Victor Alexander Haden Horsley Biography (1857-1916)


Sir Victor Horsley earned recognition as the father of neurosurgery because of his experiments in physiology, the study of living organisms. While a medical student at University College in London, Horsley served as clinical clerkto Henry Charlton Bastian and developed a lifelong interest in the nervous system. While still in medical school, Horsley assisted Bastian with the text The Brain as an Organ of the Mind, and he illustrated a lecture by neurologist Sir William Gowers on spinal nerves and their relationship to the vertebral column.

While a house surgeon at University College Hospital, Horsley was reported tohave used himself as a research subject. After earning his medical degree with a gold medal in surgery, Horsley joined the medical service at UniversityCollege Hospital and National Hospital, Queen Square. He was also appointed assistant professor of pathology at University College and became superintendent of the Brown Institution. Horsley's affiliation with Brown laid the groundwork for his career in neurosurgery.

Horsley's pioneering work would not have been possible without the discoveries of anesthesia (1846), antiseptic principles (1865) (see Lister), and cerebral localization, the process which matched brain function with anatomy.

In 1886, Horsley performed 10 operations to remove brain tumors and was nameda Fellow of the Royal Society. In 1887, Horsley and his former professor, Sir William Gowers, performed the first surgery to remove a spinal tumor. Although the surgery was successful and the patient was able to walk again, the medical community was outraged. Cranial surgeries of blood clots, abscesses, tumors and cranial nerves were within acceptable ethical limits, but noone had operated on the spinal column before. Gowers influenced Horsley to carry out anatomical experiments which Gowers used in his text Diagnosis ofDiseases of the Spinal Cord.

The American brain surgeon Harvey W. Cushing traveled to London in 1900 and wrote of his meetings with Horsley. To Cushing, Horsley appeared to lead a frenetic life. At the breakfast table, Horsley ate while dictating letters to asecretary and petting the family dog. When Horsley took Cushing on a case that involved drilling into a patient's skull, manipulating the temporal lobe and closing the wound in less than an hour, Cushing abruptly left the city. Asfar as he was concerned, Horsley's practice of surgery in London was too primitive for him to learn anything.

Horsley always managed to combine a large practice with ongoing research. Most of his practice was devoted to the treatment of nervous disorders, while his research interests lay in neurophysiology and neurological surgery. His wide ranging scientific curiosity led him to study woodpeckers, ducks and armadillos in a search for anatomical clues that would help with surgery on humans.He carried out research on canine chorea, cortical localization, thyroid function, and Pasteur's antirabies vaccine.

Throughout his career, Horsley was controversial. One of his former medical professors called him an amateur, and a colleague referred to him as an intellectual hormone. Horsley tried to advance science by carrying out research andantivivisectionists (who opposed animal experimentation) bitterly criticizedhim. Horsley was often able to see only one side of a question and he spokeout on social issues such as temperance, female suffrage, and a National Insurance Bill.

Horsley's achievements relied on his willingness to be the first to try something new. He developed the use of wax, muscle and deep anesthesia to control bleeding. He invented many surgical instruments, including a device to hold the patient's head. He was the first to expose the pituitary gland and the first to try to remove a tumor of the pineal gland. In consultation with his mentor Gowers, Horsley was the first to perform a root section fortrigeminal neuralgia, a painful nerve disease which had no known cure. He also promoted the idea of surgical treatment for intracranial expanding lesions.

Horsley received knighthood in 1902. He went on to draft a new constitution for the British Medical Association and was first chairman of its representative body. In 1911, he was the first recipient of the Lannelongue Prize, givento the person who had made the greatest contribution to surgery over the past10 years, and in 1912 he was elected to Royal Society of Uppsalla, filling the vacancy created by Lister's death.During World War I, Horsley improved conditions in military hospitals in Egypt and Mesopotamia (now Iraq) and was promoted to colonel. He died of typhoid in the Middle East.

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