Robert Todd
Robert Bentley Todd (1809-1860) was an Irish physician, anatomist, and physiologist.
Todd profoundly influenced 19th-century neurology and medical education. After training at Trinity College Dublin and Oxford, Todd became the first Professor of Physiology and Morbid Anatomy at King’s College London in 1836, where he also spearheaded the founding of King’s College Hospital in 1840. He revolutionized medical training by introducing bedside clinical teaching and became the first Dean of any London medical school.
Todd’s contributions spanned clinical practice, research, and education. He was among the first to break down broad categories of neurological disorders, distinguishing locomotor ataxia (tabes dorsalis) from general paraplegia and accurately localizing pathology to the posterior columns. His writings, including the monumental Cyclopaedia of Anatomy and Physiology and Clinical Lectures on Paralysis and Diseases of the Brain (1854), laid the groundwork for systematic neurophysiology and pathology.
Perhaps his most enduring achievement was the electrical theory of epilepsy, presented in the Lumleian Lectures (1849), decades before Hughlings Jackson. Influenced by Michael Faraday, Todd conceived of the brain as a “nervous battery” and attributed seizures to sudden electrical discharges in cortical grey matter—a concept foundational to modern neuroscience. He also described Todd’s paralysis, the transient hemiparesis following epileptic seizures. A pioneer of interdisciplinary science and compassionate clinical care, Todd died prematurely in 1860, leaving a legacy that shaped neurology, nursing, and medical education.
Biographical Timeline
- Born on April 9, 1809 in Dublin; second son of Charles Hawkes Todd (surgeon) and Elizabeth Bentley.
- 1825 – Entered Trinity College Dublin intending to study law.
- 1826 – Switched to medicine after father’s death; pupil at Richmond Hospital under Robert Graves (1796–1853).
- 1829 – Graduated B.A., Trinity College Dublin.
- 1831 – Licentiate, Royal College of Surgeons in Ireland (LRCSI); moved to London; began anatomy lectures at Aldersgate Street School.
- 1832–1833 Incorporated at Pembroke College, Oxford; earned M.A., B.M. (1833).
- 1836 – D.M. (Oxford); Appointed Chair of Physiology & Morbid Anatomy at King’s College London, aged 27.
- 1836–1839 Co-edited Cyclopaedia of Anatomy and Physiology with William Bowman; introduced terms afferent and efferent; pioneering work on neuroanatomy.
- 1840 – Helped found King’s College Hospital in London; later its most eminent physician.
- 1842 – Became first Dean of King’s College Medical Department; Croonian lecturer on “Practical remarks on gout, rheumatic fever and chronic rheumatism of the joints”
- 1844 – Elected Fellow of the Royal College of Surgeons; Fellow of the Royal Society (1838).
- 1845 – Published The Descriptive and Physiological Anatomy of the Brain, Spinal Cord and Ganglions; advanced neuron theory.
- 1849 – Delivered Lumleian Lectures on convulsive disorders, proposing first electrical theory of epilepsy; described postictal paralysis (Todd’s palsy).
- 1854 – Published Clinical Lectures on Paralysis and Diseases of the Brain.
- 1855 – Founded St. John’s House Nursing Institution, precursor to modern nursing, before Nightingale’s school.
- Died January 30, 1860 in London, aged 50, from gastrointestinal haemorrhage secondary to liver cirrhosis).
- 1861 – Statue erected at King’s College Hospital, honouring his role as founder and teacher.
Medical Eponyms
Todd’s palsy (1849)
Todd’s palsy (paralysis) refers to a focal weakness following a seizure, usually a focal motor seizure in a limb, that completely resolves usually within minutes but has been noted up to 48hrs. This can also include sensory, visual and speech deficits if the corresponding area has been affected.
Todd first mentioned a postictal paralysis in his 1849 Lumleian lecture but clarified the syndrome more in his Clinical lectures using three illustrative cases of what he called “Epileptic Hemiplegia“.
A paralytic state remains sometimes after the epileptic convulsion. This is more particularly the case when the convulsion has affected only one side or one limb: that limb or limbs will remain paralytic for some hours, or even days, after the cessation of the paroxysm, but it will ultimately perfectly recover.
Todd referred to unilateral convulsions, often accompanied by the transient paralysis he described, as “epileptiform”, emphasizing that they should be distinguished from true generalized epilepsy. While his clinical account lacked the precision of modern definitions, he concluded:
The distinction of a form of hemiplegia in connection with the epileptic paroxysm is well founded.
Todd was not the first to recognize hemiplegia following seizures—that credit belongs to Louis François Bravais (1801–1843), who discussed the phenomenon in his 1827 thesis “l’épilepsie hémiplégique.” However, Todd’s detailed clinical characterization secured his enduring association with the condition.
Ironically, Todd himself disapproved of eponymous terms:
I must say that I cannot regard it as any compliment to the great names of our profession, to attach them to any of the numerous ills which flesh is heir to.
Robert Todd on ‘Bell’s paralysis of the face’. 1854
Key Medical Contributions
Locomotor Ataxia and Romberg Sign (1847)
Todd was the first British physician to differentiate locomotor ataxia (tabes dorsalis) from paraplegia, attributing the condition to posterior column disease. He provided a particularly detailed account in his Cyclopaedia of Anatomy and Physiology
Two kinds of paralysis of motion may be noticed in the lower extremities, the one consisting simply in the impairment or loss of the voluntary motion, the other distinguished by a diminution or total loss of the power of co-ordinating movements. In the latter form, while considerable voluntary power remains, the patient finds great difficulty in walking, and his gait is so tottering and uncertain that his centre of gravity is easily displaced
This is the first clear separation of sensory ataxia from simple motor weakness, anticipating the core diagnostic principle underlying Romberg’s sign. He went on to infer posterior column involvement:
In two examples of this variety of paralysis I ventured to predict disease of the posterior columns, the diagnosis being founded upon the views of their functions which I now advocate; and this was found to exist on a post-mortem inspection.
This shows Todd not only described the clinical syndrome but linked it anatomically to the dorsal columns and confirmed his inference at autopsy, decades before systematic neurohistology. William Gowers (1845-1915) credited Todd with the first accurate description of the condition
The credit of the discovery of the disease belongs, if to anyone, unquestionably to Todd
Electrical Theory of Epilepsy (1849)
Todd pioneered the concept of epilepsy as an electrical disorder of the brain, before John Hughlings Jackson. Influenced by Faraday’s work on electromagnetism, he compared the brain to a galvanic battery:
At these points there is generated constantly and unceasingly a force, which in its nature resembles very closely the galvanic force… We may call the nervous power a polar force, generated in the centres, and propagated by the rapid polarization of the neighbouring particles in various directions.
Todd’s model anticipated the neuron doctrine and the modern concept of neuronal discharge as the basis for epileptic seizures.
Medical Education and Nursing Legacy
Todd transformed medical training in London, introducing systematic clinical teaching and physiology-based curricula at King’s College. In 1855, he founded St. John’s House Nursing Institution, which predated Florence Nightingale’s school at St. Thomas’ Hospital and influenced the modern nursing profession.
The Cyclopædia and Scientific Impact
Todd co-edited the five-volume Cyclopædia of Anatomy and Physiology (1835–1859), introducing fundamental neurophysiological terms like afferent and efferent. His collaboration with William Bowman advanced microscopic anatomy, bridging clinical neurology and experimental science.
Controversies
Potion de Todd and the Hot Toddy
Among Todd’s quirks was his enthusiastic prescription of brandy and wine in febrile illness, a practice that earned him both followers and critics. His preference may have reflected the therapeutic liberalism of his mentor Robert Graves, who famously advocated nourishing fever patients, although Graves did not prescribe alcohol.
Todd’s reputation for spirited prescriptions crossed the Channel: in the French pharmacopoeia, the “Potion de Todd” comprised brandy, cinnamon, and sugar. However, Todd had no connection to the “hot toddy” drink whose name derives from the Hindi tāṛī (palm wine) which entered the English language as early as 1611.
Tragically, Todd himself was “too fond of alcohol”; chronic excess contributed to hepatic cirrhosis, and in 1860, at age 50, he collapsed and died from a massive haematemesis in his consulting room.
Major Publications
- Todd RB (editor). The Cyclopaedia of Anatomy and Physiology. 1836 [Vol I, Vol II, Vol III, Vol IV(1), Vol IV(2), Vol IV(3), Vol V)
- Todd RB. Physiology of the nervous system In: The cyclopædia of anatomy and physiology. London. 1847; 3: 721 [Romberg’s sign]
- Todd RB. On the pathology and treatment of convulsive diseases. 1849
- Todd RB. Clinical lectures on paralysis, certain diseases of the brain and other affections of the nervous system. 1854.
- Todd RB. Clinical lectures on certain diseases of the urinary organs, and on dropsies. 1857
- Todd RB. Clinical lectures on certain acute diseases. 1860
References
Biography
- Goldblatt D. The great names of our profession. Robert Bentley Todd (1809-1860). Semin Neurol. 1986 Sep;6(3):332-5.
- Pearce JM. Robert Bentley Todd (1809-60) and Todd’s paralysis. J Neurol Neurosurg Psychiatry. 1994 Mar;57(3):315.
- McIntyre N. Robert Bentley Todd (1809-60) J Med Biogr 2008; Feb;16(1):2.
- Pearce JMS. Robert Bentley Todd. Hektoen International 2022
Eponymous terms
- Bravais LF. Recherches sur les symptômes et le traitement de l’épilepsie hémiplégique, Thèse, Paris, 1827.
- Pearce JM. Robert Bentley Todd (1809-60) and locomotor ataxia. J Neurol Neurosurg Psychiatry. 1994 Mar;57(3):359.
- Lyons JB. Some contributions of Robert Bentley Todd. J Hist Neurosci. 1998 Apr;7(1):11-26.
- Koehler PJ, Bruyn GW, Pearce JMS. Todd Paralysis. In: Neurological Eponyms. Oxford University Press 2000: 100-105
- Binder DK. A history of Todd and his paralysis. Neurosurgery. 2004 Feb;54(2):480-6; discussion 486-7.
- Reynolds EH. Todd, Faraday, and the electrical basis of epilepsy. Epilepsia. 2004 Aug;45(8):985-92.
- Reynolds EH. Robert Bentley Todd’s electrical theory of epilepsy. Epilepsia. 2005 Jul;46(7):991-4.
- Binder DK, Rajneesh KF, Lee DJ, Reynolds EH. Robert Bentley Todd’s contribution to cell theory and the neuron doctrine. J Hist Neurosci. 2011 Apr;20(2):123-34.
Eponym
the person behind the name
Emergency Medicine Trainee based in Perth, Western Australia. Keen interest in ultrasound, rural health and water-based activities.
