The British Journal of Psychiatry (2002) 181: 0
© 2002 The Royal College of Psychiatrists
Psychiatry in pictures
ROBERT HOWARD
Thomas Willis (1621-1675) studied the function of the circle
of arterial
connections at the base of the brain, noting that
‘if by chance one or
two should be stopt, there might
easily be found another passage instead of
them’. He
followed Harvey's method of injecting dye into one of the
arteries
to trace circulation and found that the dye spread ‘into
every
corner and secret place of the brain and cerebel’.
Willis's most
important contribution to psychiatry and neurology
was his insistence that
disturbance of function within the
brain underpinned conditions such as
depression and epilepsy.
Rejecting the contemporary notion that sadness was
connected
with a single bodily fluid, he brought melancholy, madness and
general feeling under the jurisdiction of basic mechanisms within
the brain
and heart. In 1683 he wrote ‘Melancholy is
a complicated distemper of
the brain and heart. For as melancholick
people talk idly, it proceeds from
the vice or fault of the
brain and the inordination of the animal spirits
dwelling in
it, but as they become very sad and fearful, this is deservedly
attributed to the passion of the heart. But we cannot here yield
to what some
physicians affirm, that melancholy doth arise
from a melancholick humour.
Melancholy being a long time protracted,
passes oftentimes into stupidity, or
foolishness, and sometimes
into madness’. Sir Christopher Wren is known
to have
attended dissections with Willis and may have carried them out
himself. Illustration of the brain in isolation, rather than
as part of an
artistic image of a dissected head, was part
of the more modern and scientific
approach that Willis and
Wren sought to bring to what we can recognise as the
beginnings
of neuroscience. Sadly, 2 years after the publication of
Cerebri Anatome, Wren was distracted from medical science by the
rebuilding
of London — the project for which he is most usually
remembered.
