Neurol. praxi. 2020;21(4):327-333 | DOI: 10.36290/neu.2020.097

Sir William Richard Gowers (1845-1915) and the first neurology textbook

prof. MUDr. Petr Kaňovský, CSc.

Neurologická klinika Lékařské fakulty UP a Fakultní nemocnice, Olomouc

William Richard Gowers was born into a shoemaker family in London on 20 March 1845. When he was eleven years old, his father and three of his siblings have died, probably due to typhoid fever, and his mother decided to return to live in Doncaster, but he started to attend Christ Church Cathedral School in Oxford. When he left the college, he tried farming for a short time, but then, thanks to his family connections, he became a medical apprentice with a local doctor in Coggeshall, Essex. Three years later, he passed the exams and was accepted to study medicine at the University College of London, graduating in 1870. After graduation, he was appointed medical registrar to the National Hospital for the Paralysed and Epileptic in Queen Square, London (nowadays known as the National Hospital for Neurology and Neurosurgery), and spent the rest of his career in this hospital, retiring in 1910. At the age of 30, Gowers married Mary Baines who came from a prominent congregationalist family and had with her four children. Gowers' offspring had diverse talents, ranging from classical music to top-level politics, with one of Gowers' great-grandsons being a world-renowned mathematician and professor in this field at Cambridge University. Gowers devoted all his working life to consulting, treating, teaching, and writing. In addition to providing in-hospital consulting services, he saw his patients daily in his own private consulting rooms in Queen Anne Street and, several times a week, gave lectures or organized clinical demonstrations at Queen Square, widely attended by both students and graduate physicians. He also was a prolific writer. Throughout his professional career, that is from 1870 to 1915, he wrote and published a total of 43 textbooks and monographs as well as an incredible 268 review or original journal articles. However, his life's work was (and still is) the two-volume neurology textbook titled "A Manual of Diseases of the Nervous System" published by J & A Churchill in London in the years 1886 (Volume 1, dealing with diseases of the peripheral nerves and spinal cord) and 1888 (Volume 2, dealing with diseases of the brain, cranial nerves, and general and functional diseases of the nervous system); its American mutation was published in Philadelphia by P. Blakiston's Son & Co in the years 1888 and 1889. Gowers apparently never considered this monumental work finished. He prepared a second, supplemented edition relatively quickly: both volumes were again published by Churchill in London in the years 1892 and 1893. The third edition was prepared with the help of his assistant James Taylor, and Volume 1 was published in 1899. However, no Volume 2 was ever published, and Gowers never revealed why it was so. Arguably, the third edition of Volume 2 was being prepared because, in 1949, MacDonald Critchley said in his biography of Gowers that, in the 1930s, he had seen with his own eyes pages of the second edition provided with Gowers' corrections, comments, and new images. However, all the material for the planned third edition of Volume 2 appears to have been carefully "hidden" afterwards, and, when delivering his Gowers Memorial Lecture in 1986, even Ian McDonald said publicly that "unfortunately, it is apparently lost". In 2008, Ann Scott, Gowers' great-granddaughter and historian of medicine, was researching for the biography of her grandfather, Gowers' son Ernest, who was Chairman of the Board of Governors at Queen Square after the war. At that time, the Queen Square Library had just assumed responsibility for the contents of cabinets unopened in years full of hospital documents which were placed in one of the numerous and infrequently visited corridors of the old hospital. It was in one of these cabinets that Ann Scott and a librarian found an album of Gowers' drawings made during holidays in the countryside (!), and underneath it was a collection of documents which was shown to be a background material for the third edition of Volume 2 of the Manual. But even this finding failed to answer the question why Gowers, while still professionally active (he retired in 1910 at the age of 65 years), stopped preparatory work and restricted the third edition of the Manual to Volume 1. Likewise, the almost detective question whether Gowers and his medical aphorisms were used by Sir Arthur Conan Doyle as a model when creating the character of Sherlock Holmes still remains to be answered.

Keywords: William Gowers, Manual of Diseases of the Nervous System, Sherlock Holmes.

Published: September 8, 2020  Show citation