medical, physiological, linguistic, and general neuroscientific literature. The main basis of the inaccuracies is an ignorance or disregard of what is contained in the primary sources about Gage, coupled with a tendency to attribute to him characteristics that belong to other cases of frontal damage. The errors and their bases are discussed in an endeavour to restore the picture of Gage to its original state. The paper includes an Appendix of verbatim quotations from the primary sources that can be compared with the later, inaccurate renditions.

Behavioral Symptoms↗
PubMed1996

The concept of inhibition in some nineteenth century theories of thinking.

The concept of inhibition was introduced into psychology and physiology at the beginning of the 19th century. Although it was quickly adapted to account for a wide range of phenomena in both disciplines, questions were soon raised about its real explanatory power. Some of the objections were on logical and scientific grounds but many were to the very notion that an inhibitory process could be an active one. Despite many analytical reviews and attempted redefinitions, no clarification resulted. Partly this was due to the influence of a variety of unstated philosophical and social-ideological assumptions about the phenomena for which inhibition was used. In this paper, some of these issues are explored in relation to "insanity," hypnosis, and normal thinking and willing. Particular attention is paid to Alexander Bain's theory of the will which David Ferrier attempted to locate in his hypothesised frontal inhibitory-motor centers.

Brain↗
PubMed1996

Phineas Gage's contribution to brain surgery.

In much contemporary literature the Phineas Gage case is described as contributing to the development of lobotomy and leucotomy but the historical evidence shows this to be an almost completely erroneous view. His case was, however, important in the development of brain surgery itself. I begin this paper by briefly mentioning four early cases of brain surgery and describing the Gage case. I then set out the context of the localisation debate, concentrating particularly on Broca's clinical observations, because Macewen planned the first operation on the brain in the light of Broca's findings. I then turn to that context as it was developed through Jackson's observations and Ferrier's experiments, because Bennett and Godlee used it in planning the first operation for the removal of a brain tumour. It was also in the localisation context that Starr first drew attention to the significance of the changes in Gage for localising frontal tumours. By the turn of the century, several operations had been performed on the frontal lobes and various difficulties with Starr's criteria had become apparent. The reasons for the difficulties will be brought out and I conclude with a brief discussion of the relation between the Gage case and the operations performed by Burckhardt, Moniz, and Freeman.

Brain↗
PubMed1992

Inhibition and the control of behavior. From Gall to Freud via Phineas Gage and the frontal lobes.

In his On the Functions of the Brain and Each of Its Parts, Franz Joseph Gall proposed that significant behaviors resulted from certain independent, irreducible, and fundamental faculties or propensities. There seems to be nothing in his system for explaining how two or more faculties interact, especially how one comes to predominate over another, other than the implicit notion that the stronger will be manifested. This peculiarity of Gall's system is consistent with the predominately "excitatory" physiology of his time in which there was no place for an independent inhibitory process. Despite the experimental demonstration of inhibitory phenonema, the sensory-motor physiological theories in the last three quarters of the 19th century were similarly deficient. The lack is seen most clearly in the experimental and clinical literature on frontal lobe function, especially in relation to the kinds of changes seen in the Gage case. The deficiencies of sensory-motor physiology are also to be found in Freud's model of the mental apparatus and in his concept of inhibition via a lateral cathexis. In the paper an attempt is made to trace the historical sequence of these ideas and to make their experimental and theorectical basis explicit.

Austria↗
PubMed1992

Possible short-term memory loss associated with nafarelin acetate.

OBJECTIVE AND DESIGN: A survey was conducted to determine the occurrence of short-term memory loss in patients using nafarelin acetate nasal spray. SETTING AND PATIENTS: A list of all patients receiving nafarelin acetate from our pharmacy over a four-month period was generated. We contacted and surveyed 16 women. INTERVENTIONS: Each patient was asked to repeat three words at the beginning of the survey and after a series of questions, each patient was asked to recall the three words. Patients were also asked if they believed that their memory was affected by nafarelin acetate nasal spray. RESULTS: Eleven patients (69 percent) recalled three words, 3 (19 percent) recalled two words, and 2 (13 percent) recalled one word at the conclusion of the survey. Nine of 16 patients (56 percent) reported some type of memory difficulty. CONCLUSIONS: Nafarelin acetate nasal spray may adversely affect short-term memory. This effect is not documented in current literature and further investigation is warranted in the possible relationship between gonadotropin releasing hormone agonists, estrogen deficiency, menopause, and short-term memory. Our survey also demonstrates the significance of communication between pharmacists and patients on newly marketed medications.

Administration, Inhalation↗
PubMedDate not supplied

Experimental and clinical studies of localisation before Flourens.

Experimental studies in the localisation of brain function did not begin with Flourens, nor did clinical studies with the phrenologists or physicians like Auburtin, Bouillaud, or Dax, shortly afterward. Although the pre-1820 literature is moderate, some of it is worth examining because of the problems associated with interpreting it. There are three separate but related problems: philosophical, methodological, and conceptual. Philosophically, whether one saw the brain as the main organ of sensibility, as did the Hippocratic writers and Galen, or the heart, as did Aristotle, determined the attention given to the brain. The methodological problems arose from the gross structure of the brain not being immediately obvious and the dominant technique of dissecting the brain in transverse sections revealing the ventricles and their immediately associated structures more readily than other structures. Conceptually, the ventricles were seen as the sites through which sensations were transferred to the muscles. Observations relevant to localisation were thus related to the ventricles or to structures lying outside the cerebrum. What are now considered major structural landmarks were not discovered until late: the Sylvian fissure in about 1640 and the fissure of Rolando in 1829, the former being dependent on new methods of dissection. In general, it was not until the first half of the nineteenth century that the cerebral structures were properly differentiated. Consequently, calls for comparative clinical studies of the effects of lesions in different parts of the brain inevitably fell on ears tuned to a framework which could not incorporate them. So, did the results of the earlier experimental studies.

Brain↗