Journal Mobile

MJ Eadie
Journal Issue: 
Volume 38: Issue 2: 2008




Marshall  Hall  (1790–1857),  who  graduated  from  the  University  of Edinburgh’s  Medical  School  in  1812,  was  considered  one  of  the  greatest physiologists of his day. He advanced knowledge in various areas of medicine, in particular elucidating the mechanism of reflex activity in 1833. Hall suggested that convulsive epileptic seizures arose from heightened activity in the afferent limb or the central component of the reflex arc. From 1838 onwards he developed the idea  that  reflex-mediated  neck  muscle  spasm  in  seizures  obstructed  cerebral venous return, congested the brain and thus caused unconsciousness. Associated reflex-mediated  laryngeal  spasm  then  caused  convulsing. This  was  the  most comprehensive  physiologically  based  explanation  of  the  major  features  of  the convulsive  epileptic  seizure  then  available.  Hall  subsequently  advocated  and employed  tracheotomy  to  prevent  epileptic  convulsing.  His  idea  was  taken  up, modified  and  made  more  acceptable  by  others,  and  for  a  generation  was  the widely acknowledged basis for interpreting epileptogenesis. However, from 1870 onwards  it  was  superseded  by  John  Hughlings  Jackson’s  accumulating  evidence that epileptic seizures often arose in the cerebral cortex.