Bread-&-Butter Brains

High over the silver Hudson, in uptown Manhattan, stands a giant's village of towering, cream-brick buildings: Columbia-Presbyterian Medical Center.* Most extraordinary of the hospitals in this doctors' Mecca is the 14-story Neurological Institute, erected ten years ago through the heroic efforts of late, great Neurologist Frederick Tilney. Last year, after wielding an influence among devoted young neurologists second only to that of famed Harvey Gushing (see p. 60), Dr. Tilney died. As acting director, the trustees appointed modest Dr. Robert Frederick Loeb. Last week, warmhearted, diplomatic Tracy Putnam came down from Harvard to take Dr. Tilney's place.

He came to no workaday hospital, devoted to textbook treatment of disease, but to a great temple of experiment, where even sober trustees are fired by the high task of ending body's tyranny over mind, To 45-year-old Dr. Putnam, as to the other bold, competent physicians in the Institute, the study of brain processes and the treatment of brain ills is a "bread-&-butter science." Deeply concerned with detours of nerve paths and battles of brain cells, he knows that a long chain of simple injections, or the sharp bite of a surgeon's knife into grey brain flesh may miraculously humanize a speechless paralytic, a savage child, a cancer victim crazy with pain.

Within a year, Dr. Putnam hopes to use the magnificent resources of the Institute for large scale clinical work in 1) multiple sclerosis, a mysterious nerve-crippling disease, probably twice as prevalent as infantile paralysis; 2) paralysis agitans, a lingering, incurable shaking palsy; 3) epilepsy (known to modernists as "convulsions"). Meanwhile, within the cheerful green walls of the Institute, turbanned patients continue to wheel their chairs through sunny wards, as 100 experimenters work on problems such as mirror-writing, abnormalities of the senses, hydrocephalus (water-on-the-brain), brain physiology and anatomy.

Brain Waves. Chief of the Institute's brain-wave station is young, German-born Dr. Paul Frederick Adam Hoefer, who came from Boston with Dr. Putnam. Close kin to a sensitive short-wave radio is the electroencephalograph. Tiny lead electrodes are pasted to the patient's scalp. From the electrodes fine, threadlike wires lead to the machine which detects, through scalp and skull, faint electric brain impulses. A connected drum and ink recorder charts patterns. Normal frequency is ten shallow, rippling, regular waves a second. Abnormal brain waves, often running to 25 a second, show up as irregular plateaus, spikes or scallops. Skilled interpreters can read characteristic abnormal wave patterns as indications of approaching epilepsy, can even use them to locate surface brain tumors. Typical epilepsy pattern looks very much like a string of trylons and perispheres.

Remarkably sensitive to aerial noises, the electroencephalograph, while attached to a patient's head, may sometimes pick up short-wave radio programs. Classic is the accident which happened to famed British Neurologist Edgar Douglas Adrian, who once hitched an amplifier to a brain recorder, for a wholesale broadcast of brain waves to an auditorium full of his colleagues. To his horror the electroencephalograph blared out God Save the King. In confusion, half the neurologists rose, half remained seated.

Brainstorms. Many unusual forms of epilepsy are often passed by unnoticed, believes Dr. Richard Max Brickner. Remarkable is the case of "D," a 77-year-old college professor, who, when he opened his eyes in the morning, was often assailed by a violent hurricane of fantastic, guilty and obscene thoughts. Although he would try with all his might, D would be unable to get a sane thought in edgewise." Sometimes within half an hour, often within a day, his brainstorms would abate, leaving him depressed but self controlled. Strangely enough, he had no convulsive movements, would lie passively in bed while racked by his thoughts. These brainstorms, believes Dr. Brickner, are convulsions of ideas, similar to the convulsions of muscles in more ordinary forms of epilepsy. Their discovery lends weight to the theory that the thinking process, in its bare physical foundation, is similar to other bodily processes such as walking or running.

Encephalitis. Less widespread than poliomyelitis (infantile paralysis), but more destructive, is encephalitis. Young victims are often left stupid, shuffling, problem children, older ones drooling cripples, with muscular tremors, mumbling speech, double vision. Twelve years ago Chemist William John Matheson gave several hundred thousand dollars for a study of the disease. The fund has dwindled, for the Matheson Commission takes no money for treatment. Executive secretary of the Commission is capable Dr. Josephine Bicknell Neal who has investigated a remarkable Bulgarian belladonna treatment for chronic cases, long used in Europe. These tablets which Dr. Neal considers "by far the most effective method of symptomatic therapy," have improved the speech, tremors and vision of 75 patients.

Pain and Tumors. About half of the Institute's 3,200 annual patients require operations for brain or spinal-cord tumors. A great proportion of these operations are performed by strong, sociable Dr. Byron Stookey in the green-tiled operating room domed with a glass observers' balcony. Sleepy-green nonreflecting arc lamps designed by Dr. Stookey spotlight the site of operation, but cast no shadow, generate little heat. Dr. Stookey performs scores of operations for the relief of "intractable" pain. Victims of agonizing, incurable cancer, for example, can usually have their last days made easy by a simple severing of certain nerve tracts in the spinal cord.

*The 71-year-old Presbyterian Hospital 132-year-old College of Physicans and Surgeons were united on 20 acres of land given by Charitarians Mrs. Stephen V. Harkness and Edward Stephen Harkness.

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