Sir Charles Bell

Sir Charles Bell (1774 – 1842) was a Scottish anatomist, physiologist, neurologist and surgeon.

Bell was a prolific medical writer, anatomical researcher and a skilled artist, especially war injuries and anatomical drawings.

Bell published and illustrated a System of Dissections whilst still at medical school. He demonstrated the relationship between the special sense organs and those circumscribed brain areas where the nerve tracts from the sense organs ended; and demonstrated the motor and sensory functions of the anterior and posterior spinal nerve roots.

Most noted for discovering a difference between sensory nerves and motor nerves in the spinal cord (1807) and for describing Bell’s palsy.


Biography
  • Born on November 12, 1774 in Doune, Perthshire
  • 1799 – Graduated medicine, University of Edinburgh
  • FRCS Fellow of the Royal College of Surgeons, Edinburgh
  • 1809 – studied gunshot wounds at Haslar Hospital after the Battle of Corunna
  • 1824 – Professor of anatomy and surgery at the Royal College of Surgeons and Edinburgh Royal Infirmary
  • 1828 – London University and King’s College
  • 1833 – Knighted by King William IV
  • 1834 – gold medal of the Royal Society
  • 1835 – Chair in Surgery at Edinburgh University
  • Died on April 29, 1842

Medical Eponyms
Bell’s palsy (1827)

Acute idiopathic unilateral paralysis of the facial nerve.

The prototypic case is a lower motor neuron lesion of the facial nerve that presents after a viral prodrome. The patient wakes up in morning and notices in the mirror signs of facial nerve paralysis. Aetiology is most commonly vascular, inflammatory or viral. Risk factors include pregnancy, obesity, hypertension and diabetes.

In 1821, Bell briefly mentioned a man whose facial nerve was injured by a:

suppuration which took place anterior to the ear and through which the nerve passed in its course to the face…cases of this partial paralysis must be familiar to every medical observer. It is frequent for young people to have what is vulgarly called a blight; by which is meant, a slight palsy of the muscles on one side of the face, and which the physician knows is not formidable

Bell C. 1821: 21, 25

In 1827, Bell’s classic description was outlined in a case of paralysis of the face on his patient Daniel Stadler.

X. January 2. 1827, Daniel Stalder accompanied his wife, who had a paralytic stroke, to the Middlesex Hospital. It was observed that the left side of his face was much distorted, and there was great wasting of the muscles. He was examined by Mr. Bell, before the pupils of the Hospital, and it proved to be a case of paralysis of the portio dura.

The two sides of his forehead presented a very striking contrast: the right side was furrowed with deep wrinkles, which were more strongly marked when he frowned : a large fold of the skin was prolonged down upon the same side of his nose, which marked the descending slip of the occipitofrontalis muscle; the left side of his forehead was perfectly smooth, the skin appearing to be stretched tightly over the bone, and there was no motion of the integuments in the act of knitting or elevating his eyebrows.

His eyelids were quite motionless. When he was desired to wink, this eye remained open, and the cornea was elevated so as to be quite hid under the upper eyelid. This eye appeared a little duller than the other, yet he says he never had any disease in it. He cannot see so clearly with it as with the other eye. The left nostril is collapsed, and has not that fulness which the right possesses. Some power of acting with his cheeks seems to remain, as in whistling there is a slight quivering observed.

Although his lips are dragged to the right side, yet they do not appear to be totally deprived of muscular power: he can grasp pretty firmly the point of the little finger, when it is introduced into the left angle of his mouth. He states that he has had this affection since he was a child

Bell. Appendix to the papers on the nerves. 1827: 47-50


Other eponyms

  • Bell’s disease
  • Bell Phenomenon – upward deviation of the eye on attempted eyelid closure.
  • Law of Bell-Magendie
  • Bell’s nerve

Grisel syndrome

Spontaneous, nontraumatic rotatory subluxation of the atlantoaxial joint following peripharyngeal inflammation or otorhino-laryngologic surgical procedures such as tonsillectomy, adenoidectomy and mastoidectomy.

In 1830, Sir Charles Bell reported a case of death from atlanto-axial subluxation which resulted in spinal cord compression in a patient with probable syphilitic ulceration of the pharynx.

A patient, who had a deep ulcer in the back part of the throat, was seized with symptoms like those of apoplexy. These symptoms continued for two hours. At this time the patient’s head fell suddenly forward, and he instantly expired. On dissection, it was found that the ulcer had destroyed the transverse ligament, which holds the process of the dentata in its place. In consequence of the failure of this support, the process was thrown back, so as to compress the spinal marrow. The parts are preserved in my collection.

Bell, Case LXIV 1830

Eponymously named after Pierre Grisel (1869–1959), a French surgeon who described the syndrome characterized by dislocation of the C1–C2 joint in patients with pharyngitis and torticollis in 1930


Controversies

Bell’s career was marred by disputes with the Edinburgh Medical Faculty and he moved to London to teach anatomy. He then left London University surgical position in 1830 ‘dissatisfied by the bureaucratic rules‘ he was forced to comply with.

Bell was one of the first to recognise the different functions of the anterior and posterior nerve roots, and argued extensively with Magendie over whose experiments were more definitive.

Bell criticised Alexander Monro secundus for publishing on the interventricular foramen (of Munro)…presuming to describe something which was already well known and for inaccuracies. Bell stated:

…there is scarcely a book which we can consult without finding the circumstance of the universal communication betwixt the Ventricles particularly mentioned.


Major Publications

References

Biography

Eponymous review


eponym

the person behind the name

Physicianly type with neurological leanings... | LinkedIn |

Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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