Victor Horsley - Medical Career

Medical Career

Horsley specialized in surgery and in physiology. He was the first physician to remove a spinal tumor, in 1887, by means of a laminectomy. He developed many practical neurosurgical techniques, including the hemostatic bone wax, the skin flap, the ligation of the carotid artery to treat cerebral aneurysms, the transcranial approach to the pituitary gland and the intradural division of the trigeminal nerve root for the surgical treatment of trigeminal neuralgia.

As a neuroscientist, he carried out studies of the functions of the brain in animals and humans, particularly on the cerebral cortex. His studies on motor response to faradic electrical stimulation of the cerebral cortex, internal capsule and spinal cord became classics of the field. These studies were later translated to his pioneering work in the neurosurgery for epilepsy. Horsley was also the first to use intraoperative electrical stimulation of the cortex for the localization of epileptic foci in humans, between 1884 and 1886, preceding Fedor Krause and Wilder Penfield.

He was also a pioneer in the study of the functions of the thyroid gland. He studied myxedema and cretinism, which are caused by a decreased level of the thyroid hormones (hypothyroidism), and established for the first time, in experiments with monkeys, that they could be treated with extracts of the gland.

Appointed in 1886 as secretary to a governmental commission formed to study the anti-rabies vaccine developed by Louis Pasteur, Sir Victor Horsley corroborated his results and created a campaign to vaccine against rabies in the United Kingdom. As a pathologist, Sir Victor carried out research on bacteria and founded the Journal of Pathology.

In June 1886 he was elected a Fellow of the Royal Society and in 1891 delivered their Croonian Lecture, jointly with his brother-in-law Francis Gotch, on the subject of the mammalian nervous system. In 1894 he won their Royal Medal for his investigations relating to the physiology of the nervous system, and of the thyroid gland, and to their applications to the treatment of disease.

His best known innovation is the Horsley–Clarke apparatus (developed together with Robert H. Clarke in 1908) for performing the so-called stereotactic neurosurgery, whereby a set of precise numerical coordinates are used to locate each brain structure. He was a pioneer in neurosurgery, having operated upon 44 patients.

He authored the book Functions of the Marginal Convolutions (1884) and, as a co-author, Experiments upon the Functions of the Cerebral Cortex (1888) and Alcohol and the Human Body (1902).