A History of Neurosurgery in Its Scientific and Professional Contexts

While orthopedists, ophthalmologists, and ear-nose-and-throat specialists have always been the surgeons dealing with their particular organs, it was usually neurologists who started persuading general surgeons to deal with neoplasms and other deformities of the nervous system. From this union emerged a new specialty, neurosurgery. One of the earliest practitioners in the field was the editor of the first History of Neurological Surgery in 1951—was A. Earl Walker (1907–95). He was even the author of the preface to this volume, and to him it is now dedicated.

Containing more than six hundred quarto pages, the book has three dozen contributors—two from Europe, the rest from the Western Hemisphere. There are numerous pages of references—not only to the “Standard Bibliography and Biography in the History of Neurosurgery and the Neurosciences” and the “Birth and Death Dates of Historical Persons,” but also to a “Cumulative Index of References Cited,” as well as more than three hundred well-chosen black-and-white illustrations.

The book begins with a short chapter on “The Historiography of Neurosurgery: Organizing Themes and Methodological Issues,” in order to provide “a historical framework that will allow the reader to understand the development of modern neurosurgery in comprehensive terms” (p. 3). Starting with medical and ritual trepanation, and approaches to head trauma before and during the Renaissance, we get to the story of infection, including Lister’s basic contribution. In the next section are chapters going back to Galen and the rise of cerebral localization, followed by the fathers of neurosurgery as such, from Macewen to Cushing. The three hundred pages of section 4 are devoted to “The Evolution of Modern Neurosurgical Techniques and Technology.” This includes chapters dealing with surgical instruments from the beginnings of cranial and intracranial intervention; neuroanesthesia; imaging and the electroencephalogram; the treatment of tumors and of neurovascular abnormalities, trauma, pediatric problems, the pituitary; and the stereotactic approach, as well as several chapters on the surgical approaches to pain, epilepsy, and psychoses.

Finally, section 5, entitled “Organizational and Philosophical Issues,” answers the question, How did schools of neurosurgery originate and develop in the United States and all over the world? Here, T. Forcht Dagi of Atlanta, Georgia (“Contributing Editor” as well as a contributor to two other chapters), provides an analysis and a summary of the approaches to this relatively recent specialty—namely science, technology, and experimentation—as they influence practice. Statistics is discussed, as well as general ethics (but there is no mention anywhere of material compensation).

The book contains an extensive index of authors and their contributions to the history of neurology, medicine, and surgery, as well as an index to pertinent biographies. The volume is impressively organized, easy to read, and reliably informative. Some repetitiveness seems inevitable. Unfortunately, the sequence of pages 243 to 274 is grossly disorganized. Thus turning page 269 leads to 274, or 253 to 258 . . .