Published online by Cambridge University Press: 06 January 2022
Horsley’s first brain operation for the treatment of posttraumatic epilepsy in May 1886 was followed rapidly by others: by the end of the year he had operated on the brain in ten cases, and by the end of the decade in forty-four.1 His technical facility in handling the brain had been developed through his experimental studies in animals and by his experience as a pathologist. His skill, self-confidence, anatomical knowledge, and ambidexterity allowed him to operate with enormous speed, thereby lessening the very real risks of anesthesia, and his adherence to the new principles of antisepsis, which many of his surgical contemporaries initially rejected, reduced the complication rate from infection. Working primarily at the National Hospital assured him of a plentiful supply of patients requiring neurosurgical intervention. Localization of the pathological abnormality was by clinical methods alone.
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