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Show Historical Note “On the Ophthalmoscopic Signs of Spinal Disease” 150 Years Later: A Tribute to Professor Sir Thomas Clifford Allbutt Downloaded from http://journals.lww.com/jneuro-ophthalmology by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdgGj2MwlZLeI= on 05/04/2022 Otto Jesus Hernandez Fustes, MD, MSc, Cláudia Suemi Kamoi Kay, MD, Paulo José Lorenzoni, MD, PhD, Renata Dal-Prá Ducci, MD, PhD, Lineu Cesar Werneck, MD, PhD, Rosana Herminia Scola, MD, PhD N euromyelitis optica (NMO) is a rare autoimmune disorder of the central nervous system that mainly affects the optic nerves and spinal cord related with serum autoantibodies to aquaporin-4 (1). In addition, the term “astrocytopathy” has been proposed because histopathological studies have shown that astrocyte injury is the primary event, which occurs in the active lesions of NMO (2). In 1894, on the Congrès Français de Médecine in Lyon, Eugène Devic (1858–1930) presented an article in which he called the disease “neuro-myélite optique aiguë.” In the same year, Devic’s student Fernand Gault (1873–1936) published his doctoral thesis, entitled “De la neuro-myélite optique aiguë.” Gault’s work is commonly considered to be the first review of NMO, and the disease was named after Devic in 1907 (3–5). However, previously in 1870, in his famous lecture On the Ophthalmoscopic Signs of Spinal Disease (6), Thomas Clifford Allbutt (Fig. 1) briefly mentioned a patient with acute myelitis and “a sympathetic eye disorder.” This case is considered the first account of a patient with NMO in the literature. Apart from the phylogenetic discussion of the NMO, the work of Professor Allbutt allowed us to deepen the theme by engaging the importance of ophthalmological evaluation in neurology. ON THE OPHTHALMOSCOPIC SIGNS OF SPINAL DISEASE The article was published by Allbutt in The Lancet on January 15, 1870, he presented 30 well-marked cases of spinal injury, and in 8 of these cases, secondary disturbance was found within the eye. “Of these cases, 17 were severe injuries which proved fatal within a few weeks, and in none of these did changes appear in the eye; the remaining 13 cases were of chronic spinal disease following accidents of less severity, and Departamento de Clínica Médica, Universidade Federal do Paraná, Hospital de Clínicas, Serviço de Neurologia, Serviço de Doenças Neuromusculares, Curitiba, Brazil. The authors report no conflicts of interest. Address correspondence to Otto Jesus Hernandez Fustes, MD, MSc, Hospital de Clinicas da Universidade Federal do Paraná (UFPR), Rua General Carneiro 181, 80060-900, Curitiba/PR; E-mail: otto.fustes@ hc.ufpr.br 126 FIG. 1. Sir Thomas Clifford Allbutt. Available at: https:// wikivisually.com/wiki/Clifford_Allbutt. it was among these 13 that I discovered the 8 cases of sympathetic disorder in the eye. Of acute myelitis I have examined 5 cases, and in 1 only did eye disorder supervene (6).” “Finally, we have learnt, from our experience of encephalic diseases, to attribute atrophy of the discs to severance of the optic nerve fibres, to sclerosis in patches, or to travelling degenerations, rather than to meningitis (6).” In this article, Albutt is recognized for the first description of edema of the optic nerve in the course of an acute myelitis, and he proposes a direct connection between the 2 syndromes (optic neuritis and myelitis) Hernandez Fustes et al: J Neuro-Ophthalmol 2021; 41: 126-127 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. Historical Note considering the possibility of an “ascending meningitis” underlying the affection of the optic nerve. SIR THOMAS CLIFFORD ALLBUTT Thomas Clifford Allbutt is still known to many as the inventor of the clinical thermometer and of interest to neurologists as a precursor to the routine clinical use of the ophthalmoscope and the disseminator of its advantages in neurological practice. He was born in Dewsbury, Yorkshire, in July 20, 1836. It was in the township of Hartshead-cum-Clifton, in the parish of Dewsbury, that the famous outlaw and archer, Robin Hood, found a last resting place. He was graduated in 1859 at Caius College, Cambridge. He was trained at St George’s Hospital, graduating MB in 1860 (7). He became a member of Duchenne’s Clinique in the Boulevard des Capucins, at the time Duchenne was working out his observations on nervous diseases, and the friendship thus formed lasted until the great teacher’s death. He was a physician of the General Infirmary at Leeds for 28 years and a professor at the Yorkshire College; he was tempted to the Regius chair of Physic at Cambridge. Pioneer, together with Gowers, in the use of the ophthalmoscope in medical practice in Great Britain; Allbutt was an exponent and important disseminator of its use in addition to the diagnosis of eye diseases, using funduscopy to show the numerous signs (optic atrophy and papilledema) of intracranial disease that the ophthalmoscope could provide (7). At the end of the 19th century, he founded, edited, and contributed in several volumes, including those containing diseases of the nervous system, the System of Medicine, which was one of the most comprehensive texts on medicine. With a high reputation and deep intellectual knowledge, Professor Allbutt was a founding member of the Medical Research Council and president of the British Medical Association. He died in Cambridge in 1925. CONCLUSION Although Allbutt might not have been the first to report on a case of NMO, it was certainly his report that created the Hernandez Fustes et al: J Neuro-Ophthalmol 2021; 41: 126-127 sustained interest of neurologists and ophthalmologists in this rare syndrome. Allbutt never used the term “neuromyelitis optica.” As a curious coincidence, however, of all authors Allbutt might have been the first to use the term “neuromyelitis” in a medical text in a way distinct from Hildenbrand’s definition (3). He was an indefatigable worker and a copious writer. His most important early work was the “Treatise on the Ophthalmoscope in its relations to Medicine,” which had a considerable success at the time. One of his many special interests was the Papworth village settlement for tuberculosis victims (now hospital). His memorial there reads: “A scholar-physician, an inspiring leader, and a beloved humanist.” STATEMENT OF AUTHORSHIP Category 1: a. Conception and design: O. J. Hernandez Fustes, and R. H. Scola; b. Acquisition of data: O. J. Hernandez Fustes, C. S. Kamoi Kay, P. J. Lorenzoni, and R. Dal-Prá Ducci; c. Analysis and interpretation of data: O. J. Hernandez Fustes, C. S. Kamoi Kay, P. J. Lorenzoni, R. Dal-Prá Ducci, L. C. Werneck, and R. H. Scola. Category 2: a. Drafting the manuscript: O. J. Hernandez Fustes, C. S. Kamoi Kay, P. J. Lorenzoni, R. Dal-Prá Ducci, L. C. Werneck, and R. H. Scola; b. Revising it for intellectual content: O. J. Hernandez Fustes, C. S. Kamoi Kay, P. J. Lorenzoni, R. Dal-Prá Ducci, L. C. Werneck, and R. H. Scola. Category 3: a. Final approval of the completed manuscript: O. J. Hernandez Fustes, C. S. Kamoi Kay, P. J. Lorenzoni, R. Dal-Prá Ducci, L. C. Werneck, and R. H. Scola. REFERENCES 1. McCreary M, Mealy MA, Wingerchuk DM, Levy M, DeSena A, Greenberg BM. Updated diagnostic criteria for neuromyelitis optica spectrum disorder: similar outcomes of previously separate cohorts. Mult Scler J Exp Transl Clin. 2018;4:2055217318815925. 2. Fujihara K. Neuromyelitis optica and astrocytic damage in its pathogenesis. J Neurol Sci. 2011;306:183–187. 3. Jarius S, Wildemann B. The history of neuromyelitis optica. J Neuroinflammation. 2013;10:8. 4. Miyazawa I, Fujihara K, Itoyama Y. Eugène devic (1858–1930). J Neurol. 2002;249:351–352. 5. Jacob A, Larner AJ. Clifford Allbutt (1836–1925). J Neurol. 2013;260:346–347. 6. Allbutt TC: On the ophthalmoscopic signs of spinal disease. Lancet. 1870;95:76–78. 7. Pearce JMS. Sir Thomas Clifford Allbutt. J Neurol Neurosurg Psychiatr. 2003;74:1443. 127 Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. |
