Saturday, February 16, 2008

9 - arlt's line , arlt's operation , arlt's syndrome - carl ferdinand von arlt

Carl Ferdinand Ritter von Arlt

German ophthalmologist, born April 18, 1812, Obergraupen near Teplitz in Bohemia; died March 7, 1887.

Arlt's line - Carl Ferdinand Ritter von Arlt - Horizontal, linear scarring of the upper tarsal conjunctiva. A classical sign of trachoma.

Arlt's syndrome: a contagious eye infection caused by Chlamydia trachomatis.

Arlt's operation: transplantation of eyelashes back from the edge of the eyelid for treatment of distichiasis.

Carl Ferdinand Ritter von Arlt was the son of a poor mining smith. He had a rough childhood and study time, attending the gymnasium in Leitmeritz and the University of Prague. He was trained in ophthalmology by professor Johann Nepomuk Fischer (1777-1847), the founder of modern eye medicine in Bohemia, and was conferred doctor of medicine in Prague in 1839. From October 1846 to July 1849 he worked as a supplementary at the chair of ophthalmology in Prague, and from August 1849 to July 1856 was professor of ophthalmology in Prague.

Upon the death of Anton Edler von Rosas (1791-1855) he was called to take over his chair in Vienna, holding this tenure from the autumn of 1856 to the end of July 1883, when he retired at the age of 70. However, although regulations forced him to leave office, Arlt continued his scientific and practical work. No less was expected from a man whose iron will and great intellect had brought him up from poverty to the peaks of academic prestige.

Arlt's great achievement lies not only in his own research and his skill as an eye surgeon, but as much in his influence on the development of ophthalmology. His brilliant lectures attracted large number of students, one of them the 17 year younger Albrecht von Graefe, who looked him up in Prague. Arlt was instrumental in influencing von Graefe to concentrate exclusively on this branch of medicine.

Despite his high office he lived in a simple, undemanding way, always opening his hand to people in want, and a fatherly friend to poor students. He maintained a lifelong attachment to his home in the Bohemian Erzgebirge, and every year visited his birthplace in order to assist the numerous people in the vicinity suffering from diseases of the eyes.

Arlt was a prolific writer. Besides his numerous books and articles, he wrote a brochure on the eye care in which he urged eye physicians to establish the strength of eyeglasses themselves, not to leave it to the optician. In his work on the diseases of the eye he presented the proof that short-sightedness is normally a consequence of an elongation of the sagittal diameter of the bulbus of the eye.

He died of Gangraene senilis on March 7, 1887. His son, born December 28, 1842 in Prague, also named Ferdinand Ritter von Arlt, followed his father into the discipline of ophthalmology. He worked at the University clinic and for years was the private assistant of his father. He practiced ophthalmology in Vienna and died there on February 23, 1917.

It was still early in his career when Arlt began publishing his large work on diseases of the eye, and in 1855, with Franz Cornelis Donders (1818-1889), became a co-editor of the journal Archiv für Ophthalmologie, which had been founded by Albrecht von Graefe.

Arlt described an operation for transplantation of the ciliary bulbs in the treatment of distichiasis.


Bibliography:

  • Pflege der Augen im gesunden und Kranken Zustande, neben einem Anhange über Augengläser.

  • Prague 1846; revised editon, Prague, 1868.
  • Die Krankheiten des Auges.

  • 3 volumes, Prag, F. A. Credner & Kleinbub, 1851, 1853 and 1856.
  • Retinitis nyctalopica, From ”Der Bericht ueber die Augenklinik.”

  • Translated, with consent of the author, by J. F. Weightmann, M. D., of Philadelphia.
    23 pages. Philadelphia, Lindsay & Blakiston, 1868.
  • Treatment of lachrymaal affections. Translated, with consent of the author, by J. F. Weightmann, M. D.

  • Philadelphia, Lindsay & Blakiston, 1868.
  • Operationslehre.

  • In Edwin Theodor Saemisch and Albrecht von Graefe: Handbuch der gesamten Augenheilkunde. Volume 3. Leipzig 1874.
  • Die Verletzungen des Auges. Vienna, 1875.

  • Die Kurzsichtigkeit, Enstehung und Ursachen. Vienna 1878.

  • Klinische Darstellung der Krankheiten des Auges zunächst der Binde-, Horn- und Liderhaut, dann der Iris und des Ciliakörpers. Wien, Braumüller, 1881.

  • Zur Lehre vom Glaucom. Vienna, 1884.

  • Meine Erlebnisse. Autobiography, Wiesbaden 1887.

  • Otto Becker, pupil of Arlt, completed his autobiography: Letzte Lebensjahre, Krankheit und Tod. Bibliography; list of honours.

    A selection of his journal papers:

  • Aphoristische Bemerkungen über einige Augenkrankheiten.

  • Vierteljahresschrift für die praktische Heilkunde, Prag, 1844.
  • Physiologisch- und pathologisch-anatomische Bemerkungen über die Bindehaut des Auges.

  • Vierteljahresschrift für die praktische Heilkunde, Prag, volume 12: 70-79.
  • Ueber Trichiasis und Entropium.

  • Vierteljahresschrift für die praktische Heilkunde, Prag, 1845.
  • Zur pathologische Anatomie des Auges.

  • Vierteljahresschrift für die praktische Heilkunde, Prag, volume 14: 44-61.
  • Ueber das Trachom.

  • Vierteljahresschrift für die praktische Heilkunde, Prag, 1848, 18: 41-68.
  • Zur pathologische Anatomie des Auges.

  • Vierteljahresschrift für die praktische Heilkunde, Prag, 1847.
  • Ueber Trachoma.

  • Vierteljahresschrift für die praktische Heilkunde, Prag, 1848.
  • Zur Nosographie und Nosogenie des Flügelfelles.

  • Vierteljahresschrift für die praktische Heilkunde, Prag, 1848, 18, 73-92.
  • Ueber den Thränenschlauch.

  • Archiv für Ophthalmologie, Berlin, 1855, I.
  • Form und Lage des Corpus ciliare und der Iris.

  • Archiv für Ophthalmologie, Berlin, 1857, III.
  • Der Ringmuskel der Augenlieder.

  • Archiv für Ophthalmologie, Berlin, 1863, IX.
  • Zur Behandlung der Thränenschlauchleiter.

  • Archiv für Ophthalmologie, Berlin, 1868, XIV.
  • Zur Lehre von Hornhautabscesse.

  • Archiv für Ophthalmologie, Berlin, 1870 XVI.
  • Winke zur Staaroperation.

  • Archiv für Ophthalmologie, Berlin, 1885, XXI.

    8 - tay sach's disease - bernard sachs

    Bernard Sachs

    American neurologist, born January 2, 1858, Baltimore, Maryland; died 1944


    Tay-Sachs disease = an autosomal recessive disorder involving the lysozymal enzymes. The result is neuronal degeneration and cherry red spot of the eyes. Death occurs before 3 years of age.


    Bernard Sachs’ parents were of Jewish descent. His father was a teacher who had grown up in a small town in Bavaria near Schweinfurth. Whilst studying in Würzburg, he eloped with a girlfriend to Hamburg in 1847 and boarded a ship to the U.S.A. They had six children.

    Although he early decided to pursue a medical career, Bernard Sachs first concentrated his studies on literature and the classics. He studied at Harvard Medical College in Cambridge from 1874 to 1878. One of his teachers, the psychologist and philosopher William James (1842-1910), was having trouble with his eyes and asked a member of the class to read a chapter from Wilhelm Wundt’s Psychology. Sachs undertook this task and this aroused his interest in the study of mental disorders.

    Sachs graduated B.A. from Harvard with honours in 1878 and went to Europe where he studied medicine in Strassburg, Vienna, and Berlin. He chose Strassburg because of the strong medical faculty at the time. He was most impressed by Adolf Kussmaul (1822-1902) but also found von Fredrich Daniel Recklinghausen (1833-1910) an inspiring teacher. Sachs quoted a comment of Wilhelm von Waldeyer-Hartz (1836-1921) who did not like any of the textbooks of anatomy except Josef Hyrtls (1810-1894) because “it contains anecdotes: you will remember the anecdotes and promptly forget the anatomy.”

    While working with Friedrich Leopold Goltz (1834-1902) Sachs wrote his first paper which appeared in Virchow’s Archiv für pathologische Anatomie und Physiologie und für klinische Medicin in 1882. He visited and worked with Karl Friedrich Otto Westphal (1833-1890) and Rudolf Virchow in Berlin. After receiving his degree from the University of Vienna in 1882 Sachs, along with fellow student Sigmund Freud (1856-1939), remained to continue postgraduate studies in cerebral anatomy and neuropsychiatry with Theodor Hermann Meynert (1833-1892). Later, in 1885, Sachs translated Meynert’s classic treatise Psychiatrie.

    To round off his education in medicine and neurological science Sachs spent a year with Jean-Martin Charcot (1825-1893) in Paris and John Hughlings Jackson (1835-1911) in London.

    Sachs sailed back to the U.S.A. in 1884 to live in New York, where his parents had settled. He spent three years in New York as an assistant to Isaac Adler (1849-1918), before establishing a private practice for the treatment of mental and nervous diseases. In 1887 Sachs, now recognized as one of America’s leading clinical neurologists, became an instructor at the New York Polyclinic Hospital.

    At this stage he wrote his article on arrested cerebral development with special referance to its cortical pathology, in which a cherry red macula had been noted clinically by his associate Herman Jakob Knapp (1832-1911). Later on, recognising the familial nature of the condition, he called the disorder “amaurotic familial idiocy”. He was unaware that Tay had already published an account of brownish-red circular spot in each macula surrounded by a whote halo in an infant. Tay considered the change to be similar to the picture of embolism of the central artery of the retina. Hughlings Jackson had been called as a consultant and was unable to find any evidence of cerebral problems. Later it was recognised that Tay and Sachs were seeing different facets of the same condition.

    In 1893 he was appointed consultative neurologist at Mount Sinai Hospital in New York and consulting physician to Manhattan State Hospital. At Mount Sinai he helped arrange for the establishment of a neurological bed service, the first separate division of its kind in a New York health facility.

    Sachs was an intelligent man with a strong sense of humour. He was outspoken and could be very sharp in repartee, but he was also a very generous man. As a neuro-psychiatrist he was often called to court cases and in his autobiography tells the story of a lady who was suffering from senile dementia and who had left most of her money to the lawyer who had drawn up her will. “I suppose’, asked the cross-examining lawyer, “that it is very easy for you, Dr. Sachs to tell whether a person is sane or insane. I presume you can tell by looking at me whether I am sane or insane.’ Very promptly I answered ‘Not by looking, but possibly by listening to you.’ That settled him.”

    He had a lucrative private practice but he lost most of his money when the stock market collapsed. Gradually, however, he regained his losses to become a philantrophist and art collector.

    Sachs published almost 200 articles and several books including The Normal Child (1926) wherein he largely advocated that parents should be guided by common sense and not pyschological theories, and in which he particularly attacked Freudian pyschology. This followed an earlier work directed at the medical profession rather than the lay public, Nervous and Mental Disorders From Birth Through Adolescence.


    Bibliography:

    • Die Hirnlähmungen der Kinder.

    • [Volkmann’s] Sammlung klinischer Vorträge, Leipzig, 1892.
    • A treatise on the Nnervous Diseases of Children.

    • New York, 1895; 2nd edition, 1905.
    • Syphilitic and Parasyphilitic Diseases of the Central Nervous System.

    • In: Modern medicine: its theory and practice, in original contributions by American and foreign authors", edited by William Osler, assisted by Thomas McCrae. Philadelphia and New York: Lea & Febiger, 7 volumes, 1907-1910. Volume 7, chapter XVII, pp. 682-720.
    • Amaurotic Family Idiocy (Tay-Sachs disease).

    • In: Modern medicine: its theory and practice, in original contributions by American and foreign authors", edited by William Osler, assisted by Thomas McCrae. Philadelphia and New York: Lea & Febiger, 7 volumes, 1907-1910. Volume 7, chapter XXI, pp. 868-874.
    • Nervous and Mental Disorders From Birth Through Adolescence.

    • With L. Hausman. New York, 1925.
    • The Normal Child. New York, 1930.

    7 - seidel's test

    Seidel

    .

    Seidel's test = a test which uses 2% sodium
    fluorescein to check for leaks such as
    post corneal trauma or post-trabeculectomy.

    Positive Seidel's test from from a punctured
    corneal wound.

    6 - stargardt's disease - karl bruno stargardt

    Karl Bruno Stargardt
    German ophthalmologist, born 4th December, 1875, Berlin; died 2nd April, 1927, Marburg.

    Stargardt's disease = The most frequently encountered juvenile onset macular degeneration characterised by multiple pisciform subretinal yellowish lesions.

    Biography:
    Karl Bruno Stargardt attended the universities of Heidelberg, Erlangen, and Berlin, and obtained his doctorate from the University of Kiel in 1899. He trained in ophthalmology in Kiel under professor Karl Völkers (born 1836), becoming assistant, respectively head physician at the university eye clinic. He then worked in the eye clinic at Strasburg and became head of ophthalmology at Bonn. In 1923 he succeeded Max Bielschowsky (1869-1940) in the chair of ophthalmology at the University of Marburg. Shortly afterwards, however, he developed nephritis and cardiac complications, and died in 1927.

    Bibliography:

    • Über Epithelzellveränderungen beim Trachom und andern Conjunctivalerkrankungen.

    • Albrecht von Graefes Archiv für Ophthalmologie, 1909, 69, 525-542.
      Degeneration of the inclusion bodies in ophthalmia neonatorum.
    • Diagnostik der Farbensinnstörungen. Berlin, 1912.

    5 - schirmer test - otto schirmer

    Otto Schirmer
    Otto Schirmer (1864-1918). German ophthalmologist.


    Schirmer test = this involves folding sterile filter paper strips and inserting them between the lower lid and the globe at the lateral one-third of the lid margin. The result is expressed as millimetres of wetting at 5 minutes. If local anaesthetic is instilled in the eye before performing this test, it is known as the basic Schirmer test.


    Otto Schirmer (1864-1918) was born in Greifswald and, after studying in the university of that city as well as in Munich, Freiburg, Königsberg and Halle, succeeded his father, Rudolf Schirmer, to the Chair of Ophthalmology in Greisfswald in 1896; he subsequently went to Kiel (1907) and Strassburg. His contributions to ophthalmology were considerable and varied, the best known being his work on the histology and biochemistry of cataract, his original description of the corneal complications of vaccinia of the eyelids, the first detailed study of rosacea keratitis, and his elaborate description of sympathetic ophthalmitis in the second edition of the Graefe-Saemisch Handbuch. His name, however, is most frequently remembered for his works on the lacrimal passages which included the elegant and simple test for the estimation of lacrimation which bears his name (1903); this was followed by his treatise on the microscope anatomy and physiology of the lacrimal system in the second edition of Graefe-Saemisch Handbuch in 1904, a hereditary task since his father had written on the diseases of the lacrimal apparatus in the first edition of this work (1877). In 1909 he left Strassburg and emigrated to New York where he joined the staff of the New York Postgraduate Medical School, the Herman Knapp Memorial Eye Hospital, and St. Marks and the Bronx Hospitals.


    Reference:

    Schirmer O: Studien zur Physiologie und Pathologie der Tranenabsonderung und Tranenabfuhr. Arch Klin Exp Ophthalmol 56:197, 1903.


    4 - sherrington's law - charles scott sherrington

    Charles Scott Sherrington



    English neurophysiologist, born 27th November, 1857, London, died 4th March, 1952, Eastbourne, Sussex.


    Sherrington's law = The law of reciprocal innervation: when one set of muscles is stimulated, muscles working against the activity of the first will be inhibited.


    Sir Charles Scott Sherrington's research, spanning more than 50 years, laid the foundations for modern neurophysiology. He maintained that the most important function of the nervous system in higher animals is the coordination of the various parts of the organism. Although best known for his long series of studies on spinal reflexes, he made equally great strides in the physiology of perception, reaction, and behaviour. He was the first to adequately study the synapse and originated the term. He also introduced the term exterioceptor, proprioceptor and viscerocepter. In 1932 he shared the Nobel Prise in Physiology or Medicine with Edgar Douglas Adrian.

    Sherrington was the son of Anne Brookes and James Norton Sherrington, of Caister, Great Yarmouth, a country physician who died when he was quite young. His mother married Caleb Rose, Jr., of Ipswich, a physician of wide cultural interests and a noted archaeologist. The Rose home, a gathering place for artists and scholars, helped to shape Sherrington's broad interest in science, philosophy, history, and poetry. One of his schoolmasters, Thomas Ashe, was a poet of considerable distinction.

    After attending the Ipswich Grammar School from 1870 to 1875, Sherrington, encouraged by his stepfather, began medical training at St. Thomas’s Hospital in London. He passed the primary examination of the Royal College of Surgeons in 1878, and a year later the primary examination for the Fellowship of that College.

    In 1879 he went to Cambridge as a noncollegiate student studying physiology under the “father of British physiology”, Sir Michael Foster (1836-1907), and in 1880 entered Gonville and Caius College there. During the years 1881-1885 he worked chiefly under two of Forster's pupils who were already becoming world famous – John Newport Langley (1852-1925) and Walter Gaskell (1847-1914). Langley and Gaskell imparted to him their dominant interest in how anatomical structure reflects, or is expressed in, physiological function.

    In 1881 he attended a medical congress in London at which Sir Michael Foster discussed the work of Sir Charles Bell and others on the experimental study of the functions of nerves that was then being done in England and elsewhere in Europe. At this congress controversy arose about the effects of excisions of parts of the cortex of the brains of dogs and monkeys done by David Ferrier (1843-1928) and Friedrich Leopold Goltz (1834-1902) of Strasbourg. Subsequently, Sherrington worked on this problem in Cambridge with Langley, and with him published, in 1884, a paper on it. In this manner Sherrington was introduced to the neurological work to which he afterwards devoted his life.

    In 1883 Sherrington became Demonstrator of Anatomy at Cambridge under Professor Sir George Humphrey, and during the winter session of 1883-1884 at St. Thomas's Hospital he demonstrated histology.

    From 1884 to 1887 Sherrington completed his medical courses. After graduation he worked with Langley, studying the anatomical changes in the cord and brain stem of decorticate dogs which had first been exhibited by Friedrich Goltz at the International Congress in 1881. This led to the first of many visits to Goltz' laboratory in Strassburg.

    Between 1884 and 1887 he turned his attention to bacteriology. In 1885 Sherrington went, as a member of a Committee of the Association for Research in Medicine, to Spain to study an outbreak of cholera, and in 1886 he visited the Venice district also to investigate the same disease. In Spain he met Santiago Ramón y Cajal (1852-1934) and later persuaded him to lecture in England. He also went to Berlin to have the cholera material examined under the supervision of Rudolf Virchow (1821-1902), who later sent Sherrington to Robert Koch (1843-1910) for a six weeks' course in technique. Sherrington stayed with Koch to do research in bacteriology for a year. Thus he gained a superb grounding in physiology, morphology, histology, and pathology.

    He obtained his M.R.C.S. in 1884 and in 1885 a First Class in the Natural Sciences Tripos at Cambridge with distinction. During this year he published a paper of his own on the subject of Goltz's dogs. In 1885 he also took his M.B. degree at Cambridge and in 1886 became a Licentiate of the Royal College of Physicians.

    In 1887 Sherrington was appointed lecturer in physiology at St. Thomas’s medical school in London, where he continued to investigate the spinal tract. From 1891 to 1905 he served as physician-superintendent of the Brown Institution, a centre for human and animal physiological and pathological research, succeeding Sir Victor Alexander Haden Horsley (1857-1916). Here he was able to observe animals with chronic spinal lesions.

    In 1895 Sherrington was appointed Holt Professor of physiology in Liverpool, where he did much of his best work. From 1913 until his retirement in 1935 he held Waynflete chair of physiology at Oxford, succeeding Francis Gotch (1853-1913).

    Research
    Working on cats, dogs, monkeys and apes that had been bereaved of their cerebral hemispheres, he found that reflexes must be considered integrated activities of the total organism, not just the result of the activities of the so-called reflex-arcs, a concept then generally accepted. The proofs supporting "total integration" were his demonstration during the years 1895 to 1898 of reciprocal innervation of muscles, also known as Sherrington's law: when one set os muscles is stimulated, muscles working against the activity of the first will be inhibited.

    He developed the theory of transmission at the synapse being in one direction, decerebrate rigidity was then a background in which the presence of reciprocal inhibition was lost and these findings and theories resulted in his publication in 1906 a monograph entitled Integrative action of the nervous system which remains a classic.

    In this classic of modern neurology, he summed up his years of experiments and observations on the nervous system and the reflexes and developed a theory that has had a far-reaching and profound influence on modern neurophysiology and clinical neurology. Briefly, his theory was that the nervous system acts as the coordinator of various parts of the body and that the reflexes are the simplest expressions of the interactive action of the nervous system, enabling the entire body to function toward one definite end at a time. Shared the Nobel prize with Adrian for their work on the nervous system.

    He established the nature of postural reflexes and their dependence on the anti-gravity stretch reflex and traced the afferent stimulus to the proprioceptive end organs which he had already shown to be sensory in nature.

    Most of his work occurred after he had been appointed professor of physiology at Liverpool on 1895.

    The man
    Sherrington married Ether Wright of Suffolk, England, on August 27, 1891; their only child, Carr E. R. Sherrington, was born in 1897

    In physique Sherrington was a well-built, but not very tall man with a strong constitution which enabled him to carry out prolonged researches. During the First World War, as Chairman of the Industrial Fatigue Board, he worked for a time in a shell factory at Birmingham, and the daily shift of 13 hours, with a Sunday shift of 9 hours, did not, at the age of 57, tire him. From his early years he was short-sighted, but he often worked without spectacles.

    Besides his scientific work Sherrington was a man of wide interests and accomplishments: biographer, medical historian, poet, and book collector – and sportsman. As a boy and a young man Sherrington was a notable athlete both at Queen Elizabeth's School, Ipswich, where he went in 1871, and later at Gonville and Caius College, Cambridge, for which College he rowed and played rugby football; he was also a pioneer of winter sports at Grindelwald, Switzerland.

    Sherrington always had a love for classics and poetry and in 1925 published a volume of collected verse, The Assaying of Brabantius and other Verse.

    Following his retirement he published Man on his Nature, which centres round the life and views of the 16th century French physician Jean Fernel , and in 1946 The Endeavour of Jean Fernel.

    He was elected President of the Royal Society of Physicians in 1920 and held this chair of honour for five years. Other honours included the Knight Grand Cross of the British Empire (1922) and the Order of Merit (1924). At his death he was an honorary fellow, member, or associate of more than forty academies, and he had received honorary degrees from twenty-two universities.

    In 1932 Sir Charles Scott Sherrington shared the Nobel Prise in Physiology or Medicine with Edgar Douglas Adrian, 1st Baron Adrian (1889-1977). The received the prize "for their discoveries regarding the function of neurons."

    From 1941 onwards he developed a painful arthritis which remained with him until he died. Right until the end he maintained his mental alertness and was an entertaining conversationalist.

      Suppose we choose the hour of deep sleep. Then only in some sparse and out of the way places are nodes flashing and trains of light-points running. Such places indicate local activity still in progress. At one such place we can watch the behaviour of a group of lights perhaps a myriad strong. They are pursuing a mystic and recurrent manoeuvre as if of some incantational dance. They are superintending the beating of the heart and the state of the arteries so that while we sleep the circulation of the blood is what it should be. The great knotted headpiece of the whole sleeping system lies for the most part dark, and quite especially so the roof-brain. Occasionally at places in it lighted points flash or move but soon subside. Such lighted points and moving trains of light are mainly far in the outskirts, and wink slowly and travel slowly. At intervals even a gush of sparks wells up and sends a train down the spinal cord, only to fail to arouse it. Where however the stalk joins the headpiece, there goes forward in a limited field a remarkable display. A dense constellation of some thousands of nodal points burst out every few seconds into a short phase of rhythmical flashing. At first a few lights, then more, increasing in rate and number with a deliberate crescendo to a climax, then to decline and die away. After due pause the efflorescence is repeated. With each such rhythmic outburst goes a discharge of trains of travelling lights along the stalk and out of it altogether into a number of nerve branches. What is this doing? It manages the taking of our breath the while we sleep.
      Man on His Nature, Chapter 7.

      Paradoxical though it may sound, the more skilfully a demonstration experiment is performed the less from it do some students learn.
      Mammalian Physiology, Preface.

      "It is as if the Milky Way entered upon some cosmic dance. Swiftly the brain becomes an enchanted loom, where millions of flashing shuttles weave a dissolving pattern, always a meaningful pattern though never an abiding one; a shifting harmony of subpatterns."
      The Integrative Action of the Nervous System

      Men think themselves free, because they are conscious of their volitions and of their desires and are oblivious to the causes which dispose them to desire and to will.
      Man On His Nature, page 163

      Swiftly the head-mass becomes an enchanted loom where millions of flashing shuttles weave a dissolving pattern, always a meaningful pattern though never an abiding one; a shifting harmony of sub-patterns. Now as the waking body rouses, subpatterns of this great harmony of activity stretch down into the unlit tracks of the stalk-piece of the scheme. Strings of flashing and travelling sparks engage the lengths of it. This means that the body is up and rises to meet its waking day.
      Man On His Nature, page 178

      The mind is a something with such manifold variety, such fleeting changes, such countless nuances, such wealth of combinations, such heights and depths of mood, such sweeps of passion, such vistas of imagination, that the bald submission of some electrical potentials recognizable in nerve-centres as correlative to all these may seem to the special student of mind almost derisory. It is, further, more than mere lack of corresponding complexity which frustrates the comparison.
      Man On His Nature, page 228

      If as you say thoughts are an outcome of the brain we as students using the energy-concept know nothing of it; as followers of natural science we know nothing of any relation between thoughts and the brain, except as a gross correlation in time and space. In some ways this is embarrassing for biology.
      Man On His Nature, page 229

      We have to regard the relation of mind to brain as not merely unresolved but still devoid of a basis for its very beginning.
      Man On His Nature

      The eye sends, as we saw, into the cell-and-fibre forest of the brain, throughout the waking day continual rhythmic streams of tiny, individually evanescent, electrical potentials. This throbbing streaming crowd of electrically shifting points in the spongework of the brain bears no obvious semblance in space-pattern, and even in temporal relation resembles but a little remotely the tiny two-dimensional upside-down picture of the outside world which the eyeball paints on the beginnings of its nerve-fibres to the brain. But that little picture sets up an electrical storm .... A shower of little electrical leaks conjures up for me, when I look at him approaching, my friend's face, and how distant he is from me they tell me. Taking their word for it, I go forward and my other senses confirm that he is there.
      Man On His Nature, page 128-129


    Reference:

    • On the regulation of the blood supply.

    • With Charles Smart Roy (1852-1897). Cambridge, 1890.
    • Notes on the arrangement of some motor fibres in the lumbo-sacral plexus.

    • Journal of Physiology, London, 1892, 13: 621-772.
    • Further experimental note on the correlation of antagonistic muscles.

    • Proceedings of the Royal Society of London, 1893, 53: 407-420.
      The first of Sherrington's papers investigating reciprocal innervation of muscles.
    • The Central Nervous System. In volume III of Michael Foster, A Textbook of Physiology. 7th edition. London 1897.

    • The Mammalian Spinal Cord as an Organ of Reflex.

    • Croonian Lecture. Proceedings of the Royal Society, 1897, 61: 220-221.
      Abstract. Printed fully in:
    • Experiments in Examination of the peripheral Distribution of the fibres of the Posterior Roots of Some Spinal nerves.

    • Philosophical Transactions of the Royal Society of London, 1898, 190B: 45-186.
    • Decerebrate Rigidity and Reflex Co-ordination of Movements.

    • Journal of Physiology, 1898, 22: 319-332.
    • On the Spinal Animal (The Marshall Hall Lecture).

    • Medico-Chirurgical Transactions, London, 1899, 82: 449-477.
    • The Parts of the Brain Below the Cerebral Cortex.

    • In Edward Albert Schäfer (1850-1935), editor: Text Book of Physiology. II. Edinburgh, 1900: 783-1025.
    • Cutaneous Sensations.

    • In E. A. Schäfer, editor: Text Book of Physiology. II. Edinburgh, 1900: 783-1025.
    • The Muscular Senze.

    • In E. A. Schäfer, editor: Text Book of Physiology. II. Edinburgh, 1900: 783-1025.
    • The Correlation of Reflexes and the Principle of the Common Path.

    • Report of the British Association for the Advancement of Science, 1904, 74: 1:14.
    • On the proprio-ceptive system, especially in its reflex aspect.

    • Brain, 1906, 29: 467-482.
    • The integrative action of the nervous system.

    • New York, Charles Scribner's Sons, 1906. London, Constable, 1911. "Entirely reset with a new foreword by the author and a bibliography of his writings", Cambridge University Press, 1947.
    • Reflex Inhibition as a Factor in the Co-ordination of Movements and Postures.

    • Quarterly Journal of Experimental Physiology, 1913, 6: 251-310.
    • A manual of school hygiene.

    • With E. W. Hope and E. A. Browne; Cambridge, 1913.
    • Mammalian physiology. Oxford and London, 1919.

    • Some Aspects of Animal Mechanism. Presidential Address. British Association for the Advancement of Science.

    • Report of the British Association for the Advancement of Science, 1922, 1: 1-15.
    • Reflexes in response to stretch (myotatic reflexes).

    • Written with E. G. T. Liddell. Proceedings of the Royal Society of London. Series B, Biological Sciences, 1924, 86: 212-242.
    • The Assaying of Brabantius and Other Verses. Oxford, 1925.

    • Remarks on Some Aspects of Reflex Inhibition.

    • Proceedings of the Royal Society, 1925, 97B: 519-545.
    • Numbers and Contraction-values of Individual Motor-units Examined in Some Muscles of the limb.

    • Written with J. C. Eccles. Proceedings of the Royal Society, 1930, 106B: 326-357.
    • The Reflex Activity of the Spinal Cord.

    • Written with R. S. Creed, at al. Oxford, 1932.
    • Inhibition as a Co-ordinative Factor. Stockholm, 1932.

    • The Nobel lecture delivered at Stockholm, December 12, 1932.
    • The Brain and Its Mechanism. Cambridge, 1933.

    • Man on His Nature.

    • The Gifford lectures, Edinburgh: New York: MacMillan, 1937-1938. Cambridge, 1940. 2nd edition, 1952. This work is still in print. The 1978 edition is edited by Derek Ernest Denny-Brown (1901-1981).
    • The Endeavour of Jean Fernel. Cambridge, 1946.

    • Jean François Fernel (1497-1558), author of the first work devoted exclusively to physiology and the first to call the subject by that name: De naturali parte medicinae libri septem. Parisiis, apud Simonem Cooinaeum, 1542.
    • Marginalia. In E. A. Underwood, editor: Science, Medicine, and History, II. Oxford, 1954: 545-553.

    • Edgar D. Adrian:

    • The Analysis of the Nervous System: Sherrington Memorial Lecture.
      Proceedings of the Royal Society of Medicine, London, 1957, 50: 991-998.
    • John F. Fulton:

    • Sir Charles Scott Sherrington, O. M.
      Journal of Neurophysiology, 1952; 25: 167-190.
      Contains a complete Sherrington bibliography.

      Historical Reflections on the Backgrounds of Neurophysiology: Inhibition, Excitation, and Integration of Activity. In Chandler M. Brooks and P. F. Cranefield, editors, The Historical Development of Physiological Thought. New York, 1959.

    • Judith P. Swazey:

    • Sherrington’s Concept of Integrative Action.
      Journal of the History of Biology, 1968, 1: 57-89.
      Reflexes and Motor Integrations: Sherrington’s Concept of Integrative Action. Cambridge, Massachusetts, 1969. Contains an extensive although not complete bibliography.



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