Citation

Ganz JC. Neurosurgery 2013; 73(1): 167-75; discussion 176.

Copyright

(Copyright © 2013, Congress of Neurological Surgeons)

DOI

10.1227/01.neu.0000429851.45073.a8

PMID

23615105

Abstract

The 18 century was the time when trauma neurosurgery began to develop into the modern discipline. Prior to this, the management had, for the most part, changed little from the days of Hippocrates, Celsus and Galen. Attention was directed to skull injuries and the brain was treated as the seat of the rational soul, but without other function. Symptoms following trauma were attributed to injuries to the bone and meninges.Following the lead of the Royal Academy of Surgery in Paris, it was accepted from the 1730s that the brain was the seat of symptoms following cranial trauma. During the eighteenth century at least 12 surgeons published on cranial injury, 6 of whom described significant clinical series on this topic. They were Henri-François Le Dran (1685 - 1770) of Paris, Percival Pott (1714 - 1788) of London, James Hill (1703 - 1776) from Dumfries, Sylvester O'Halloran (1728 - 1807) of Limerick in Ireland, William Dease (1750 - 1798) of Dublin, and John Abernethy (1764-1831) of London.This paper analyses these series. Each individual made a different contribution. It is suggested that the relatively lesser-known James Hill in Scotland demonstrated the greatest understanding of the management of brain trauma and achieved the best results. A product of the Scottish Enlightenment, he adapted his management to his own experience and was not tied to the accepted authorities of his day, but improved the management of each case following his experience with previous patients. He deserves to be remembered.

Language: en