Historical perspective Brown-Sequard and his work on the spinal cord

Abstract

Charles Edouard Brown-Sequard was born in Mauritius in 1817, graduated as a physician in Paris in 1846, was a founder-physician of the National Hospital (for Neurology and Neurosurgery) in England, and held the Chair of Physiology and Pathology of the Nervous System at Harvard College before succeeding Claude Bernard as professor of medicine at the College de France in Paris, where he remained until his death in 1894. Erratic and unpredictable, he spent much of his life in traveling between Europe and the United States, married three times, fathered three children, authored almost 600 scientific publications, and was the founder-editor of three journals. Widely regarded as a founder of modern endocrinology, his work on tissue extracts toward the end of his career brought scorn and derision from colleagues and much of the lay public, but was the foundation of modern hormone replacement therapy. Brown-Sequard made many contributions to neurology, but is best known for his work on the sensory pathways in the spinal cord. He initially showed that these pathways are not confined to the posterior columns and that certain sensory fibers decussate soon after their entry into the spinal cord, and he subsequently described the clinical features of the syndrome now named after him. In his later life, he modified his views to suggest that dynamic spinal mechanisms are responsible at least in part for the sensory changes resulting from spinal cord lesions, stressing that any deficit is not simply the result of the interruption of a hard-wired system. The clinical implications of these views are profound, but this aspect of his work has been virtually ignored until very recently.