Diabetic Lumbosacral Radiculoplexopathy DLSRP

Diabetic Lumbosacral Radiculoplexopathy DLSRP

www.rrnmf.com Early, Early Neurology History The Tale of Two Toms Richard J. Barohn, MD Chair, Department of Neurology Gertrude and Dewey Ziegler Professor of Neurology University Distinguished Professor Vice Chancellor for Research University of Kansas Medical Center Kansas City, KS Early, Early Neurology History 1600s Thomas Willis (1621 1675) B. Great Bedwyn, Wiltshire; Grew up near Oxford B.A. from Christ Church, Oxford (1637-1639) & M.A. (1642)

Bach. Med (1646) During Civil war between Charles I & Cromwell (he sided with King!) William Harvey Oxford De Motu Cordis (1628) also in Oxford Physician in Oxford for 20 years; went to market to find patients; kept clinical, notebook, did autopsies, busy practice, Poll Tax said he was highest earner in Oxford Restoration of Charles II - became Sedleian Prof of Natural Philosophy; Oxford; got MD Lectured every Wednesday & Saturday 8 AM Willis Students: (who took notes) Robert Hooke - microscopy John Locke - physician & philosopher Christopher Wren - architect 1663 - Original Fellow of Royal Society

1667 - Moved to London Buried in Westminster Abbey Early, Early Neurology History 1600s Thomas Willis (1621 1675) CONTRIBUTIONS The Founder of Neurology 1st used term neurology Doctrine of Nerves 1st experimental medicine in neuro 1664 Cerebri anatome AKA The Anatomy of the Brain & Nerves; 9 editions The Harvey of the Nervous System Landmark book on neuroanatomy & cerebral vessels Illustrated by Christopher Wren

Injected ink into constids noted circle Significance: If by chance one or two should be stopped, there might easily be found another passage Early, Early Neurology History 1600s Thomas Willis (1621 1675) OTHER BOOKS 1667 Pathologiae Cerebri et Nervosi Generis Specimen 1672 De Anima Brutorum 1st textbook of neuropsychiatry 1672 De moto musculari 1672 Hysteria and Hypochondria Mental retardation and hysteria brain disorders 1672 De Sanguiniis ascensione

1675 Pharmaceutice rationalis 1688 Dr. Willis Practice of Physics Of the Palsey 1st description of Myasthenia Gravis: woman temporarily lost speech and became mute as a fist Early, Early Neurology History 1600s Thomas Sydenham (1624 1689) THE ENGLISH HIPPOCRATES 1624: born Wynford Eagle, Dorset UK 1642-1648: Oxford, Magdalen Hall Sided with Parliamentarians joined army during college Did not practice medicine until 1661 in London 1665: Plague went to Cambridge; Doc of Medicine While in Cambridge, competed: Method of Treating Fevers Based on His Own Observations Dedicated to Robert Boyle, 1676 detailed 1st medical epidemiologist. 4 More books: All descriptive practical medicine/observations/no hypothesis

Emphasized careful hx/exam, not theory Did not dispense drugs (exercise, cooling, diet) Did not emphasize research pathologic data Thought path data would confuse physicians Opposite of Willis / better clinician / less scientific The original Osler Early, Early Neurology History 1600s Thomas Sydenham (1624 1689) MEDICAL OBSERVATIONS The more I observed the facts of this science with an attentive eye, and the more I studied them with due and proper diligence, the more I became confirmed in the opinion which I have held to up to the present hour, that the art of medicine was to be properly learned only from its

practice and its exercise. (Sydenham, Epistle Dedicatory to the Third Edition of His Book Medical Observations, in Latham, 1848) Letter to friend/pupil, John Mapletoft Early, Early Neurology History 1600s Thomas Sydenham (1624 1689) NEUROLOGY Wrote little on neurology because he did not undertake to write upon diseases that he was unable to cure St. Vitus Dance or Chorea described in 2 books: Schedula Monitoria (1686) Processus Integri (1692) QUOTE: Chorea Sancti Viti is a sort of Convulsion which chiefly invades Boys and Girls from ten years of Age to Puberty. First it shews itself by a certain Lameness or rather Instability of one of the Legs, which the Patient drags after him like a Fool; afterward it appears in the hand of the same side; which he that is affected with this Disease can by no means keep in the same Posture for one moment, if it be brought to the Breast or any other Part, but it will be distorted

to another Position or Place by a certain Convulsion, let the Patient do what he can. If a cup of Drink be put into his Hand he represents a thousand Gestures like Juglers, before he brings it to his mouth; for whereas he cannot carry it to his mouth in a Right line, his hand being drawn hither and thither by the Convulsions, he turns it about for some time till at length happily reaching his Lips, he flings it suddenly into his mouth and drinks it greedily as if the poor Wretch designed only to make Sport Dissentatio epistolaris (1682): Hysteria Disorder of nervous system simulating organic illness; men & women Early, Early Neurology History 1600s The Tale of Two Toms Thomas Willis The WHY Tom (Also a Royalist) Thomas Sydenham The WHAT Tom (Also a Parliamentarian)

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