Brain Vol. 127 No. 10 © Guarantors of Brain 2004; all rights reserved
Book review |
SOUL MADE FLESH: THE ENGLISH CIVIL WAR AND THE MAPPING OF THE MIND
Carl Zimmer
2004. London: Heinemann
Price £17.99. ISBN 0434010464
Montreal Neurological Institute and Osler Library of the History of Medicine, McGill University Email: william.feindel{at}mcgill.ca
Vindicating Willis
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put it unequivocally. ‘Thomas Willis practically refounded the anatomy and physiology of the brain and nerves.... He collated bedside observation with anatomical fact. He, as had Fernel, a century before him, shifted the seat of the anima from the chambers of the brain to the actual substance of the brain itself.... Willis put the brain and the nervous system on their modern footing so far as that could be then done.’ Charles Symonds (1955) was one of the first to point out the clinical significance of observations by Willis and his team on the anatomy and physiology of the cerebral circulation and to emphasize the innovative role of Willis as a physician who combined a busy medical practice with his role as head of a team of neurological investigators. Symonds (1960) sampled earlier protagonists of Willis by quoting Soury (1899). ‘Que l'on considère la structure, les fonctions ou les maladies de cerveau, surtout les grands névroses, telles que l'épilepsie et l'hystérie, il n'est pas un point de fait ou de doctrine dans lequel on ne puisse encore démêler aujourd'hui l'influence de Willis, et l'on se persuade sans peine en réalisant les oeuvres du vieux maitre que la force vive de son génie n'est pas encore épuisée.’ And Symonds concluded about Thomas Willis, ‘As a man he was not a courtier but a pious industrious person whose medical practice was informed by the search for truth and whose success as a doctor must be attributed as much—perhaps more—to the honesty and warmth of his character as to his skill.’ Willisian sites
Some geographic sites in England associated with Willis provide provenance to various stages of his career. In 1961, the memorial floor stone for Willis in Westminster Abbey was identified, renewed and rededicated, an event sponsored by British and Canadian neurologists: its lapidary inscription had been ablated unknowingly by the footsteps of a million visitors on their way to the Royal Chapels (Feindel, 1962a). A few years later, a charming thatched brick cottage in Great Bedwin was rediscovered as the birthplace of Willis (Symonds and Feindel, 1969); it was marked by a heritage plaque in 1994 under the auspices of the World Federation of Neurology through the efforts of F. Clifford Rose and others (Feindel, 1996). The houses that Willis leased in Oxford, from about 1657—Beam Hall and Number 3 Merton Street—were depicted (Feindel, 1962a). The Willis family home, Ferry Cottage near Oxford, was pictured by Hughes in 1991. These and other sites identified with Willis were recently described in a ‘neuroarchitectural tour’ (Feindel, 1999).
Distinct among medical memorials is the ‘Patronal Festival’, held each year since 1734 at Fenny-Stratford, mid-way between Oxford and Cambridge, to celebrate the life of Thomas Willis in St Martin's Church (Willis died on November 11, 1675, St. Martin's Day) where a fine chapel was dedicated by Browne Willis, the grandson and heir of the famous doctor. Three times during the day, six ‘Fenny-Poppers’—cast iron mugs stuffed with gunpowder—are set off in mortar trenches to give satisfactory bangs (Viets, 1917; Feindel, 1969). This is followed by a convivial supper in ‘The Bull’, the pub next door to the church. A celebratory church service includes a sermon, often by a prominent medical person, who in 1916 was Sir William Osler, then Regius Professor of Medicine at Oxford and a member of Willis' college, Christ Church. Osler praised Willis as ‘a good scientific man and a first class physician’—a testimonial with which the immortal soul of Thomas Willis no doubt would be content.
The founding of neurology
From the early 1960s, a series of publications began to catalogue the astonishingly able contributions of Thomas Willis and his Oxford circle to the anatomy, physiology, pathology and clinical disorders of the nervous system. For these observations and for coining the term ‘neurology’ (as he is credited in the Oxford English Dictionary), Willis was substantially claimed as ‘The founder of neurology’ (Feindel, 1962a). To commemorate the 300th Anniversary of the publication in 1664 of his celebrated Cerebri Anatome, the 1681 edition of ‘The Anatomy of the Brain and Nerves’, as ‘Englished’ by Samuel Pordage (Willis, 1681), was published in folio facsimile (Feindel, 1965a). A companion volume of commentary included the first biography of Willis and his friends, as well as a bibliographic survey of the 23 editions of this famous book (they appeared as separate editions or as part of Willis's Opera Omnia published in London, Amsterdam, Geneva, Lyon and Venice) which was created by the expertise of Howard Denham (1965) of the Wellcome Historical Medical Library. This tercentenary set was dedicated to Sir Charles Sherrington and Sir Charles Symonds and graced with a Foreword by Wilder Penfield. In designing this special edition, the two volumes were printed on Spanish hand-moulded paper, watermarked with the family arms of Dr Willis; the splendid anatomical figures from the first quarto edition of brain dissections drawn by Christopher Wren and of the spinal and autonomic nerves by Richard Lower, as well as portraits of Willis and his Oxford colleagues were reproduced by top lithographers and printers. Keele (1967), in a scholarly essay on this tercentenary edition, historically situated Willis in the context of the 17th century ‘instauratio’, with its strong political, religious and scientific undercurrents to which the group in Oxford were central.
Among others, Paul Cranefield (1961) wrote about the clinical and pathological correlations of Willis in relation to mental deficiency and psychiatric disorders. Meanwhile, Kenneth Dewhurst (1963a), a psychiatrist with a keen interest in 17th century medicine at Oxford, published a seminar on ‘Thomas Willis as a Physician’ (1964), a monograph on the Oxford lectures of Willis copied by Richard Lower and John Locke (1980), as well as biographies of Locke (1963b, 1984) and Sydenham (1966). Dewhurst (1981) also unearthed original documents and details having to do with Willis's life and medical practice—his case-book, details of his income (said to be the highest of anyone in Oxford), his clinic at the Angel Inn on the High Street in Oxford that served the London–Bristol carriage trade, and his acquisition of large estates in London and near Fenny-Stratford.
During this same time, Alfred Meyer and Raymond Hierons (1962, 1965, 1967) published important detailed analyses on Thomas Willis's concepts of neuro-anatomy and neurophysiology. In his definitive History of Cerebral Anatomy, Meyer (1971) also attributed to Willis the discovery and naming of many structures in the brain. Spillane (1981) devoted a major part of his book on The Doctrine of the Nerves to Willis and his works. He neatly wound up the controversy that stemmed from derogatory but unfounded strictures about Willis by his contemporaries that were uncritically repeated by Foster, Mettler and others.
Two full-length biographies about Willis have appeared, the first by Hansruedi Isler of Zurich, published in 1965 and translated into English in 1968, followed in 1999 by a generously illustrated volume by J. Trevor Hughes from Oxford.
Over the past two decades, another generation of scholars added substantially to Willisian studies. These include Robert Frank's authoritative biographical entry (1976) and his comprehensive monograph (1980) on ‘Harvey and the Oxford Physiologists’ and essays by Robert Martensen (1999) on the cultural influence of Willis, by James O'Connor (2003) on the religious views of Willis as displayed in his anatomical writings and by Zoltán Molnár's (2004) recent perspective that summarizes the evidence for Willis as the founder of clinical neuroscience. Christine Kenny (1998) gave a historical review of illustrations depicting aspects of the arterial circle before Willis compared with its anatomical and clinical definition in Cerebri Anatome (Feindel, 1962a, 1965b). In a thorough examination of the clinical neurology of Willis, Eadie (2003) discusses at length the role that ‘animal spirits’ and ‘nervous juice’ played in the Willisian neuropathology of brain disorders. Willis's attempt, Eadie concludes, ‘to record and interpret all nervous system disease on the basis of disorder of function of a single underlying mechanism represents a formidable synthetic intellectual endeavour on the part of a very busy physician.’
Wren's intravenous invention
In regard to the findings of Willis and his circle, an important point to emphasize is that much of their ‘new’ cerebral anatomy would have been impossible from inspection of brains ravaged by the usual post-mortem disintegration. It was here that Christopher Wren's ingenuity came into play. He invented a technique for intravenous injection which he applied to examine the effects of wine and ale, opium and other drugs in dogs (Gibson, 1970). Wren's technique eventually led to one of the earliest examples of blood transfusion in dog and in man by Lower and King, a demonstration enthusiastically observed by some members of the Royal Society. Robert Boyle had helped Wren to carry out his intravenous procedure in the dog. Boyle himself had used ‘spirit of wine’ to preserve anatomical specimens, ‘for this liquor being very limpid, and not greasy, leaves a clear prospect of the bodies immers'd in it’. Soaked in alcohol, specimens held their original shape and could be sliced open for study. We know also from the letters of Richard Lower to Robert Boyle, in London, that Willis and Lower injected coloured dyes into the carotid arteries and observed their widespread distribution throughout the brain (Symonds, 1954; Feindel, 1962b). These first ‘angiograms’ established the principle of collateral circulation so crucial to our present understanding and treatment of stroke. It seems quite probable that they would also have injected alcoholic liquids through the carotid arteries to preserve the brain. Indeed, the excellent copperplate ‘Figura Ia’ by Wren that illustrates the arterial circle on the base of the brain shows many anatomical details which strongly suggest it was thus preserved. The fullness of the convolutions and narrowness of the sulci represent an appearance familiar to neuropathologists who have perfused formaldehyde through the carotid arteries to fix the brain. In contrast, the brains illustrated in the atlases of Vesalius, Casserius and Veslingius show distortion of the basal structures, especially of the mesial parts of the temporal lobe and upper brainstem, that obscures the configuration of arterial vessels and the origins of the cranial nerves (Feindel, 1962a, 1965b).
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The brain figures
This series of handsome anatomical figures by Wren and Lower has been interleaved in Carl Zimmer's book titled, Soul Made Flesh. Thomas Willis, The English Civil War and Mapping of the Mind. They add pictorial lustre to his lively and readable account that focuses largely on the fabulous work of Thomas Willis and his Oxford circle—the prototype of the modern research team in clinical neurosciences. Zimmer narrates the wide sweep of the events in England and in the middle third of the 17th century—a bloody civil war, the beheading of an English king, a plague that wiped out 300 000 Londoners followed by the Great Fire which burnt out the core of the city. He situates Willis in the broader context of the natural and religious philosophy that preceded and then surrounded him.
Though artistically decorative, the anatomical figures could have been more informative by adding their original legends to explain the lettered parts. For example, for Wren's notable ‘Figura Ia’, the original captions indicate the famous arterial ‘circle of Willis’ (or polygon as it is called in French and Spanish). This would help the average reader, even though this term is known to every medical student and used daily by neurologists, neurosurgeons and neuroradiologists. The legends also point out details of the cranial nerves for which the numbering and classification by Willis held sway for a century or more in anatomical teaching. Rarely mentioned is the first precise delineation in this brain figure of the temporal lobes, especially the uncus that comprises part of the amygdala, the forward part of the hippocampus and some of the entorhinal cortex, all of which feature so prominently today in the neurology of temporal lobe seizures, Alzheimer's disease and memory functions.
In ‘Preface to the Reader’ of The Anatomy of the Brain and Nerves, Willis stated, ‘Wherefore to explicate the uses of the Brain seems as difficult a task as to paint the Soul, of which it is commonly said, that it understands all things but itself....’ His use of the term ‘explicate’, from the verb ‘explicare’, meaning to ‘unfold’, was particularly apt, because his new method of dissection revealed insights into brain anatomy by ‘unfolding’ the occipital lobes forward to reveal the ‘brain's innermost regions’ and then by judicious dissection ‘to unlock the secret places of man's mind’ that previous anatomists had not examined as clearly.
This mode of dissection gave Willis and his friends a field day to display accurately (and sometimes to name for the first time) parts of the brain such as the corpus callosum, the thalamus, anterior commissure, corpus striatum, fornix, internal capsule and corpora quadrigemina (see Figura VIIa).
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Beam Hall
Zimmer opens his story with an imaginative olfactory tour of Oxford that gives the reader a strong whiff of the grisly dissection room where Willis and his friends presumably performed their anatomizing in Beam Hall. This 15th century gabled stone house on Merton Street was leased by Willis in 1657 at the time of his marriage to Mary, sister to the authoritative Bishop John Fell. Willis lived there until he moved to London in 1667. We know from several sources that regular Anglican services were held illegally at Beam Hall during the Cromwellian regime. Willis also lived here when he was carrying out the programme of brain dissection with his group in the early 1660s. It is tempting to think that it was in Beam Hall where they met ‘to confer and reason about the uses of the Parts’ and then wrote up their findings; thus Willis's dwelling can be claimed as the first ‘Neurological Institute’ (Feindel, 1996). Zimmer takes up this claim enthusiastically. His elaborate description of the dissection room derives from the fine frontispiece in the Dutch edition of Cerebri Anatome by Schagen in 1665, which appears at the start of his Chapter Eight (Feindel, 1999). However, Zimmer's description of ‘Three hundred notorious royalists crowding everyday into this same small house’ for Anglican services seems somewhat exaggerated.
Cromwell and Canterbury
Willis eventually fared surprisingly well, despite the political and religious upheaval of the Civil War in the 1640s, during which time the university at Oxford languished, both his parents died and his medical studies were interrupted. After serving in the army of Charles I, he finished his brief medical course and began a medical practice at the age of 25. He attached himself to William Petty, a man of many parts and Professor of Music as well as Professor of Anatomy. Petty and Willis gained some notoriety in 1650 from the strange case of Anne Green, who caused a certain frisson locally when she was resuscitated after being hanged in December—possibly one of the rare examples of the benefit of Oxford's hypothermia (Feindel, 1962a).
During the next decade of the Cromwellian period, Willis diligently continued his medical practice. At the restoration in 1660, he fell into good fortune, partly because of his strong royalist and Anglican connections, when at the age of 39 he was appointed Sedleian Professor of Natural Philosophy and granted his MD from Oxford on the recommendation of Charles II. For this position he was sponsored by Gilbert Sheldon, one time Warden of All Souls, who then was Bishop of Oxford (1660) and eventually became Archbishop of Canterbury (1663) and Chancellor of Oxford (1667). Willis dedicated his three groundbreaking books on the anatomy, pathology and clinical aspects of the nervous system to his patron, friend and patient, Archbishop Sheldon—surely a unique medical and ecclesiastical connection (Willis, 1664, 1667, 1672).
The soulful brain
Once Willis took over his Chair, which mandated him to give weekly lectures on Aristotle and Galen, he soon became dissatisfied with the state of knowledge of the ‘offices of the senses’ and the ‘Faculties and Affections of the Soul’. So with ‘all delay being layed aside’ he determined to take himself ‘wholly to the study of anatomy and did chiefly inquire into the offices and uses of the Brain and its nervous Appendix.’ He attracted for this project, Richard Lower, a skillful and tireless prosector, Christopher Wren, then Professor of Astronomy who had superb artistic talent, and Thomas Millington, a ‘most learned’ Cambridge physician.
Even before Cerebri Anatome was published, Willis had already programmed another work on the pathology of the brain (Willis, 1667). Following that, perhaps his most interesting book, De Anima Brutorum (The Souls of Brutes), was largely devoted to comparative neuro-anatomy and clinical neurology (Willis, 1672). In this latter work, Willis again expostulates his views on an immaterial rational soul separate from the brain and a sensitive material soul that was based on a collection of spirits that travelled through the nervous networks which could become diseased like any other part of the body.
Zimmer presents an erudite and highly attractive account of the intricate highways and byways involving these medical and philosophical debates that involve Willis' former student, John Locke and many other luminaries. His colourful comments and references to many interesting characters are supported by back notes, a Dramatis Personae, an extensive bibliography and a useful index. He sometimes takes a certain artistic licence and fills in fact with fiction to keep the story moving.
His copy editors might have forestalled a few minor errors—such as referring to the Greek work ‘neurologia’ as Latin (p. 6). Not all of the brain drawings of Descartes were ‘woefully crude’ (p. 36)—his figures of the cerebellum and cerebral convolutions were as accurate as those of Wren.
In his final chapter entitled ‘The Soul's Microscope’, Zimmer makes a giant temporal and technological leap from the Willisian era in Oxford to a Princeton research laboratory of brain imaging and the revolutionary exploration of brain action now carried on by neuroscientists using functional magnetic resonance. The radio signals recorded in a high magnetic field for specific tasks given to the subject's brain depend on small changes of blood flow that are associated with brain cell activation—a local blushing of the brain—which one can take as an extension of the observations by Willis, Wren and Lower on the cerebral circulation over 300 years ago. Thomas Willis would have been astounded that so much of the brain's work can now be examined without, as he wrote, ‘the opening of Heads especially, and of every kind, and to inspect as much as I was able frequently and seriously the contents.’
The problem of neurology
Carl Zimmer has faithfully recounted the long saga of the problem of explicating the brain and how it became more scientifically based as a result of the studies of Willis and his colleagues that still stand out as enlightening landmarks in the transition from medieval to modern views of the brain (Feindel, 1989). However, as Lawrence Kruger (2004) has commented recently, ‘Perhaps discoveries of the brain shall change the world, but for the neurobiologist who may aspire to change the world, the glass might seem half empty until more significant strides are made in reversing the irreparable ravages of neurological disease, deciphering the mechanism of memory storage and retrieval, or understanding the penchant for violence in our species.’ Wilder Penfield (1965) summed it up in his Foreward to the tercentenary edition of The Anatomy of the Brain and Nerves of Thomas Willis when he wrote, ‘The problem of neurology is to understand man himself’.
References
Cranefield PF. A 17th century view of mental deficiency and schizophrenia: Thomas Willis on ‘Stupidity or Foolishness’. Bull Hist Med 1961; 35: 291–316.[Medline]
Denham HR. A bibliographic survey of Cerebri Anatome. In: Feindel W, editor. Thomas Willis. The anatomy of the brain and nerves. Tercentenary edn. Vol. 1. Montreal: McGill University Press; 1965. p. 67–104.
Dewhurst K. An Oxford medical quartet. Sydenham, Willis, Locke, and Lower. Br Med J 1963a; 2: 857–60.[Web of Science][Medline]
Dewhurst K. John Locke: physician and philosopher: a medical biography. London: Wellcome Medical Library; 1963b.
Dewhurst K. Thomas Willis as a physician. Los Angeles: William Andrews Clark Memorial Library, University of California; 1964.
Dewhurst K. Dr Thomas Syndenham (1624–1689): his life and original writings. Los Angeles: University of California Press; 1966.
Dewhurst K. Thomas Willis's Oxford lectures. Oxford: Sandford Publishing; 1980.
Dewhurst K. Willis's case book. Oxford: Sandford Publishing; 1981.
Dewhurst K. John Locke (1632–1704), physician and philosopher. New York: Garland; 1984.
Eadie MJ. A pathology of the animal spirits—the clinical neurology of Thomas Willis (1621–1675). J Clin Neurosci 2003; 10: 14–29, 146–57.[CrossRef][Web of Science][Medline]
Feindel W. Thomas Willis (1621–1675). The founder of neurology. Can Med Ass J 1962a; 87: 289–92.
Feindel W. Restoration of memorial to Dr Thomas Willis (1621–1675) in Westminster Abbey. Br Med J 1962b; 1: 552–3.
Feindel W. (ed.) Thomas Willis. The anatomy of the brain and nerves. Tercentenary edn. Vol. 1 Introduction; Vol. 2 Facsimile. Montreal: McGill University Press; 1965a.
Feindel W. The origin and significance of Cerebri Anatome. In: Feindel W, editor. Thomas Willis. The anatomy of the brain and nerves. Tercentenary edn. Vol. 1. Montreal: McGill University Press; 1965b. p. 5–59.
Feindel W. Fenny Poppers: a quaint celebration for Dr Thomas Willis. Can Med Assn J 1969; 109: 447–9.
Feindel W. The influence of Thomas Willis (1621–1675) on neurology and psychiatry on the continent. XXXI Congresso Internazionale di Storia della Medicina. Bologna (Italy): Monduzzi Editorie Spa; 1989. p. 795–802.
Feindel W. Domus Willisi: a neuro-achitectural tour. J Hist Neurosci 1996; 5: 268–70.
Feindel W. The beginnings of neurology. Thomas Willis and his circle of friends. In: Rose FC, editor. A short history of neurology. The British contribution 1660–1910. Oxford: Butterworth Heinemann; 1999. p. 1–18.
Frank R Jr. Thomas Willis. In: Gillespie CJ. Dictionary of scientific biography. Vol. 14. New York: Charles Scribner's Sons; 1976. p. 404–9.
Frank R. Jr. Harvey and the Oxford physiologists. Los Angeles: University of California Press; 1980.
Gibson WC. The bio-medical pursuits of Christopher Wren. Med Hist 1970; 14: 331–41.[Medline]
Hierons R. Willis's contributions to clinical medicine and neurology. J Neurol Sci 1967; 4: 1–3.
Hughes JT. Thomas Willis 1621–1675. His life and work. London: Royal Society of Medicine; 1991.
Isler H. Thomas Willis. Wegbereiter der modernen Medizin. Stuttgart, Wissenschaftliche Verlagsgesellschaft MBH; 1965.
Isler H. Thomas Willis 1621–1675. Doctor and scientist. London: Haffner Publishing Company; 1968.
Keele KD. Thomas Willis on the brain. Med Hist 1967; 11: 194–200.
Kenney C. A historical review of the illustrations of the circle of Willis from antiquity to 1664. J Biocom 1998; 25: 26–32.
Kruger L. Finding the mind in the brain. Nature Neurosci 2004; 7: 685.[CrossRef]
Martensen R. When the brain came out of the skull: Thomas Willis (1621–1675), anatomical technique and the formation of the ‘cerebral body’ in 17th century England. In: Rose C, editor. A short history of neurology. The British contribution 1660–1910. Oxford. Butterworth Heinemann; 1999. p. 19–35.
Meyer A. Historical aspects of cerebral anatomy. London: Oxford University Press; 1971.
Meyer A, Hierons R. Observations on the history of the ‘circle of Willis’. Med Hist 1962; 6: 119–30.[Medline]
Meyer A, Hierons R. On Thomas Willis's concepts of neurophysiology. Med Hist 1965; 9: 1–15, 142–55.[Medline]
Molnár Z. Thomas Willis (1621–1675), The founder of clinical neuroscience. Nature Rev Neurosci 2004; 5: 329–35.[Web of Science][Medline]
O'Connor JP. Thomas Willis and the background to Cerebri Anatome. J R Soc Med 2003; 96: 139–43.
Penfield W. Foreward. In: Feindel W, editor. Thomas Willis. The anatomy of the brain and nerves. Tercentenary edn. Vol. 1. Montreal: McGill University Press; 1965. p. xii–xiv.
Sherrington C. Man on his nature. London: Cambridge University Press; 1951.
Soury J. Le système nerveux central. Histoire critique des théories et des doctrines. Paris: Masson et Cie; 1899.
Spillane JD. The doctrine of the nerves. Chapters in the history of neurology. Oxford: Oxford University Press; 1981.
Symonds C. The circle of Willis. Br Med J 1954; 12: 119–24.
Symonds C. Thomas Willis, F.R.S. (1621–1675). In: Hartley H, editor. The Royal Society. Its origins and founders. London: Notes and Records of the Royal Society of London Vol. 3. 1960; 91–7.
Symonds C, Feindel W. Birthplace of Thomas Willis. Brit Med J 1969; 3: 648–649.
Viets HR. A Patronal Festival for Thomas Willis (1621–1675) with remarks by Sir William Osler, Bart. FRS. Ann Med Hist 1917; 1: 118–24.
Willis T. Cerebri Anatome. Londoni: typis Ja. Flesher, impensis Jo. Martyn and Ja Allestry; 1664.
Willis T. Pathologiae Cerebri. Oxonii: excudebat Guil. Hall, impensis Ja. Allestry; 1667.
Willis T. De Anima Brutorum. Oxonii: e Theatro Sheldoniano; impensis. R. Davis; 1672.
Willis T (Translated by Pordage S). The remaining medical works of that famous and renowed physician Dr Thomas Willis. London: T Dring, C Harper, J Leigh, S Martyn; 1681.
Zimmer C. Soul made flesh. Thomas Willis, The English Civil War and the mapping of the mind. London: Heinemann; 2004.
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