||Before the term ‘neurology’ was coined, Benjamin Rush, a physician on the staff of Pennsylvania Hospital, and signer of the Declaration of Independence, argued that illness was the result of imbalances in the body's physical system and was caused by malfunctions of the brain. Rush’s successors in Philadelphia, later in the 19th Century, focused their clinical acumen on the many disorders that they could describe but not explain. American neurology was largely born during the Civil War through the work of S.W. Mitchell at Turner's Lane Hospital. With the closing of this military facility, the United States was left without an institution dedicated to neurologic research and the treatment of nervous system diseases. As America's first and comprehensive peacetime neurologic facility, the Philadelphia Orthopedic Hospital and Infirmary for Nervous Diseases filled this gap, and fostered the evolution of neurology as a separate, viable specialty in the post-Civil War period and provided as a focus for the study of interactions among orthopedic, nutritional, and neurologic disorders.
The medical faculties at the University of Pennsylvania and Jefferson Medical College were persuaded to recognize neurology as a specialty. In 1871, Horatio Woods was appointed as Chair of Philadelphia’s first Department of Neurology, at the University of Pennsylvania, Soon after, Jefferson Medical College established a Division and then Department of Neurology. Many of the early descriptions of conditions as diverse as neurosyphillis and phantom limb pain followed, and Wood wrote one of America’s first neurology textbooks. The Philadelphia Neurological Society was founded in 1884, with S. Weir Mitchell as President. During his time in Philadelphia, William Osler was an active member. As neuropathology, with detailed anatomic observations developed, William Spiller, with his neurosurgeon colleague Charles Frazier, invented spinal cordotomy, and trigeminal root surgery for intractable pain. The first books and articles concerning neuro-ophthalmology were written by Spiller and his colleagues.
Philadelphia neurologist’s myriad achievements from the early 20th Century to the present include, among many others, the first use of still and cine photography in medicine (A.Ornsteen, 1920’s), development of stereotactic neurosurgery (Spiegel and Wycis, 1940’s), development of epilepsy monitoring (Eli Goldensohn, 1963), use of positron emission tomography to study brain glucose utilization (Reivich), the 1st demonstration of altered blood-brain-barrier in MS using Gadolinium (Grossman et al), FMR to quantify cerebral blood flow (Detre), and fast forward to contemporary genetics, immunology, and imaging