{"title":"The early history of the knee-jerk reflex in neurology.","authors":"J Wayne Lazar","doi":"10.1080/0964704X.2021.1980965","DOIUrl":null,"url":null,"abstract":"<p><p>Medical interest in the knee-jerk reflex began in about 1875 with simultaneous and independent publications by Wilhelm Heinrich Erb (1840-1921) and Carl Friedrich Otto Westphal (1833-1890) contending that the knee jerk was absent (and the ankle clonus was present) in all clear cases of locomotor ataxia (tabes dorsalis). Physicians in the medical communities of Europe, Great Britain, and North America responded with case and large group studies that tested this contention. These studies revealed the usefulness of the knee jerk and other myotatic reflexes, but also unexpected characteristics. The knee jerk, apparently so simple, proved to be a complex phenomenon depending the strength of the strike on the patella, induced muscle tension, and inhibition from the brain. Was it a reflex with afferent and efferent nerves and an intervening process in the spinal cord, or was it a local phenomenon confined to the muscle itself? Experimental studies directed at the reflex issue investigated latencies from patella strike to leg extension or muscle contraction and compared them with latencies from direct muscle strikes and theoretical calculations based on reflex components. Such studies were unable to resolve the reflex issue during the nineteenth century. The physicians were shown to be limited, like all scientific explorers of the unknown, by their knowledge, methodology, and technology.</p>","PeriodicalId":49997,"journal":{"name":"Journal of the History of the Neurosciences","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the History of the Neurosciences","FirstCategoryId":"98","ListUrlMain":"https://doi.org/10.1080/0964704X.2021.1980965","RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/7 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HISTORY & PHILOSOPHY OF SCIENCE","Score":null,"Total":0}
引用次数: 0
Abstract
Medical interest in the knee-jerk reflex began in about 1875 with simultaneous and independent publications by Wilhelm Heinrich Erb (1840-1921) and Carl Friedrich Otto Westphal (1833-1890) contending that the knee jerk was absent (and the ankle clonus was present) in all clear cases of locomotor ataxia (tabes dorsalis). Physicians in the medical communities of Europe, Great Britain, and North America responded with case and large group studies that tested this contention. These studies revealed the usefulness of the knee jerk and other myotatic reflexes, but also unexpected characteristics. The knee jerk, apparently so simple, proved to be a complex phenomenon depending the strength of the strike on the patella, induced muscle tension, and inhibition from the brain. Was it a reflex with afferent and efferent nerves and an intervening process in the spinal cord, or was it a local phenomenon confined to the muscle itself? Experimental studies directed at the reflex issue investigated latencies from patella strike to leg extension or muscle contraction and compared them with latencies from direct muscle strikes and theoretical calculations based on reflex components. Such studies were unable to resolve the reflex issue during the nineteenth century. The physicians were shown to be limited, like all scientific explorers of the unknown, by their knowledge, methodology, and technology.
医学界对膝跳反射的兴趣始于1875年,Wilhelm Heinrich Erb(1840-1921)和Carl Friedrich Otto Westphal(1833-1890)同时发表了独立的论文,认为在所有明显的运动性共济失调(背侧表)病例中,膝跳不存在(踝关节阵挛存在)。欧洲、英国和北美医学界的医生们用案例和大型群体研究来验证这一观点。这些研究揭示了膝跳和其他肌张力反射的有用性,但也揭示了意想不到的特征。膝跳,看起来如此简单,被证明是一个复杂的现象,这取决于打击髌骨的力量,引起的肌肉紧张和大脑的抑制。它是传入神经和传出神经的反射以及脊髓的干预过程,还是局限于肌肉本身的局部现象?针对反射问题的实验研究调查了髌骨撞击到腿部伸展或肌肉收缩的潜伏期,并将其与直接肌肉撞击和基于反射成分的理论计算的潜伏期进行了比较。在19世纪,这种研究无法解决反射问题。就像所有探索未知领域的科学探险家一样,医生们的知识、方法和技术都是有限的。
期刊介绍:
The Journal of the History of the Neurosciences is the leading communication platform dealing with the historical roots of the basic and applied neurosciences. Its domains cover historical perspectives and developments, including biographical studies, disorders, institutions, documents, and instrumentation in neurology, neurosurgery, neuropsychiatry, neuroanatomy, neurophysiology, neurochemistry, neuropsychology, and the behavioral neurosciences. The history of ideas, changes in society and medicine, and the connections with other disciplines (e.g., the arts, philosophy, psychology) are welcome. In addition to original, full-length papers, the journal welcomes informative short communications, letters to the editors, book reviews, and contributions to its NeuroWords and Neurognostics columns. All manuscripts are subject to initial appraisal by an Editor, and, if found suitable for further consideration, full- and short-length papers are subject to peer review (double blind, if requested) by at least 2 anonymous referees.