SOUL MADE FLESH: THE ENGLISH CIVIL WAR AND THE MAPPING OF THE MIND * Carl Zimmer * 2004. London: Heinemann * Price  17.99. ISBN 0434010464

For more than a century, admirers of the life and work of Thomas Willis (1621–1675) have tried to retrieve him from the penumbra cast by the historical limelight of his famous Oxford compatriots—Harvey, Sydenham,Boyle, Wren and Lower—and his brilliant students Hooke and Locke. Their sustained efforts have had some success. Charles Sherrington (1951) 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.’ 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. 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.’ 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). from the Octavo 1664 edition of Cerebri Anatome 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). unfolded sheep's brain 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. 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 when at the age of he was Professor of and his from Oxford on the of Charles For this he was sponsored by one time of who then was Bishop of Oxford and eventually of and of Oxford Willis dedicated his on the anatomy, pathology and clinical aspects of the nervous system to his and a medical and (Willis, Willis his which him to give lectures on and he with the of of the of the and the and of the with being he to himself to the of anatomy and into the and uses of the Brain and its nervous He for this Richard Lower, a and Christopher then Professor of who had and Thomas a before Cerebri Anatome was Willis had another work on the pathology of the brain (Willis, his of was largely devoted to neuro-anatomy and clinical neurology (Willis, In this Willis his views on an soul separate from the brain and a soul that was on a of that through the nervous which could other part of the Zimmer an and account of the and these medical and that Willis' John Locke and many other His and to many by a an and a He sometimes takes a certain and in with to the story His have a few as to the work as all of the brain of were figures of the and cerebral convolutions were as as of In his ‘The Zimmer a temporal and from the Willisian in Oxford to a research of brain and the of brain on by The in a field for to the brain on small of blood that associated with brain of the one can as an of the observations by Willis, Wren and Lower on the cerebral circulation 300 years Thomas Willis would have been that so much of the work can be examined as he of and of every and to as much as was able and the Carl Zimmer has the of the of the brain and it more as a of the studies of Willis and his colleagues that out as in the from to modern views of the brain (Feindel, However, as (2004) has of the brain the but for the who to the the until more in the of neurological the mechanism of memory and or understanding the for in our Wilder (1965) it up in his to the tercentenary edition of The Anatomy of the Brain and Nerves of Thomas Willis when he ‘The of neurology is to man

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.