Book Review

Brown-Sequard: A Visionary of Science

N Engl J Med 1993; 329:1662November 25, 1993

Article

Brown-Sequard: A Visionary of Science
By Michael J. Aminoff. 211 pp., illustrated. New York, Raven Press, 1993. $68. ISBN: 0-88167-956-9

Aminoff has taken great care in crafting a portrait of Charles Edouard Brown-Sequard, a man of many quirks, tremendous intuitive insights, and impressive scientific accomplishments. Immortalized in the eponym that describes the clinical syndrome of spinal cord hemisection, Brown-Sequard made contributions to several fields. He laid the foundations for hormone-replacement treatments and demonstrated experimentally that the adrenal glands are essential for life. He should be considered among the founding fathers of endocrinology; however, many minimized his contributions, in part because of the association of his name with testicular extracts promoted by charlatans. Brown-Sequard's experiments and his interpretation of Claude Bernard's work led to the understanding of neural control of the vasculature. During the emergence of the localization theory of brain function, championed by Broca and many prominent neurologists of the day, Brown-Sequard differed and promoted what would now be described as neural-network theory, professing that “each function of the brain is carried out by special organs . . . composed of scattered cells diffused in many parts of the brain, in communication, of course, one with the other by fibres and forming a whole.” Brown-Sequard cannot claim the honor of developing network theory, but his observations reflect his ability to form fundamental theories from relatively crude clinical and experimental observations.

Several nations lay claim to Brown-Sequard. He was born in Mauritius, an English colony, the son of a French woman and an American sea captain. Educated in Paris and eventually earning the prestigious post of professor of medicine at the College de France, he was known to the French intelligentsia and earned the dubious distinction of a caricature in Le Figaro for his organ-extract experiments. Brown-Sequard spent much time lecturing in the United States and became professor of physiology and medical jurisprudence at the Medical College of Virginia in Richmond. The university and Brown-Sequard gladly parted company after only one term. His colleagues were disappointed in his lack of social graces and his disgust for slavery. The people of Richmond worried that Brown-Sequard was performing the work of the devil when students collected animals for experiments and classroom demonstrations. Brown-Sequard left happily for the more intellectual life of Europe but returned often to the United States, spending a stormy time at Harvard as professor of physiology and of the pathology of the nervous system. He traveled to England and served at the National Hospital for the Paralysed and Epileptic at Queen Square, where he influenced a young John Hughlings Jackson. As pointed out by the St. James' Gazette on his death, Brown-Sequard's essential English heritage was exemplified by “his moral courage, pertinacity, and coolness.”

The greatest strength of this biography lies in Aminoff's in-depth understanding of Brown-Sequard's scientific achievements in the context of the age. The author's appreciation stems partly from his being both a neurologist and a physiologist. But he clearly has a deep love and respect for Brown-Sequard, and this is reflected in the obvious care taken in the preparation of each word of the biography.

Henry J. Kaminski, M.D.
Case Western Reserve University School of Medicine, Cleveland, OH 44106