Sir Francis Walshe (1885–1973)

Excerpt

Sir Francis Martin Rouse Walshe (1885–1973) was born in London on 19 September 1885, but others report Ireland as his birthplace [7]. He was the elder of the two surviving children of Rose and Michael Charles, whose firstborn had died in infancy [8]. He went to Church school, to Prior Park College, Bath (1898–1901) and to University College School in London (1901–1903). Walshe loved history and English, but his dominant father, fascinated by the research and charisma of William R. Gowers (1845–1915) and John Hughlings Jackson (1835–1911), who lived within a few hundred yards from their home [8], chose a medical career for him [3]. Despite the advice of Francis’ headmaster about young Francis’ total lack of capacity to profit by the instruction [8], and although he had never had lectures on science apart from short elementary courses on physic and chemistry [8], Walshe joined University College London. In 1908 he took the B.Sc. with first-class honours in physiology, and two years later he graduated with honours M.B., B.S. Interestingly, he decided to work in neurophysiology and clinical neurology after reading Sir Charles Sherrington’s ‘The integrative action of the nervous system’ [8]. During his training, he worked under E. H. Starling and W. M. Bayliss; for a short time, he held a lectureship in clinical physiology at Oxford under the aegis of Sherrington, who encouraged his analytical approach and his interest in synthesizing neurophysiology and clinical neurology [3]. Walshe also worked with John Rose Bradford and Wilfred Trotter, was house-surgeon to Sir Victor Horsley and held two house appointments at University College Hospital for one year before joining the National Hospital, Queen Square, as house physician and resident medical officer for four ‘precious and happy years’ [8]. He then spent a few months in Germany to learn the language. In 1913 he added M.D. to his qualifications, with a thesis on the Sherringtonian analyses of reflexes in patients with spastic paraplegia [8]. During the First World War, he served as consultant neurologist to the British Forces in Egypt, Palestine and the Middle East [3], where an unusual prevalence of wounds infected with the Klebs–Loeffler bacillus led him to study the local and generalized neural complications of diphtheria [5]. He also did research on beri-beri and on forms of peripheral neuritis in troops in those areas, usually on top of the demanding daily routine of military medicine [8]. He was mentioned in dispatches and awarded the OBE [7]. After the war Walshe returned to his work at Gower Street and Queen Square as physician in charge of the neuropathic department at University College Hospital (1924–1950) and to the National Hospital. He took the D.Sc. in physiology of the University of London in 1924 and was visiting neurologist at the Johns Hopkins Hospital, Baltimore, in 1925. His research mainly focused on anatomo-physiological correlations in the sensorimotor system and on the operational definition of consciousness [3]. He wrote crucial papers on Betz cells, the motor cortex and the pyramidal tract [9], on cutaneous sensation [10], as well as on the relationship between brain stem and consciousness, encephalitis lethargica, poliomyelitis, and on the weak points of Head’s concept of epicritic and protopathic sensation as example of hierarchical sensory evolution [7]. Walshe’s outstanding clinical methods directly derived from William R. Gowers, William Osler (1849–1919) and Gordon M. Holmes (1876–1965). He always admired Jackson’s deductive and inductive approaches towards neurological phenomena, but never embraced the psycho-physical parallelism in dealing with behavioral problems, nor did he define an alternative view [6]. Most important, he strongly believed in careful clinical observation, punctilious note-taking, precise reviewing of the methods and logical analysis of the premises and conclusions [6]. Devoid of fear in the great medical arena, free in his personal thoughts and actions, he was characterized by elegant and impeccable prose and a keen sense of humour [4]. Philosopher of science as well as severe critic of socio-political trends [4], he continued to work under the National Health Service while scorning to accept any financial recognition for his labours [5]. He thus made his living only on the fees from his private medical practice [2]. Sometimes rather solitary in nature, he managed to make intimate contact with almost every patient, combining a brilliant and penetrating discourse with comforting gestures [6]. As the author of academic neurological texts (among others, Diseases of the Nervous System), he preferred letters, preferably typewritten by himself, to any other literary medium, and there he once again showed consummate accomplishments in the sphere of mordant invective, leavened by sheer verbal clowning [5]. Among the few contemporary clinicians elected Fellow of the Royal Society (1946), he delivered the Harveian Oration in 1948. In 1950 his wife died. Walshe was knighted in 1953, the same year in which he ended his 16-year editorship of Brain. Founder member and president of the Association of British Neurologists (1950–1951), President of the Royal Society of Medicine (1952–1954), he was awarded the Harben Gold Medal in 1964. He was active in practice for 60 years, which spanned a long and distinguished career as honorary consultant physician to the National Hospital, Queen Square and to University College Hospital [1], but also as neurologist to the Hospital for Tropical Diseases and the Dreadnought Hospital, Greenwich. With great scientific humility, he always recognized the limits of knowledge, but never stopped to jolt them. ‘Only the Peter Pans of science do not feel the urge to openly question the omnicompetence of natural science to comprehend God and His Universe’, is one of his many aphorisms [3]. In conclusion, he can be truly considered the natural successor of the epic tradition established by his eminent parental neighbours Gowers and Hughlings Jackson [1]. Walshe died on 21 February 1973, at the age of 87. He was survived by two sons.

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