A revisionist history of American neurology

Abstract

Neurology as a well organized and defined body of knowledge and a set of practices did not emerge at any precise time. Nor did it first come into being in any specific geographical context. Although many historians trace the intellectual history of neurology back to antiquity, it is noteworthy that the origins of the specialty in hospitals and universities can be located only in the mid-nineteenth century and afterwards, a fact that makes it difficult to identify the way neurological knowledge was systematically acquired before this period (McHenry, 1969; DeJong, 1982). Moreover, the inclusion of neurology as a discipline recognized within the medical profession in terms of autonomous hospital departments, university teaching and professional certification occurred only around the period of World War I (Magoun, 1975). Given these facts, it is surprising that whilst nineteenth-century neurology and earlier periods have received great historical scrutiny, historians have largely ignored the important inter-war and post-war periods (Dwyer, 2000). That is a circumstance now significantly adjusted by the publication of the two excellent works under consideration in this essay. Historians routinely associate the intellectual origins of American neurology with studies of wounded soldiers first conducted by Silas Weir Mitchell and William A. Hammond during the American Civil War. The work of these physicians and their contemporaries ushered in a period of heightened enthusiasm for studying ailments of the nervous system, especially among a small cadre of physicians working in the northeastern United States (Blustein, 1979). As these physicians began elaborating a set of practices that would trigger the local emergence of modern neurology throughout North America, a simultaneous convergence of social, economic and intellectual forces in the commercial and industrial milieu of the post-bellum United States made the formation of clinical specialties increasingly acceptable to the medical profession and the public. …