Hughlings Jackson's neurological ideas.

Hughlings Jackson's neurological ideas are scientifically valid and practically useful. He began by emphasizing the focal lesion as the key to analysing patients' symptoms. He proclaimed that 'Epilepsy is the name for occasional, sudden, excessive, rapid, and local discharge of grey matter.' He eliminated any need for a direct appeal to metaphysical agents by asserting that the nervous system is an exclusively sensorimotor machine constrained by the newly discovered conservation laws. In constructing his neurophysiology he accepted the phrenological assumption that the nervous system is composed of a number of physiologically discrete organs, each with a single function accessible to the diagnostician. By observing the march of epileptic seizures he developed the idea of somatotopic representation. He claimed that the nervous system is an evolutionary hierarchy of three levels connected by the process of weighted ordinal representation. His assertion of the Doctrine of Concomitance further separated the concerns, and the institutions, of the neurophysiologist from that of the psychiatrist. He came to reject the idea of the unconscious because he could not observe unequivocally unconscious behaviour at the bedside. Each of these ideas emerged from contemporaneous scientific streams, but Hughlings Jackson was the one to incorporate them into practical medicine. These neurological ideas gave physicians the methods, tools, principles and structures with which to establish a new science of clinical neurology.

Localization of language function in the twentieth century.

In the twentieth century the method of identifying pathology in patients with aphasia has fluctuated between localizing and holistic theories. The practical localization of sensation and voluntary movement became a clinical commonplace in the beginning of the century, but the mental component of aphasia made its localization controversial. In Paris before the war, Pierre Marie made the localization of aphasia the centerpiece of his personal feud with Jules Dejerine. After the war Konstantin von Monakow used the phenomenon of recovery from aphasia to support his holistic views of localization. Henry Head, in a 1926 study that remains influential today, took a neo-Jacksonian approach to localization and the physiology of language. Kurt Goldstein led the postwar anti-localizationists, asserting that physicians must look after the whole person and that brain function was inherently unified. Norman Geschwind reflected 1960s physiological thought in analyzing aphasia as a type of disconnection of distinct functional areas. In the twenty-first century the localization of aphasia remains dependent on theory, with competition between holistic and localizing ideas.

Chapter 3: neurology in ancient Egypt.

Neurology, in the modern sense, did not exist in ancient Egypt, where medicine was a compound of natural, magical and religious elements, with different practitioners for each form of healing. Nevertheless, Egyptian doctors made careful observations of illness and injury, some of which involved the nervous system. Modern scholars have three sources of information about Egyptian medicine: papyri, inscriptions, and mummified remains. These tell us that the Egyptians had words for the skull, brain, vertebrae, spinal fluid and meninges, though they do not say if they assigned any function to them. They described unconsciousness, quadriparesis, hemiparesis and dementia. We can recognize neurological injuries, such as traumatic hemiparesis and cervical dislocation with paraplegia, in the well known Edwin Smith surgical papyrus. Similarly recognizable in the Ebers papyrus is a description of migraine. An inscription from the tomb of the vizier Weshptah, dated c. 2455 BCE, seems to describe stroke, and Herodotus describes epilepsy in Hellenistic Egypt. We have very little understanding of how Egyptian physicians organized these observations, but we may learn something of Egyptian culture by examining them. At the same time, modern physicians feel some connection to Egyptian physicians and can plausibly claim to be filling a similar societal role.

Hughlings Jackson's suggestion for the treatment of epilepsy.

John Hughlings Jackson articulated a neurologic method of systematically evaluating the anatomy, physiology, and pathology of every patient with neurologic disease. He used this mode of analysis to develop a theory of the physiology of epilepsy. We examined an example of his method in a newly discovered, unpublished manuscript containing his suggestions for the treatment of epilepsy based on his physiologic ideas. He had his private papers destroyed at the time of his death, but the Rockefeller Library of the University College London Institute of Neurology, Queen Square, contains a collection of his papers probably saved from destruction by his collaborator James Taylor. Among these articles is an 1899 memorandum, labeled "For Private Circulation" and entitled "A Suggestion for the Treatment of Epilepsy." In it, Hughlings Jackson claimed that focal discharging lesions cause both focal and generalized epilepsy, and that the cells in the lesion discharge their energy more easily than normal tissue. Citing microscopic evidence that such lesions are congested and inflamed, and that tuberculin destroys such tissue in the lung, he reasoned that destroying these unstable neurons with tuberculin would improve epilepsy. In this private manuscript, Hughlings Jackson uses an unusually detailed analysis of the pathology, anatomy, and physiology of epilepsy to predict a scientific approach to its treatment.

Cooperative control of UAVs for localization of intermittently emitting mobile targets.

Compared with a single platform, cooperative autonomous unmanned aerial vehicles (UAVs) offer efficiency and robustness in performing complex tasks. Focusing on ground mobile targets that intermittently emit radio frequency signals, this paper presents a decentralized control architecture for multiple UAVs, equipped only with rudimentary sensors, to search, detect, and locate targets over large areas. The proposed architecture has in its core a decision logic which governs the state of operation for each UAV based on sensor readings and communicated data. To support the findings, extensive simulation results are presented, focusing primarily on two success measures that the UAVs seek to minimize: overall time to search for a group of targets and the final target localization error achieved. The results of the simulations have provided support for hardware flight tests.

Weir Mitchell's observations on sensory localization and their influence on Jacksonian neurology.

BACKGROUND: John Hughlings Jackson (1835-1911) in London was critical in advancing the concept of cerebral localization. Hughlings Jackson, however, did not work in a vacuum. Silas Weir Mitchell (1829-1914), in Philadelphia, published several clinical observations related to localization. OBJECTIVE: To examine Weir Mitchell's clinical observations on sensory localization, to determine whether they influenced Jacksonian neurology, and to elucidate the private relationship between the two men. METHODS: The authors reviewed published (fictional and scientific writings of Weir Mitchell and scientific writings of Hughlings Jackson) and archival sources (Weir Mitchell's unpublished autobiography and Hughlings Jackson's unpublished correspondence with Weir Mitchell). RESULTS: In the 1860s, Weir Mitchell, through his work on phantom limb syndrome and other nerve injuries, made oblique references to the central representation of body parts, specifically with regard to sensation. Hughlings Jackson had an interest in somatotopic representation in the nervous system and repeatedly cited Weir Mitchell's work in support of his ideas. The two shared several patients, met at least once in London, and carried on a friendly correspondence. CONCLUSIONS: Weir Mitchell's observations on sensory localization were well known to Hughlings Jackson, who cited them in seminal articles on cortical localization. Their correspondence provides an example of trans-Atlantic scientific and clinical communication at the time that neurology emerged as a distinct clinical discipline.

Teaching real-time ultrasonic imaging with a 4-channel sonar array, TI C6711 DSK and MATLAB.

Ultrasonic medical imaging courses often stop at the theory or MATLAB simulation level, since professors find it challenging to give the students the experience of designing a real-time ultrasonic system. Some of the practical problems of working with real-time data from the ultrasonic transducers can be avoided by working at lower frequencies (sonar to low ultrasound) range. To facilitate this, we have created a platform using the ease of MATLAB programming with the real-time processing capability of the low-cost Texas Instruments C6711 DSP starter kit and a 4-channel sonar array. With this platform students can design a B-mode or Color-Mode sonar system in the MATLAB environment. This paper will demonstrate how the platform can be used in the classroom to demonstrate the real-time signal processing stages including beamforming, multi-rate sampling, demodulation, filtering, image processing, echo imaging, and Doppler frequency estimation.

Commentary. The diseases of Alexander the Great.

The accompanying articles that speculate that Alexander the Great had a traumatic carotid dissection or congenital cervical scoliosis demonstrate the difficulties in retrospective diagnosis as a historical enterprise. The extant primary sources were written centuries after Alexander's death and are ambiguous in their original languages, and even more so in translation. Thus we cannot be certain what illness Alexander actually had. Furthermore, anachronistic diagnosis removes Alexander from the medical context of this time, telling us little of historical significance about him. Such investigations also illustrate the more general limits that the absence of context imposes on the study of ancient history.