The Genesis of Neuroscience (review)

A. Earl Walker (1907–95) was one of the commanding figures of international neurosurgery and neuroscience in the mid-twentieth century. Early in his extraordinary career at Johns Hopkins (1947–72), he edited A History of Neurological Surgery (1951), the first comprehensive review of the subject. During the last ten years of his retirement at the University of New Mexico, he offered a series of increasingly popular lectures on the history of neuroscience. The present volume is an outgrowth of that later effort. When Dr. Walker died, the manuscript was well along but still incomplete and disorganized. Two of his most distinguished residents invested an intensive labor of love in bringing the book to publication. They were constantly aided by his devoted widow, Agnes Marshall Walker.

The actual scope of the book is a little less sweeping than its title. It describes the development of neurology and neurosurgery from prehistory to the early twentieth century. The clinical practices of each era or topic are introduced in the context of the relevant basic neuroscience. The first two chapters (totaling 86 pages) deal with events prior to the nineteenth century; this long period is thus covered thoroughly, but not in an encyclopedic way. The approach is unabashedly Whiggish: Walker wants to point out the precedents of our current knowledge and theories. Hence, Galenic practices are well described, but their theoretical basis in Greek humoral pathophysiology is insufficiently emphasized.

The bulk of the text (146 pages) describes the development of neurology and related neuropathology in the nineteenth century. Its format is based on disease syndromes or entities, generally preceded by the relevant neuroscience. This section is almost encyclopedic, making the book a very useful reference tool. Forty-one pages are devoted to “The Evolution of Neurosurgery,” covering trauma and tumors; since the details of specific tumors were not well covered in the history that I recently edited, ¹ this chapter is especially welcome.

To simply praise this book without mentioning its weaknesses would not befit the memory of Dr. Walker’s standards of scholarship. Because he was not vouchsafed the extra years to finish it, there are occasional errors of detail and some larger deficiencies, especially bibliographic. Despite a list of more than eight hundred titles in the reference section (and others in appendices), it is not uncommon to see a name in the text and find no direct citation. Nonetheless, by undertaking this laborious project, the editors and publisher have said, in effect, that it is much better to have this last major contribution from Dr. Walker in its imperfect form than to allow the manuscript to languish unseen and unused. I agree wholeheartedly with that practical sentiment. The book has an important place in the historiography of the neurosciences.

During the current Decade of the Brain, we have enjoyed a resurgence of interest in the history of the neurosciences. This interest needs to be served and encouraged by the publication of new or updated, comprehensive histories of neuroscience and its subdisciplines. The history of basic neuroscience (with a behavioral bent) is well covered by Stanley Finger’s Origins of Neuroscience (1994), and a new history of neurosurgery appeared in 1997, as mentioned above. However, nothing has yet replaced Garrison’s History of Neurology, which was first published in 1925 and revised by Lawrence McHenry, Jr., in 1969. The Genesis of Neuroscience can serve as an update for Garrison-McHenry in many ways. Since Dr. Walker did not intend his book to go much beyond the year 1900, the need for a history of clinical neurology in the twentieth century remains urgent.