History of the Brain
All started in the Pre-History, at 3000 years B.C., with the trepanations.
The perforation of the cranium by principals of mystic nature - the surgeon who practiced them, made it in cadaverous human body's and even in alive persons. The most part of the "ills" died in the surgery, or in consequence of the same; one died immediately, the others because of the infections that were caused by the lack of asepsis. But some of them survived and the perforations scared, although the brutality of the therapeutic techniques adopted.
If in the reality the propose would be cure, in some of the cases, it's pure conjecture. Perhaps it was just the consecration of a victim, in sacrifice. But, in the ilimitated fields of the hipotese, speculates at the respect of the medicinal character of the trepanations. In the death human body's, they could be made to try to give them life. In the live persons, a way to gave escape to a demon, that was aprisioned in the brain of the people that had headaches, hysteria or epilepsy. This type of possessions by demons still exists in the primitive tribes. Also in the Medium Age we could find usually the brutal perforation of the cranium of the epileptics with the intention of killing the demons that were aprisioned inside victims.
Whatever was the finality of the pre-historic trepanations, we put over discussion the ability of whom who made it. Trepanations consisted in the simple remission of a osseous rectangle obtained by perforating four little holes. In other cases, the surgeon used the alignment of the holes, in bigger number, in rectangular or circular formation, to remove the portion of the cranium box.
Now, we're in the Renaissance. Leonardo Da Vinci and Andre Vesalio(1514 -1564), were the two most important figures in Medicine. Leonardo Da Vinci made the draws of the anatomical parts of the human body. Vesalio, most dedicated to the anatomy of the body, made important discoveries in the field of the Central Nervous System (CNS), and it's also considered as the Father of the Anatomy. Leonardo Da Vinci made a draw of the brain(Figure 1), drawing the "spectacular net", the ramifications of the brain. He was most known, in the medical field, as a physiognomyst, doing the so well known draws of the anatomical regions of the body, like the heart, brain, placenta, and so on.... The discoveries that Vesalio had made in the brain, can be seen in Figure 2, the blood vessels that ramificate the brain.
In Renaissance, the period of the "renaissance" of antique ideas of the Greeks, Romans, and other important civilizations of the past, which had made important researches in many fields. One of them, it's the Medicine, included in the Humanism. Claudio Galeno, an antique Greek doctor, born in Pergamus, in the year of 130 A.D. had lived 71 years, full of experiences and researches. But Vesalio, in the Renaissance, criticized very much Galeno affirming this: "The infallible Galeno was wrong, sometimes he only dissected monkeys". Vesalio knew what he was doing when he referred to "the famous master Galeno" in his book "De Humani corporis fabrica septum", published in 1543. This book has many things about the human body, corrections that Vesalio had made, of other anatomists from the past. Today, doctors consider him the Father of the Anatomy, and he's famous, not for his contribution giving new discoveries in the field of the Anatomy, but for the corrections that he had made to what was wrong (correct in the past, but wrong for Vesalio) and the contribution of his scientific method in the description of the human body's structure.
Now, we're going to the XVIII century where the brain became almost discovered, but the "last job" would be reserved to the next century. Well, in this century, François Magendie(1783-1855) wrote in one of his experiences:
"I have under my eyes the posterior roots of the lumbar nerves and sacrum and put them up, successively, with the sharps of little scissors , I can cut which of them, leaving intact the spinal cord (...) I also saw that they were moving, even if the sensibility was totally absent (...) I thought probable that the posterior roots of spinal nerves could have a different function of the anterior roots, and also that they were specially related with the sensibility."
These are the 3 principal points of an essential experience, realized and related by François Magendie. Born in France, he always fought against the vitalism, and he only accepted what was true, only if that thing was experimentally demonstrable. Because of that constant doubt, he would discover the true function of the posterior roots of the spinal nerves. With the researches of Charles Bell(1774-1842), that discovery gave origin to the law of Bell-Magendie, about the function of the roots of the spinal nerves. In fact the English, Charles Bell, discovered, before Magendie that the posterior roots could be cut "without agonizing the muscles"- that only happens if the anterior root were touched. Before this law(Bell-Magendie), some doctors had the intuition that a cerebral location could exist in many mental functions, specially the psiquic ones. Then, in the 17th November of 1708, the French surgeon, François De Le Peyronie (1678-1747), made a communication to the Real Society of Sciences, in Montpellier, where he showed one anatomic-clinic method of studying the brain, in six patients, only trying to see the aspect of the location zones of the brain.
Franz Joseph Gall(1758-1814), German doctor, used the idea of François De La Peyronie, and toke this idea to the last consequences. He taught that certain intellectual functions were in correspondence with some cerebral zones. In fact, he thought that, the intensity of that intellectual functions variated with the bosses in the brain (said Gall). Because of this, the palpation and inspection of a person cranium, permits to define his/her, moral/intellectual personality. This theory is most known like phrenology. It seems that Gall really believed in his theory and between 1810 and 1819, he published in Paris the "Anatomy and Phisiology of the Nervous System in General and of the Brain in Particular". In this book, Gall, makes the difference between the gray mass and the white mass. He also wrote that, the nerves functioned like transmitters that arrive to the brain using "ways" or spinal cord roots.
Here we are; the XIX century. With some exceptions of discovers in the XX century, the brain became "totally" discovered.
In 1855, Bartolomeu Panizza, recognizes in the cerebral cortex of the occipital lobe, the center of the vision. In 1861, Pierre Paul Broca (1824 -1880), founds the center of speak, where the lesion of this part conduces to a "truth motor aphasia". We are going to write a little bit more about Pierre Paul Broca.
Pierre Paul Broca, French, born in Saint-Foy-la-Grande, diplomat in Medicine, in Paris (1849). Seven years later he becomes professor (ups one degree), and he starts to practice surgery in many hospitals. In 1868 he gets specialized in anatomic surgery. In 1861, the foundator of the modern surgery of the brain, starts to get interest by a central zone of the organ, situated in the beginning of the 3th frontal circumvolution of the cerebral cortex, in the interior part of the left hemisphere. His anatomy-pathologic researches were made in cadavers that during life, lost the capacity of speaking, without any peripheral lesions of speak (tongue or another phonation organs). During the autopsies, Broca always founds a lesion in that central zone. In February of 1861, a scientist, presents a work about the mean of the brain volume-and that document brings a discussion about the cerebral locations. At that time, Broca was treating a patient that had an inflammation in a thigh, and that a long time ago lost the speak. When the patient died, Broca did the autopsy and the result was a cerebral lesion, because of an extensive softness of the left hemisphere. Broca also observed that the oldest part of the lesion was precisely the 3th frontal circumvolution of the cerebral cortex: in this point is located the center of the articulated language. First, this phenomena was called by Broca as "aphemia", but it was changed by Trousseau to "aphasia".
Finally, to end this century, the last revolutionary discovery of the brain. The name of the doctor who made this discovery is Camillo Golgi.
Camillo Golgi(7 July 1844 - 21 January 1926), born in Valcamonica (Italian) , start studying in Pavia and ended that studies in 1865. Before Golgi, in the beginning of the century, Reil described the external aspect of the brain and his fissures. Ehrenberg, in 1833, discovers the path followed by some nerves. Von Helmhotz, Remak and Purkinje, described, thanks to the old dissection methods, the biggest cells of the brain.
The substitution of the alcohol by the chromic acid or, potassium dichromate, increased the tissues resistance, that permited Wagner and Deiters to show, for the first time, that all the nerve has origin in one unique cell. All the discovers that were made(by Reil, Ehrenberg, Von Helmhotz, Remak, Purkinje, Wagner and Deiters), are the basis of the works and discovers of Golgi.
Then, in 1873, in the Lombard Italian Medicine Magazine, appears an article titled: "About the structure of the gray substance of the brain", were is described a revolutionaire method of coloration, called "black reaction", or, "chrome-argent impregnation" . The author of the article and of the new method, is the Italian, Camillo Golgi. It was marked a new step in the histology and pathology of the brain. Thanks to the black reaction, impregnating with the silver chromate the nervous cells in all is expansions, Golgi can follow the cellular tissue in the many thin ramifications.
The black reaction, with superior clearness of a draw, reveals all the cellular body. Before this, the scientists only saw confuse contours, but now they could see clear images. We can see it in Figure 5, and in Figure 6, were we have the sharps with the chrome-argent impregnation, prepared by Golgi.
The news of his death, in 21 January 1926, appeared like this, in a newspaper:
"All the people of the medical and biological sciences respect the memory of the master that honored in the world of science, our country"
In the XX century, the humanity gets one important step in the pathology of the brain. For that important step contributed, until nowadays, Harvey Cushing and Egas Moniz. Both surgeons, and from diferent countries (Harvey Cushing was American and Egas Moniz, Portuguese), made the most important discoveries of this century. In this "chapter", we will write about Harvey Cushing and about all the important Portuguese doctors (between them is Egas Moniz). And you will ask "Why only Portuguese doctors?", and the answer is "Because we are Portuguese".
Harvey Cushing(8 April 1869 - 7 October 1939), born in Cleveland, Ohio. In 1891, is in the Harvard Medical School. When he finishes college, he goes to the General Hospital of Boston, where he worked until 1896. He goes and stays 11 years in the Johns Hopkins Hospital, in Baltimore. During that time, Cushing, made an improvement of the surgery technique of the CNS. The first results are dramatics. The major part of the patients died in the surgery room. The neuron-surgery team became terrified. Then in February of 1910, Cushing, makes the operation to the chief of the Major State of the American Army, extracting the meningiome(tumor) of the occipital lobe of the brain. In 1912, Cushing is invited by Harvard. The team is changed and together they established one of the most famous surgery clinics of the U.S.A.: the Peter Bent Brigham Hospital. In the same year, he published his first monograph about pituitary tumors, that made him internationally known. In 1932, Cushing, is obliged to leave the Chief-Surgeon place, because of his age. He leaves with sadness the place where he worked during 20 years. At this age, he gets Neurology in the University of Yale. Cushing, enter in contact with an ex-student, John Fulton, to which he wants to transmit "all the knowledgement that he had received from the Professor William Osler, the biggest humanist doctor of his generation". He also entered in contact with a friend of him, Arnold Klebs, proposing to make an union with him and Fulton making a "pact of friendship and donation to the science". The three agreed in donate, after their death, their libraries to the University of Yale, but only if they built a building, only to the library, and only if it was instituted a subject of History of Medicine. He died in the 7th October 1939, in New Haven.
Antonio Caetano de Abreu Freire(29 November 1874 - 13 December 1955), or Egas Moniz, doctor and neurosurgeon, born in Alvença, Portugal. He was the inventor of the pre-frontal leukotomy (also known as frontal lobotomy), a surgery method to the treatment of many mental diseases(psychosurgery).
For his work in this area, Moniz had received the Medicine and Physiology Nobel Prize in 1947, with the Swiss physiologist Walter Hess. Moniz, studied medicine in the University of Coimbra (in Portuguese, Universidade de Coimbra) and neurology in the Universities of Bordeaux and Paris. He returned to the University of Coimbra with the Ph. D. in neurology, in 1902, but soon left the medicine by a politic career. Then, he left politics in 1920 and he returns to the medicine life and teacher, in the University of Lisbon, were he stayed between 1921 and 1944. There, he developed, in 1927, the technique of contrasted X-Radiography, of the blood vessels in the brain (arteriography), that later became a valuable method to the diagnostics of many cerebral diseases, like tumors, aneurysms, congenit cerebral malformations, etc.... In 1936, Egas Moniz and his assistant Almeida Lima developed, for the first time, a surgery technique to stop the nervous fibers that connect the thalamus (an intermediary relay to the sensorial information that arrives to the brain from the exterior) and the pre-frontal cortex (cerebral structure that is involved in the superior intellectual capacities , and also involved with the emotional control).
His technique was used very often in all the world, and Moniz received many scientific recognizement, finishing with the Nobel Prize. Egas Moniz became paralyzed as result of a shot given by one of his ex-patients. Died in Lisbon, Portugal, in the 13 December 1955.
Now, we will talk about Antonio Damasio.
Antonio Damasio is Van Allen Distinguished Professor and head of the Department of Neurology at the University of Iowa: and Adjunct Professor at The Salk Institute in La Jolla.
Damasio's work has focused on elucidating critical problems in the fundamental neuroscience of mind behavior, at the level of large-scale systems in humans, although his investigations have also encompassed parkinsonism, Alzheimer's disease and autism. His contributions have had a significant and sometimes radical influence on our understanding of the neural basis of decision-making, emotion, language, visual recognition, and memory.
Damasio is a member of the National Academy of Sciences' Institute of Medicine; a Fellow of the American Academy of Arts and Sciences a member of the national Advisory Council on Neurological Diseases and Stroke; a Fellow of the American Academy of Neurology a member of the European Academy of Sciences and Arts and of the Royal Academy of Medicine in Belgium; a member of the American Neurological Association, and a board member of leading neuroscience journals. He is a Past President of the Academy of Aphasia and of the behavioral Neurology Society.
Damasio's distinguished lectureships include the Wilson Lecture (Wellesley), the Steubenbord Lectures (Cornwell University), the Public Lecture at the Society for Neuroscience, the Arid Lectures (University of California, San Francisco, the Nobel Conference, the Karolinska research lecture at the Nobel Forum, and the Presidential Lecture at The University of Iowa). Since 1981 he has delivered an annual series of lectures on the neurology of behavior at Harvard Medical School. Among several distinctions that recognize his contributions to medical science and are the William Beaumont Prize from the American medical Association (1990) and the Golden Brain Award (1995). In 1992 he and his wife shared the Pessoa Prize.
Antonio Damasio's' book "Descartes' Error: motion, Reason and the Human Brain" (Putnam, 1994) has been published in over 20 countries.
Damasio was born in Portugal. He received both his MD and his doctorate from the University of Lisbon, and began his research in the are of cognitive neuroscience with the late Norman Geschwind.
Below it's a little bit of its Curriculum VitÆ, if we can call it like that:
Medical School
MD, University of Lisbon Medical School, Portugal
Doctorate, University of Lisbon, Portugal
Internship and Residency
(Neurology), University Hospital, Lisbon, Portugal
Rotating Internship, University Hospital, Lisbon, Portugal
Fellowship
Research Fellowship, Aphasia Research Center, Boston
Honors and Awards
Elected to American Academy of Arts and Sciences, 1997
Elected to Neurosciences Research Program, 1997
Elected to the National Academy of Sciences' Institute of Medicine, 1995.
Golden Brain Award, 1995.
Order of Santiago da Espada (Grand Oficial), 1995.
Elected to the European Academy of Arts and Sciences, 1993.
Pessoa Prize, 1992.
Elected to the Royal Academy of Medicine of Belgium, 1991.
William Beaumont Prize from the American Medical Association, 1990.
Professional Activities/Editorial Boards
National Advisory Neurological Disorders and Stroke Council
Planning Subcommittee, National Advisory Neurological Disorders and Stroke Council
Advisory Board, The Neuroscientist
Board Editor, Learning and Memory (Cold Spring Harbor Laboratory)
Board Editor, Cognitive Brain Research
Board Editor, Journal of Neuroscience
Board Editor, Cerebral Cortex
Clinical Interests
Disorders of behavior and cognition
Movement disorders
Research Interests
The neurobiology of the mind, specifically the
understanding of the neural systems which subserve memory, language, emotion, and
decision-making.
Recent Publications/ Reviews
Damasio AR: Descartes' Error: Emotion, Reason and the
Human Brain, Grosset/Putnam, New York, 1994; (hardcover); Avon Hearst, New York, 1995;
(paperback).
Bechara A, Tranel D, Damasio H, Adolphs R, Rockland C, Damasio A: A double dissociation of conditioning and declarative knowledge relative to the amygdala and hippocampus in humans. Science, 269:1115-1118, 1995.
Damasio AR: The somatic marker hypothesis and the possible functions of the prefrontal cortex. Proceedings of The Royal Society, 351: 1413-1420, 1996.
Will we one day, discover completly the brain?
Can we, one day, make cerebral transplants?
Will we be able, one day, to make a substitute of the neurons?
Only the future knows, and many persons like these one, described
upper in the text, will appear, and will make many important discoveries.
