Charles-Édouard Brown-Séquard

Charles-Édouard Brown-Séquard was born on the island of Mauritius. His father, Charles Edward Brown, was an Irish-American naval officer from Philadelphia, while his mother, Charlotte Séquard, a vivacious young lady, was French. His father was lost with his ship soon after the marriage. He took his mother's name in 1846, but did not legalize it until 1858. He was born Charles Édouard Brown, a British subject, but just before becoming professor at the Collège de France in 1878 he became a French citizen.

Brown-Séquard's early life was difficult. Born after his father’s death, he was raised by his mother in modest circumstances. Like Claude Bernard (1813-1878) he went to Paris to be a playwright, but after meeting with little success as a writer, he turned to the study of medicine, and by 1842 was working with the internist Armand Trousseau (1801-1867) and Henri Louis Roger (1809-1891), the ablest clinicians of the time. Again like Claude Bernard he preferred not to settle down to practice but to continue his physiological investigations.

When in 1843 his mother, who had accompanied him to Paris and eked out a living for the two of them, suddenly died, the blow was such that he rushed back to Mauritius in an almost delirious state of confusion. Finding that the island had no proper niche for him, he returned to Paris – on borrowed money.

He was conferred doctor of medicine in Paris on January 3, 1846. He now became the protégé of Pierre Rayer (1793-1867) and concentrated his efforts in investigative medicine, beginning his work at the Charité. In medicine his talents and curiosity found creative outlets. Taking a particular interest in digestion, he would swallow sponges, pull them up, saturated by a string, and analyse the gastric juice.

His dissertation foreshadowed the discovery always associated with his name: the syndrome following hemisection of the cord. In his thesis, Brown-Séquard stated that after sectioning the dorsal columns of the cords of cold-blooded vertebrates, birds and mammals, sensation in every case persisted in the parts situated below the section. He also commented on the ease with which he had found sensory impressions to be transmitted from one side of the cord to the other. The thesis was shortly followed by a series of papers in which he clearly established that hemisection of the cord was succeeded by sensory loss on the opposite side of the body and retention and even increase of sensation on the same side.

He contributed greatly to Claude Bernard's discovery of the vasomotor system by showing in the rabbit that stimulation of the cervical sympathetic caused blanching of the ear. This work took place between 1843 and 1852 when Brown-Séquard was living in desperate straits. His experiments were carried on in his apartment, and his animals were housed there. To reduce the need for much food he drank coffee incessantly; some eighteen hours of his day were spent writing, reading, experimenting; he became seriously ill from an infection following a wound in the dissecting room. Realizing the poor state of his health and position, and having become involved in revolutionary activities, he decided that he must go to America. He hardly knew a word of English.

He boarded a ship armed with a letter from his young friend and partisan, the pathologist, neurosurgeon, and anthropologist Pierre Paul Broca (1824-1880), addressed to the University of Pennsylvania: " . . . Brown-Séquard . . . has imposed upon himself incredible sacrifices . . . and today has nothing left save an honourable character, profound erudition, and scientific articles which everyone can appreciate."

In Philadelphia he eked out his earnings giving lectures, delivering babies at cut-rate prices, and teaching French. The year not having brought him an appointment, after his marriage to Ellen Fletcher of Boston, he was again on the high seas in July 1853. Again Paris was unheeding, and he and his wife continued to Port Louis, Mauritius. There they found, in May 1854, an epidemic of cholera that was to take the lives of 8000 people. Immediately he helped organize a hospital. He ingested material vomited by victims to test the efficacy of opium as a cure. Imagining that he himself had the symptoms – as the story goes – he took so large a dose of laudanum that he almost died.

Fortune once favouring him, he received an offer of a professorship, again on Broca's recommendation, from the Medical College of Virginia in Richmond, which he accepted. But he was to stay only about four months. To the faculty he has a "surplus of honesty" – he disapproved of slavery – with a lack of energy. His lectures were "not very unlike an attack of spasmodic asthma". The agony of trying to make himself understood was, if anything, topped by the agony of his listeners, trying to comprehend. His demonstrations, by contrast, were "like wonders wrought by a stage magician." Something was wrong, for in Paris this short wiry person had always been in constant motion and he had a great gift of elocution.

Back in Paris once more, in 1855, his practice as a neurologist began in earnest with the loan by Pierre François Olive Rayer (1793-1867) of an electrical stimulator, which he proceeded to apply with great skill to human patients. But observing convulsions in the guinea pigs upon the spinal cords of which he had performed various operations, he spent much of his subsequent life in the attempt to discover the causes and treatment of epilepsy. Later on, he was instrumental in introducing bromide for epilepsy, as suggested by Sir Charles Locock (1799-1875) in 1857.

In 1856 he again gave courses in Boston but suddenly decided to live in England, where he taught at the Royal College of Surgeons in 1858. As a physician at the National Hospital for the Paralysed and Epileptics, Brown lived in London from 1860 to 1863. In this period he exercised great influence on the young John Hughlings Jackson (1835-1911).

Although having suffered great poverty, Brown-Séquard never later seems to have cared much about money. Asked to see a patient in Liverpool for a fee of £200 he insisted that his ordinary fee would do; offered a fee of £10.000 to see a boy in Italy, he declined, saying that he was not the right person to advise on the case.

He was elected to the Royal Society in 1861. Becoming in England more and more the slave of professional practice, he fled to Paris and then to Boston. The Harvard Medical School offered him the chair of physiology and pathology, which he held from 1864 to 1867. In 1866 he delivered the address opening the Medical Lectures at that school.

"I would urge upon you," he said, to make good use of those low creatures, endowed with so little sensitivity, - the frogs, the fishes, and the turtles; to which list I might add the rabbits, animals whose sensibility is so dull, that they will hardly stop eating a carrot (even when not particularly in need of food) while you are cutting their flesh . . . "

Arguing that the use of such animals for experimenting was for the good of mankind he said, "I am selfish enough to prefer mankind to frogkind, rabbitkind, etc."

After the death of his wife in 1867, Brown-Séquard again left the United States for Paris, probably for the sake of his twelve-year old son, and he gave the course in comparative and experimental pathology at the Faculté de Médecine in 1869. But since he could not be accorded professorial rank in Paris – he was still not a French citizen, not to speak of his libertarian leanings – he returned to America again, in 1870. He married Maria Carlisle, of Cincinnati, Ohio, in 1872.

His activity then knew no respite: he founded a new journal and organized a physiology laboratory in New York; lectured in Boston, London, Dublin, and Paris; and wrote several dozen scientific articles. His travel’s increased after his second wife’s early death, and in 1877, in Geneva, after the birth of a daughter. He then married an Englishwoman named Emma Dakin, the widow of a painter.

In 1878 he came to Paris again, the only city he really cared for. Claude Bernard had just died. Taking out naturalization papers he became, finally, a real Frenchman, and on August 3, 1878 he succeeded Claude Bernard as professor of experimental medicine at the Collège de France. He retained this post until his death but divided his time between Paris and Nice, leaving his assistant, Jacques Arsène d’Arsonval (1851-1940), to give the winter courses. In 1886 Brown-Séquard was elected to the Académie des Sciences.

He founded and edited - until 1863 - Journal de la physiologie de l’homme et des animaux. In 1868, with Jean Martin Charcot (1825-1893) and Edmé Félix Alfred Vulpian (1826-1887), he founded the Archives de physiologie normale et pathologique, and he was also a contributor to the Dictionnaire encyclopédique des sciences médicales. In 1873 he published Archives of Scientific and Practical Medicine and Surgery (Philadelphia and New York).

Although the physiology of the nervous system was his chief field of work, his inquiring mind early led him to endocrinology. Addison had published in 1855 his observations on the clinical effect of disease of the suprarenal capsules, and a year later Brown-Séquard showed how fatal adrenalectomy is. He also became one of the founders of organ therapy. Already Théophile de Bordeu (1722-1776) had theoretically arrived at assuming the occurrence of secretion from the internal organs, stating in his Analyse médicinal du sang: J’en conclus que de sang roule toujours dans son sein des extraits de toutes les parties organiques .. chaque organ sert de foyer et de laboratoire à une humeur particulière, qu’il renvoie dans le sang après d'avoir préparée dans son sein, après lui avoir donné son caractère radical.

In 1855 Claude Bernard had followed up these thoughts of Bordeu, in that he concerned himself particularly with the liver and tried to establish that the glands, excepting the outer secretions, the components of which were extracted from the blood, also make their own products, and that each produces a particular one. Already Bernard spoke of «inner secretion». In 1889 Brown-Séquard reported a view, at which he had arrived through experiments, that the blood glands give off components to the blood, and that these components influence remote organs. This we call hormones.

On June 1, 1889 Brown-Séquard presented a sensational report to the Société de Biologie: he believed that he had «rejuvenated" himself with subcutaneous injections of a liquid extracted from the testicles of freshly killed guinea pigs and dogs (Comptes rendus de la Société de biologie, 1889; 41: 415-422). His extravagant claim stimulated the development of modern organotherapy and exerted strong influence on sex hormones.

Brown-Séquard's investigations show more intuition than critical sense. His great achievement was understanding that through «internal secretion» the cells become dependent on one another by means of a mechanism other than the action of the nervous system. His most important discovery was that the adrenal glands are essential for life.

He was founder and editor of:

Works referred to etc:


• Théophile de Bordeu:
  Recherches sur les maladies chroniques. VI. Analyse médicinale du sang. Paris, 1775.
  De Bordeu first conceived the idea of internal secretion by his hypothesis that every organ, tissue, and cell discharge into the blood products which indfluence other parts of the body.
  
  
• Sir Charles Locock, baronet;
  [Contributions to discussion on paper by E. H. Sieveking].
  Lancet, London, 1857, 1: 528.
  Refers to Sir Edward Henry Sieveking (1816-1904), who, in 1858, published: On epilepsy and epileptiform seizures, their causes, pathology, and treatment.
  Locock, physician accoucheur to Queen Victoria, recommended bromide of potassium in the treatment of epilepsy.
  
  Works by Brown-Séquard:
• Recherches et expériences sur la physiologie de la moëlle épinière. Thèse de Paris, 1846.
• Recherches sur le rétablissement de l’irritabilité musculaire chez un supplicié treize heures après la mort.
• Résumé de plusieurs mémoires de physiologie expérimentale, lus ou présentés à l’Académie des sciences, dans l’année 1847.
• De la transmission croisée des impressions sensitives par la moelle épinière.
  Comptes rendus de la Société de biologie, 1851, 2: 33-44.
• Experimental researches applied to physiology and pathology.
  Medical Examiner, Philadelphia, 1852, 8: 481-504.
  By applying a galvanic current to the superior part of the divided sympathetic nerve and causing vascular contraction and a fall in temperature, Brown-équard inferred that section of the sympathetic paralysed and dilated the blood-vessels (pp. 489-490).
• Experimental researches applied to physiology and pathology. New York, 1853.
• Note sur la découverte de quelques-uns des effets de la galvanisation du nerf grand sympathetique au cou.
  Gazette médicale de Paris, 1854, 3 sér., 9: 22-23.
• Sur les résultats de la section et de la galvanisation du nerf grand sympathetique au cou.
  Gazette médicale de Paris, 1854, 3 sér., 9: 30-32.
• Deux mémoires sur la physiologie de la moelle épinière.
  Paris, 1855.
• Examen de la théorie de M. Longet relative à la transmission des impressions sensitives. Paris, 1855.
  Longet is the physiologist François-Achille Longet (1811-1871).
• Recherches expérimentales sur la transmission croisée des impressions dans la moëlle épinière. Paris, 1855.
• Experimental and clinical researches on the physiology and pathology of the spinal cord and some other parts of the nervous centres.
  Richmond, Virginia, 1855.
• Recherches expérimentales sur la physiologie et la pathologie des capsules surrénales.
  Comptes rendus hebdomadaires des séances de l’Académie des sciences. Paris, 1856, 8: 422-425.
  By the simple experiment of excising the adrenal gland of animals, he proved that the glands were indispensable to life. It is one of the first works to demonstrate the function of the glands of internal secretion and is basic to the development of endocrinology.
• Recherches expérimentales sur la production d'une affection convulsive épileptiforme, à la suite de lésions de la moëlle épinière.
  Archives générales de médecine, Paris, 1856, 5 sér., 7: 143-149.
  Experimental epilepsy (section of sciatic nerve).
  See also Archives de physiologie normale et pathologique, Paris, 1869, 2: 211-220, 422-438, 496-503.
  Archives de physiologie normale et pathologique, Paris, 1870, 3: 153-160.
• Researches on epilepsy: its artificial production in animals, and its etiology, nature and treatment in man etc. Boston, 1857.
• Course of lectures on the physiology and pathology of the central nervous system. Delivered at the R. C. S. of England in May 1858. Philadelphia, 1860.
  Brown-Séquard's investigations of spinal cord transection in which he defines the relative function of the posterior and anterior cord sections and their relationship to other neural pathways is one of his foremost accomplishments and is explained fully in this impressive series of lectures.
• Lectures on the diagnosis and treatment of the principal forms of paralysis of the lower extremities. Philadelphia 1861.
  This study of the pathway of conduction of the spinal cord and its relationship to paralysis was written shortly before Brown-Séquard accepted an appointment as physician at the National Hospital for the Paralysed and Epileptics in Queen's Square, London.
• Recherches sur la transmission des impressions de tact, de chatouillement, de doleur, de tmpérature et de contraction (sens musculaire) dans la moëlle épinière.
  Journal de physiologie, Paris, 1863, 6: 124-125, 232-248, 581-646.
  His study of the pathways of conduction in the spinal cord was among Brown-Séquard's best work
• Advice to students: an address delivered at the opening of the medical lectures of Harvard University, Nov. 7, 1866.
  Cambridge, Wilson, 1867.
• Lectures on the diagnosis and treatment of functional nervous affections. Philadelphia, 1868.
• Dual character of the brain. Delivered April 22, 1874.
  Washington, 1877.
• Two letters on convulsions and paralysis as affects of disease of the base of the brain.
  Philadelphia, 1878.
• Expérience démontrant la puissance dynamogénique chez l'homme d'un liquide extrait de testicule d'animaux.
  Archives de physiologie normale et pathologique, Paris, 1889, 5, sér. 1: 651-658.
  This was perhaps the first employment of "male sex hormone".
  Further papers on this subject were published by Brown-Séquard in:
  Archives de physiologie normale et pathologique, Paris, 1889, 5 sér., 1: 739-746;
  Archives de physiologie normale et pathologique, Paris, 1890, 2: 201-208, 443-457, 641-648;
  Archives de physiologie normale et pathologique, Paris, 1891, 3: 747-761.
• Notice sur les travaux scientifiques de C. E. Brown-Séquard.
  Paris, Masson, 1883. Comprises 397 works until 1883.
• Gerhard Armauer Hansen:
  Brown-Séquards indsprøitninger. Naturen 1893, side 48-51.
• M. Berthelot:
  Notice sur la vie et les travaux de M. Brown-Séquard.
  Paris, 1904.
• E. Dupuy:
  Notice sur M. le Pr. Brown-Séquard, ancien président de la Societé de biologie.
  Mémoires de la Société de biologie, Paris, 1894, 46: 759-770.
• E. Gley:
  C.-E. Brown-Sequard.
  Archives de physiologie normale et pathologique, Paris, 5th ser., 1894, 6: 501-516.
• J. M. D. Olmsted:
  Charles-Edouard Brown-Séquard. A Nineteenth Century Neurologist and Endocrinologist. Baltimore, 1946.
• F. A. Rouget:
  Brown-Séquard et son oeuvre. Port Louis, Mauritius, 1930.
• L. Delhoume.
  De Claude Bernard à d'Arsonval. Paris, 1939.
  Contains an interesting set of letters between Brown-Séquard and his assistant d'Arsonval.