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A Contribution to the Subject of Tumors of the Spinal Cord : with remarks upon their diagnosis and their surgical treatment with a report of six cases in three of which the tumor was removed.

1895réf. 685241895. Am. J. Med. Sc. 109. - Philadelphia June 1895 8° 25 pp. 7 Fig. orig. wrappers. Rare Offprint! "Horsley's paper had a tremendous impact on the medical community. He passionately recommended operating on patients with spinal tumors as the alternative - conservative treatment - was associatedwith a very high mortality: 74%of patients with unoperated extradural tumors and 83% of patients with unoperated intradural tumors died due to respiratory failure pneumonia urinary septicemia or decubitus ulcera to mention the commonest causes of death. Horsley was convinced that surgery could prevent grave complications and death for a significant number of patients even given the prevailing enormous diagnostic and technical restraints. His paper was so stimulating that Starr could report on 19 spinal tumor operations as early as 1895 adding three cases of his own. Eleven of these however died from postoperative complications.With increasing experience however mortality figures could be reduced." Jörg Klekamp & Madjid Samii: Surgery of Spinal Tumors 2007 pp.1-6 Moses Allen Starr 1854-1932 'Professor of Neurology in the College pf Physician and Surgeons at Columbia University New York City' "had plans for a career in classical culture when he graduated from Princeton and embarked for Germany to study Greek and Roman history. In Berlin however several visits to Helmholtz's laboratory revived a latent interest in natural science. He returned to his native New York graduated from the College of Physicians and Surgeons P&S Columbia University did a residency at Bellevue Hospital then returned to Europe to work at Heidelberg Vienna and Paris. On return to New York he set up a laboratory in his home and in 1884 published an essay on the sensory tracts of the central nervous system elucidating some of the then-current questions of myelination. Starr's regard as an American pioneer in the field of cerebral localization stemmed from his participation in a symposium on that subject with the famous English neurologist David Ferrier and neurosurgeon Victor Horsley who were delegates to the 1888 Congress of American Physicians and Surgeons in Washington D.C. He became professor of nervous diseases at the Montreal Neurological Institute. During neurosurgical operations they electrically stimulated the surface of the exposed unanesthetized brains of patients who were talking. On-going speech was blocked by excitation of the parietal-temporal area the inferior frontal area and the supplemental motor area of the left hemisphere Penfield & Roberts 1959. Those experimental protocols were a continuation of Penfield's long quest to add to the knowledge of body representations on the neocortex." H.W. Magoun & L. Marshall; American Neuroscience in the Twentieth Century 2005 pp.383-384 unknown

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