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William Gowers

Sir William Richard Gowers (1845 - 1915)

Sir William Richard Gowers (1845 – 1915) was an English neurologist.

Biography
  • Born 20 March 1845
  • 1895 – Formed his own Society of Medical Phonographers to further Pitman’s shorthand method of communication
  • Died 4 May 1915
On nomenclature and the use of eponyms:

I have avoided the use of these terms [eponyms]. This nomenclature is one full of inconvenience, increasing the difficulties of the student, and leading to frequent mistakes in scientific writings. There are very few observations in medicine regarding which it is not obvious that they would speedily have been made by someone other than the actual observer; that it was very much of an accident that they were made by certain individuals. Scientific nomenclature should be itself scientific, not founded upon accidents. However anxious we may be to honour individuals, we have no right to do so at the expense of the inconvenience of all future generations of learners.

Gowers 1880: 11
Medical Eponyms
Gowers sign (1879)

Physical examination finding seen in patients with proximal weakness of the extensor muscles of the thighs and is most often associated with Duchenne muscular dystrophy. Process of arising from the squatting position with the aid of the hands placed on the floor beside and behind the feet to give a push upward. The patient is unable to stand from a sitting position with the arms outstretched.

Gowers first described the sign in a lecture he gave at Queen Square on ‘Pseudo-hypertrophic muscular paralysis‘ in July, 1879:

Neologisms and new definitions:

abiotrophy: (1904) (Gr, lack of + organism + turn) First used by Gowers in his discussion of spinocerebellar degeneration. Signifies the cessation of growth of an organ. It is used to label a process whereby the previously normal metabolism of certain cell lines ceases, frequently as an age-related process.

ataxic paramyotonia (1892) (Gr, beside + muscle + stretching) Acquired nervous disease characterized by tonic spasms in certain muscle groups associated with ataxia and both sensory and motor deficits, first described by Gowers.

basal ganglia (1885) Gowers used the term to describe the deep cerebral nuclei concerned with the elaboration of motor activity

borderland of epilepsy (1907) group of disorders including fainting, vagal and vasovagal attacks, vertigo, migraine, and sleep disorders which by their abrupt onset, repetitive nature, and brief duration resemble seizure disorders.

clasp-knife rigidity (1886) When the examiner attempts to extend the flexed limb of a patient with a pyramidal lesion, Gowers records:

If gradually extended, when near full extension the spasm suddenly comes on and completes the movement, as the blade of a pocket knife moves under the influence of the spring. Hence this has been termed ‘clasp-knife rigidity’.

Gowers 1886: 150

cutaneous reflexes (1886) Motor activity occurring reflexly in response to stimulation of skin or mucous membranes.

[reflex action] excited by stimulation of the skin, more readily by a gentle stimulation, as a touch, than by a strong, painful impression. The cutaneous reflex actions may be excited at almost any part of the skin, but at some parts they are very definite in character, and are distinguished by special names. The most important are the ‘plantar reflex,’ from the sole; the ‘gluteal reflex,’ a contraction in the gluteus when the skin over the muscle is stimulated; the ‘cremaster reflex,’ a retraction of the testicle on stimulation of the skin on the inner part of the thigh; the ‘abdominal reflex,’ in the muscles of the abdominal wall when the skin over the side of the abdomen is stroked…

Gowers 1886: 11

knee-jerk (1892)

the jerk of the leg which occurs when the patellar tendon is tapped. It has been called the ‘knee-phenomenon’ by Westphal, the ‘patellar tendon-reflex’ by Erb, the ‘knee-jerk’ by myself.

Gowers 1892: 15
Gowers Knee-jerk 1892
Gowers Knee-jerk 1892

teakettle calves (1893) The appearance of the calves in pseudohypertrophic muscular dystrophy

Rarely, the patient is conscious of no symptoms until after puberty, at the age of eighteen or twenty, but in such apparently late onset, there has been enlargement of muscles long before power becomes impaired, and the disease began much earlier than it seemed to do. One patient, for instance, in whom weakness was only noticed when she was twenty, had been often “chaffed,” when a young girl at school, on account of her “teakettle calves”

Gowers 1893

rachialgia (1892) (Gr, spine + pain) “Spinal irritation . . . local pain and tenderness referred to the spinal column itself”

combination of local pain and tenderness frequently occurs in cases of neuralgic pain, “rachialgia” — a condition that is often loosely termed ‘spinal irritation,’ especially when it succeeds, as it often does, concussion of the spine.

vasovagal attacks (1907)

Major Publications
References

Biography

Eponymous terms

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, 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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