'Here there are lions'

Abstract

Alastair CompstonBrain Editorial Office ED Adrian Building Department of Clinical Neurosciences University of Cambridge, Forvie Site Cambridge CB2 0PY, UK E-mail: brain@medschl.cam.ac.ukAsked by the White Rabbit ‘Where shall I begin, please your majesty’, the King said gravely ‘Begin at the beginning, and go on till you come to the end: then stop’ [Lewis Carroll (1832–98): Alice's Adventures in Wonderland, 1865]. But is the beginning also the start? Thomas Willis (1621–75) borrowed a word from the Greek for sinew, tendon or bowstring based on his observations while dissecting cranial, spinal and autonomic nerves, and coined a phrase that has stuck: ‘Interim hâc speculatione dimissa, pensi nostri Anatomici quod residuum est, νευρολογιαε sc. Specialem, aggrediemur’ [in the meantime, leaving this Speculation, we shall proceed to the remaining Task of our Anatomy, to wit, the Neurologie or of the Nerves, in particular] (Cerebri Anatome 1664, p. 273; translated in The Remaining Medical Works etc.: 1681, p. 136). In ‘A TABLE of all the hard words derived from the Greek and Latin, of all Terms of Art and other words not vulgarly received, with the explanation of them’, his translator, S[amuel] P[ordage] Esq. (1633–c.1691), offers a definition: ‘Neurologie, The doctrine of the Nerves’ [The remaining medical works etc.; 1681 (p. 8)]. Now, clinical neurology integrates knowledge on structure and function of the brain and spinal cord in health and disease; a system of deductive conversation and physical examination for describing altered function; a range of ancillary laboratory investigations led by the revelations of brain imaging; an evolving nosology of neurological disease; and progress towards mechanism-based therapeutics aimed at limiting and repairing the damage in a range of disorders that threaten physical and intellectual activities across the entire lifespan. The history of neurology is characterized by periods of intense activity interspersed with long intervals when progress was slow: the pillars of knowledge secure amongst the rubble of …