"I could see, and yet, mon, I could na` see" : William Macewen, the agnosias, and brain surgery

Two little noticed cases in which William Macewen used symptoms of visual agnosia to plan brain surgery on the angular gyrus are reviewed and evaluated. Following a head injury, Macewen’s first patient had an immediate and severe visual object agnosia that lasted for about 2 weeks. After that he gradually became homicidal and depressed and it was for those symptoms that Macewen first saw him, some 11 months after the accident. From his examination, Macewen concluded that the agnosia clearly indicated a lesion in “the posterior portion of the operculum or in the angular gyrus.” When he removed parts of the internal table that had penetrated those structures the homicidal impulses disappeared. Macewen’s second patient was seen for a chronic middle ear infection and, although neither aphasic nor deaf, was ‘word deaf.’ Slightly later he became ‘psychically blind’ as well. Macewen suspected a cerebral abscess pressing on both the angular gyrus and the first temporal convolution. A large subdural abscess was found there and the symptoms disappeared after it was treated. The patients are discussed and Macewen’s positive results analysed in the historical context of the dispute over the proposed role of the angular gyrus as the visual centre.

Localisation and William Macewen`s early brain surgery part I: the controversy

Neurosurgery for the removal of brain tumours based on localising signs is usually dated from the 1884 operation by Bennett and Godlee. However, within weeks of that operation claims were made on behalf of William Macewen, the Glasgow surgeon, to have been the real pioneer of such surgery. According to Macewen's protagonists, he had conducted seven similar operations earlier than Bennett and Godlee and, in a notable 1888 address, Macewen described these seven pre-1884 cases and a number of others operated on after 1884. This paper, which is in two parts, contains an evaluation of the claims made for the priority of Macewen's pre-1884 operations. Part I deals mainly with Macewen's work in fields other than brain surgery that are relevant to it and sets out the facts of the controversy. It begins with a brief biography of Macewen, describes his pioneering work in antiseptic and aseptic surgery, his work on osteotomy and bone regeneration, and his use in brain surgery of the knowledge so gained. Part I concludes with an examination of the battle waged in the newspapers between Macewen's and Bennett's and Godlee's supporters, and of previously unpublished correspondence between Macewen himself, David Ferrier and Hughes Bennett. The primary records of the patients on whom Macewen operated, together with other materials relevant to the controversy, are examined in Part II.

Sir George Simpson : 19th century fur trade governor and precursor of systematic management

Purpose – Sir George Simpson, the Governor of the Hudson's Bay Company (HBC) from 1821 to his death in 1860, was the subject of numerous biographical works that described various facets of the man including his managerial abilities, literary prowess, physical stamina, abundant energy, extensive art collection and ethnological specimens. Two related aspects of his outstanding management style have been overlooked: the genesis of his management style and where it can be placed in the evolution of management practices during the 19th century.

Design/methodology/approach – Primary data from the Hudson's Bay Company archives plus secondary sources.

Findings – Simpson's management abilities came from his grammar school education and his apprenticeship to a counting house. More importantly, it can be attributed to his association with his mentor Andrew Wedderburn, his dedication to the HBC, and his high level of physical and intellectual energy. His information intensive management style was also a significant precursor to systematic management, which occurred later in the 19th century.

Research limitations/implications – Future research should examine other examples of the evolution of management during the 19th century, particularly the transition from sub-unit accountability to systematic management.

Originality/value – The paper emphasizes the importance of managers in making management systems work.