Victor Horsley

Sir Victor Alexander Haden Horsley (April 14, 1857-July 16, 1916) was an accomplished scientist and professor. He was born in Kensington, London. He was educated at Cranbrook School, Kent and studied medicine at University College London and in Berlin, Germany (1881), and in the same year started his career as a house surgeon and registrar at the University College Hospital. From 1884 to 1890 Horsley was Professor-Superintendent of the Brown Institute. In 1886 he was appointed as Assistant Professor of Surgery at the National Hospital for Paralysis and Epilepsy, and as a Professor of Pathology (1887-1896) and Professor of Clinical Surgery (1899-1902) at University College London. He was a supporter for Women's Suffrage, and was an opponent of tobacco and alcohol.

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Horsley specialized in surgery and in physiology. He was the first physician to remove a spinal tumor, in 1887, by means of a laminectomy. He developed many practical neurosurgical techniques, including the hemostatic bone wax, the skin flap, the ligation of the carotid artery to treat cerebral aneurysms, the transcranial approach to the pituitary gland and the intradural division of the trigeminal nerve root for the surgical treatment of trigeminal neuralgia.

As a neuroscientist, he carried out studies of the functions of the brain in animals and humans, particularly on the cerebral cortex. His studies on motor response to faradic electrical stimulation of the cerebral cortex, internal capsule and spinal cord became classics of the field. These studies were later translated to his pioneering work in the neurosurgery for epilepsy. Horsley was also the first to use intraoperative electrical stimulation of the cortex for the localization of epileptic foci in humans, between 1884 and 1886, preceding Fedor Krause and Wilder Penfield.

He was also a pioneer in the study of the functions of the thyroid gland. He studied myxedema and cretinism, which are caused by a decreased level of the thyroid hormones (hypothyroidism), and established for the first time that they could be treated with extracts of the gland, in experiments with monkeys.

Appointed in 1886 as secretary to a governmental commission formed to study the anti-rabies vaccine developed by Louis Pasteur, Sir Victor Horsley corroborated his results and created a campaign to vaccine against rabies in the United Kingdom. As a pathologist, Sir Victor carried out research on bacteria and founded the Journal of Pathology.

His best known innovation is the Horsley-Clarke apparatus (developed together with Robert H. Clarke in 1908) for performing the so-called stereotactic neurosurgery, whereby a set of precise numerical coordinates are used to locate each brain structure. He was a pioneer in neurosurgery, having operated upon 44 patients.

He authored the book Functions of the Marginal Convolutions (1884) and, as a co-author, Experiments upon the Functions of the Cerebral Cortex (1888) and Alcohol and the Human Body (1902).

According to his biographers, Tan & Black (2002), "Horsley's kindness, humility, and generous spirit endeared him to patients, colleagues, and students. Born to privilege, he was nonetheless dedicated to improving the lot of the common man and directed his efforts toward the suffrage of women, medical reform, and free health care for the working class (...) An iconoclast of keen intellect, unlimited energy, and consummate skill, his life and work justify his epitaph as a "pioneer of neurological surgery."

Victor Horsley was knighted in 1902.

In the oubreak of the First World War, Sir Victor requested for active duty in the Western Front, but was posted in 1915 as a colonel and Director of Surgery of the British Army Medical Service in Egypt, in the Dardanelles Campaign. In the following year he volunteered for field surgery duty in Mesopotamia, where he died unexpectedly in Amarah, Iraq, on July 16, 1916, of heatstroke and severe hyperpyrexia, at only 59 years of age.

The Walton Centre for Neurology & Neurosurgery NHS Trust in Liverpool, England, a leading Hospital Neurosurgery, dedicted their Intesive Care Unit to Sir Victor Horsley and is called the Horsley ward.

References

• Tan TC, Black PM.: Sir Victor Horsley (1857-1916): pioneer of neurological surgery. Neurosurgery. 2002 Mar;50(3):607-11.
• Hanigan WC: Obstinate valour: the military service and death of Sir Victor Horsley. Br J Neurosurg. 1994;8(3):279-88.
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• Lyons, J B [2]
• AIM25 [3]

Source

From: The History of Psychosurgery
By: Renato M.E. Sabbatini, PhD
Brain & Mind Magazine, June 1997
Reprinted by permission.