Charles Bell
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Sir Charles Bell (12 November 177428 April 1842) was a Scottish surgeon,
anatomist Anatomy () is the branch of morphology concerned with the study of the internal structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old scien ...
,
physiologist Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a subdiscipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out chemical and ...
,
neurologist Neurology (from , "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the nervous system, which comprises the brain, the ...
, artist, and philosophical theologian. He is noted for discovering the difference between sensory nerves and motor nerves in the spinal cord. He is also noted for describing
Bell's palsy Bell's palsy is a type of facial paralysis that results in a temporary inability to control the facial muscles on the affected side of the face. In most cases, the weakness is temporary and significantly improves over weeks. Symptoms can vary f ...
. His three older brothers included Robert Bell (1757–1816) a
Writer to the Signet The Society of Writers to His Majesty's Signet is a private society of Scottish solicitors, dating back to 1594 and part of the College of Justice. Writers to the Signet originally had special privileges in relation to the drawing up of documen ...
, John Bell (1763–1820), also a noted surgeon and writer; and the advocate George Joseph Bell (1770–1843) who became a professor of law at the
University of Edinburgh The University of Edinburgh (, ; abbreviated as ''Edin.'' in Post-nominal letters, post-nominals) is a Public university, public research university based in Edinburgh, Scotland. Founded by the City of Edinburgh Council, town council under th ...
and a principal clerk at the
Court of Session The Court of Session is the highest national court of Scotland in relation to Civil law (common law), civil cases. The court was established in 1532 to take on the judicial functions of the royal council. Its jurisdiction overlapped with othe ...
.


Early life and education

Charles Bell was born in
Edinburgh Edinburgh is the capital city of Scotland and one of its 32 Council areas of Scotland, council areas. The city is located in southeast Scotland and is bounded to the north by the Firth of Forth and to the south by the Pentland Hills. Edinburgh ...
on 12 November 1774, as the fourth son of the Reverend William Bell, a clergyman of the Episcopal Church of Scotland. Charles's father died in 1779 when he was five years old, and so his mother had a unique influence on his early life, teaching him how to read and write. In addition to this, his mother also helped Charles's natural artistic ability by paying for his regular drawing and painting lessons from David Allan, a well-known Scottish painter. Charles Bell grew up in Edinburgh, and attended the prestigious
High School A secondary school, high school, or senior school, is an institution that provides secondary education. Some secondary schools provide both ''lower secondary education'' (ages 11 to 14) and ''upper secondary education'' (ages 14 to 18), i.e., ...
(1784–88). Although he was not a particularly good student, Charles decided to follow in his brother John's footsteps and enter a career in medicine. In 1792, Charles Bell enrolled at the
University of Edinburgh The University of Edinburgh (, ; abbreviated as ''Edin.'' in Post-nominal letters, post-nominals) is a Public university, public research university based in Edinburgh, Scotland. Founded by the City of Edinburgh Council, town council under th ...
and began assisting his brother John as a surgical apprentice. While at the university, Bell attended the lectures of Dugald Stewart on the subject of spiritual philosophy. These lectures had considerable impact on Bell, for some of Stewart's teachings can be traced in Bell's later works in a passage on his ''Treatise on the Hand''. In addition to classes on anatomy, Bell took a course on the art of drawing in order to refine his artistic skill. At the university he was also a member of the
Royal Medical Society The Royal Medical Society (RMS) is a society run by students at the University of Edinburgh Medical School, Scotland. It claims to be the oldest medical society in the United Kingdom although this claim is also made by the earlier London-based ...
as a student and spoke at the Society's centenary celebrations in 1837. In 1798, Bell graduated from the University of Edinburgh and soon after was admitted to the Edinburgh College of Surgeons where he taught anatomy and operated at the
Edinburgh Royal Infirmary The Royal Infirmary of Edinburgh (RIE) was established in 1729, and is the oldest voluntary hospital in Scotland. The new buildings of 1879 were claimed to be the largest voluntary hospital in the United Kingdom, and later on, the Empire."In Comi ...
. While developing his talents as a surgeon, Bell's interests forayed into a field combining anatomy and art. His inherent talent as an artist came to the fore when he helped his brother complete a four-volume work called ''The Anatomy of the Human Body''. Charles Bell completely wrote and illustrated volumes 3 and 4 in 1803, as well as publishing his own set of illustrations in a ''System of Dissections'' in 1798 and 1799. Furthermore, Bell used his clinical experience and artistic eye to develop the hobby of modelling interesting medical cases in wax. He proceeded to accumulate an extensive collection that he dubbed his Museum of Anatomy, some items of which can still be seen today at Surgeon's Hall. Charles Bell's stay in Edinburgh did not last long due to an infamous feud between John Bell and two faculty members at the University of Edinburgh: Alexander Monro Secundus and John Gregory. John Gregory was the chairman of the Royal Infirmary and had declared that only six full-time surgical staff members would be appointed to work at the infirmary. The Bell brothers were not selected and thus barred from practicing medicine at the Royal Infirmary. Charles Bell, who was not directly involved in his brother's feuds, attempted to make a deal with the faculty of the University of Edinburgh by offering the university one hundred guineas and his Museum of Anatomy in exchange for allowing him to observe and sketch the operations performed at the Royal Infirmary, but this deal was rejected.


Professional career

In 1804, Charles Bell left for
London London is the Capital city, capital and List of urban areas in the United Kingdom, largest city of both England and the United Kingdom, with a population of in . London metropolitan area, Its wider metropolitan area is the largest in Wester ...
and in 1805 had established himself in the city by buying a house on Leicester Street. From this house Bell taught classes in anatomy and surgery for medical students, doctors, and artists. In 1809, Bell was among a number of civilian surgeons who volunteered to attend to the many thousands of ill and wounded soldiers who had retreated to Corunna, and 6 years later he again voluntarily attended to the ill and wounded in the aftermath of the Battle of Waterloo. Regrettably, of Bell's 12 amputation cases, only one man survived. In addition to the amputation surgeries, Bell was quite fascinated by musket-ball injuries and in 1814, he published a ''Dissertation on Gunshot Wounds''. A number of his illustrations of the wounds are displayed in the hall of the Royal College of Surgeons of Edinburgh. In 1811, Charles Bell married Marion Shaw. Using money from his wife's dowry, Bell purchased a share of the Great Windmill Street School of Anatomy which had been founded by the anatomist William Hunter. Bell transferred his practice from his house to the Windmill Street School Bell ended up teaching students and conducting his own research until 1824. In 1813–14, he was appointed as a member of the London College of Surgeons and as a surgeon at the Middlesex Hospital. In addition to his domestic pursuits, Bell also served as a military surgeon, making elaborate recordings of neurological injuries at the
Royal Hospital Haslar The Royal Hospital Haslar in Gosport, Hampshire, which was also known as the Royal Naval Hospital Haslar, was one of Britain's leading Royal Naval Hospitals (and latterly a tri-service Ministry of Defence (United Kingdom), MOD hospital) for over ...
and famously documenting his experiences at Waterloo in 1815. For three consecutive days and nights, he operated on French soldiers in the Gens d'Armerie Hospital. The condition of the French soldiers was quite poor, and thus many of his patients died shortly after he operated on them. Dr Robert Knox, who was one of Bell's surgical assistants at Brussels, was critical of Bell's surgical skills and commented rather negatively on Bell's surgical abilities; (the mortality rate of amputations carried out by Bell ran at about 90%). Bell was instrumental in the creation of the
Middlesex Hospital Middlesex Hospital was a teaching hospital located in the Fitzrovia area of London, England. First opened as the Middlesex Infirmary in 1745 on Windmill Street, it was moved in 1757 to Mortimer Street where it remained until it was finally clos ...
Medical School, and became, in 1824, the first professor of Anatomy and Surgery of the College of Surgeons in London. In that same year Bell sold his collection of over 3,000 wax preparations to the
Royal College of Surgeons of Edinburgh The Royal College of Surgeons of Edinburgh (RCSEd) is a professional organisation of surgeons. The RCSEd has five faculties, covering a broad spectrum of surgical, dental, and other medical and healthcare specialities. Its main campus is locate ...
for £3000. In 1829, the Windmill Street School of Anatomy was incorporated into the new
King's College London King's College London (informally King's or KCL) is a public university, public research university in London, England. King's was established by royal charter in 1829 under the patronage of George IV of the United Kingdom, King George IV ...
. Bell was invited to be its first professor of
physiology Physiology (; ) is the science, scientific study of function (biology), functions and mechanism (biology), mechanisms in a life, living system. As a branches of science, subdiscipline of biology, physiology focuses on how organisms, organ syst ...
, and helped establish the Medical School at the University of London, gave the inaugural address when it formally opened, and even helped contribute to the requirements of its certification program. Bell's stay at the Medical School did not last long and he resigned from his chair due to differences of opinion with the academic staff. For the next seven years, Bell gave clinical lectures at the Middlesex Hospital and in 1835 he accepted the position of the Chair of Surgery at the University of Edinburgh following the premature death of Prof John William Turner. He was made a Knight of the
Royal Guelphic Order The Royal Guelphic Order (), sometimes referred to as the Hanoverian Guelphic Order, is a Kingdom of Hanover, Hanoverian order of chivalry instituted on 28 April 1815 by the Prince Regent (later King George IV). It takes its name from the House ...
in 1833. Bell died at Hallow Park near Worcester in the Midlands, while travelling from Edinburgh to London, in 1842. He is buried in
Hallow Sacred describes something that is dedicated or set apart for the service or worship of a deity A deity or god is a supernatural being considered to be sacred and worthy of worship due to having authority over some aspect of the universe ...
Churchyard near Worcester.


Honours and awards

Bell was elected a
Fellow of the Royal Society of Edinburgh Fellowship of the Royal Society of Edinburgh (FRSE) is an award granted to individuals that the Royal Society of Edinburgh, Scotland's national academy of science and Literature, letters, judged to be "eminently distinguished in their subject". ...
on 8 June 1807, on the nomination of
Robert Jameson image:Robert Jameson.jpg, Robert Jameson Robert Jameson Fellow of the Royal Society, FRS FRSE (11 July 1774 – 19 April 1854) was a Scottish natural history, naturalist and mineralogist. As Regius Professor of Natural History at the Univers ...
, William Wright and Thomas Macknight. He served as a Councillor of the RSE from 1836 to 1839. He was elected a
Fellow of the Royal Society of London Fellowship of the Royal Society (FRS, ForMemRS and HonFRS) is an award granted by the Fellows of the Royal Society of London to individuals who have made a "substantial contribution to the improvement of natural knowledge, including mathematic ...
on 16 November 1826, and awarded the Royal Society's gold medal for his numerous discoveries in science. Bell was
knight A knight is a person granted an honorary title of a knighthood by a head of state (including the pope) or representative for service to the monarch, the church, or the country, especially in a military capacity. The concept of a knighthood ...
ed into the Guelphic Order of Hanover in 1831. Like
Sir Richard Owen Sir Richard Owen (20 July 1804 – 18 December 1892) was an English biologist, comparative anatomist and palaeontologist. Owen is generally considered to have been an outstanding naturalist with a remarkable gift for interpreting fossils. ...
, he was also elected a foreign member of the
Royal Swedish Academy of Sciences The Royal Swedish Academy of Sciences () is one of the Swedish Royal Academies, royal academies of Sweden. Founded on 2 June 1739, it is an independent, non-governmental scientific organization that takes special responsibility for promoting nat ...
.


Works

Charles Bell was a prolific author who combined his anatomical knowledge with his artistic eye to produce a number of highly detailed and beautifully illustrated books. In 1799, Bell published his first work "''A System of Dissections, explaining the Anatomy of the Human Body, the manner of displaying Parts and their Varieties in Disease''". His second work was the completion of his brother's four-volume set of "''The Anatomy of the Human Body"'' in 1803. In that same year, Bell published his three series of engravings titled "''Engravings of the Arteries"'', "''Engravings of the Brain''", and "''Engravings of the Nerves".'' These sets of engravings consisted of intricate and detailed anatomical diagrams accompanied with labels and a brief description of their functionality in the human body and were published as an educational tool for aspiring medical students. The "''Engravings of the Brain"'' are of particular importance for this marked Bell's first published attempt at fully elucidating the organization of the nervous system. In his introduction to the work, Bell comments on the ambiguous nature of the brain and its inner workings, a topic that would hold his interest for the remainder of his life. In 1806, with his eye on a teaching post at the
Royal Academy The Royal Academy of Arts (RA) is an art institution based in Burlington House in Piccadilly London, England. Founded in 1768, it has a unique position as an independent, privately funded institution led by eminent artists and architects. Its ...
, Bell published his ''Essays on The Anatomy of Expression in Painting'' (1806), later re-published as ''Essays on The Anatomy and Philosophy of Expression'' in 1824. In this work, Bell followed the principles of
natural theology Natural theology is a type of theology that seeks to provide arguments for theological topics, such as the existence of a deity, based on human reason. It is distinguished from revealed theology, which is based on supernatural sources such as ...
, asserting the existence of a uniquely human system of
facial muscles The facial muscles are a group of striated skeletal muscles supplied by the facial nerve (cranial nerve VII) that, among other things, control facial expression. These muscles are also called mimetic muscles. They are only found in mammals, alth ...
in the service of a
human species Humans (''Homo sapiens'') or modern humans are the most common and widespread species of primate, and the last surviving species of the genus ''Homo''. They are great apes characterized by their hairlessness, bipedalism, and high intelligenc ...
with a unique relationship to the Creator, ideals which paralleled with those of
William Paley William Paley (July 174325 May 1805) was an English Anglican clergyman, Christian apologetics, Christian apologist, philosopher, and Utilitarianism, utilitarian. He is best known for his natural theology exposition of the teleological argument ...
. After the failure of his application (Sir
Thomas Lawrence Sir Thomas Lawrence (13 April 1769 – 7 January 1830) was an English people, English portrait painter and the fourth president of the Royal Academy. A child prodigy, he was born in Bristol and began drawing in Devizes, where his father was a ...
, later President of the Royal Academy, described Bell as "lacking in temper, modesty and judgement"), Bell turned his attentions to the nervous system. Bell published detailed studies of the
nervous system In biology, the nervous system is the complex system, highly complex part of an animal that coordinates its behavior, actions and sense, sensory information by transmitting action potential, signals to and from different parts of its body. Th ...
in 1811, in his privately circulated book ''An Idea of a New Anatomy of the Brain''. In this book, Bell described his idea of the different nervous tracts connecting with different parts of brain and thus leading to different functionality. His experiments to investigate this consisted of cutting open the spinal cord of a rabbit and touching different columns of the cord. He found that an irritation of the anterior columns led to a convulsion of the muscles, while an irritation of the posterior columns had no visible effect. These experiments led Bell to declare that he was the first to distinguish between sensory and motor nerves. While this essay is considered by many to be the founding stone of clinical neurology, it was not well received by Bell's peers. His experimentation was criticized and the idea that he presented of the anterior and posterior roots being connected to the cerebrum and cerebellum respectively, was rejected. Furthermore, Bell's ''original'' essay of 1811 did not actually contain a clear description of motor and sensory nerve roots as Bell later claimed, and he seems to have issued subsequent incorrectly dated revisions with subtle textual alterations. Despite this lukewarm response, Charles Bell continued to study the anatomy of the human brain and laid his focus upon the nerves connected to it. In 1821, Bell published the ''"On the Nerves: Giving an Account of some Experiments on Their Structure and Functions, Which Lead to a New Arrangement of the System"'' in Philosophical Transactions of the Royal Society. This paper held Bell's most famous discovery, that the facial nerve or seventh cranial nerve is a nerve of muscular action. This was quite an important discovery because surgeons would often cut this nerve as an attempted cure for facial neuralgia, but this would often render the patient with a unilateral paralysis of the facial muscles, now known as Bell's Palsy. Due to this publication, Charles Bell is regarded as one of the first physicians to combine the scientific study of neuroanatomy with clinical practice. Bell's studies on
emotional expression An emotional expression is a behavior that communicates an emotional state or attitude. It can be verbal or nonverbal, and can occur with or without self-awareness. Emotional expressions include facial movements like smiling or scowling, simple ...
played a catalytic role in the development of Darwin's considerations of the origins of human emotional life; and, while he rejected Bell's theological arguments, Darwin very much agreed with Bell's emphasis on the expressive role of the
muscles of respiration The muscles of respiration are the muscles that contribute to inhalation and exhalation, by aiding in the expansion and contraction of the thoracic cavity. The diaphragm and, to a lesser extent, the intercostal muscles drive respiration during ...
. Darwin detailed these opinions in his ''
The Expression of the Emotions in Man and Animals ''The Expression of the Emotions in Man and Animals'' is Charles Darwin's third major work of evolutionary theory, following ''On the Origin of Species'' (1859) and '' The Descent of Man, and Selection in Relation to Sex'' (1871). Initially in ...
'' (1872), written with the active collaboration of the psychiatrist James Crichton-Browne. Bell was one of the first physicians to combine the scientific study of neuroanatomy with clinical practice. In 1821, he described in the trajectory of the
facial nerve The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of ta ...
and a disease,
Bell's Palsy Bell's palsy is a type of facial paralysis that results in a temporary inability to control the facial muscles on the affected side of the face. In most cases, the weakness is temporary and significantly improves over weeks. Symptoms can vary f ...
which led to the unilateral paralysis of facial muscles, in one of the classics of neurology, a paper delivered to the Royal Society entitled ''On the Nerves: Giving an Account of some Experiments on Their Structure and Functions, Which Lead to a New Arrangement of the System.'' Bell also combined his many artistic, scientific, literary and teaching talents in a number of wax preparations and detailed anatomical and surgical illustrations, paintings and engravings in his several books on these subjects, such as in his book ''Illustrations of the Great Operations of Surgery: Trepan, Hernia, Amputation, Aneurism, and Lithotomy'' (1821). He wrote also the first treatise on notions of anatomy and physiology of
facial expression Facial expression is the motion and positioning of the muscles beneath the skin of the face. These movements convey the emotional state of an individual to observers and are a form of nonverbal communication. They are a primary means of conveying ...
for painters and illustrators, titled ''Essays on the Anatomy of Expression in Painting'' (1806). In 1829, Francis Egerton, the eighth Earl of Bridgewater, died and in his will, he left a large sum of money to the President of the Royal Society of London. The will stipulated that the money was to be used to write, print, and publish one thousand copies of a work on the Power, Wisdom, and Goodness of God. The President of the Royal Society, Davies Gilbert appointed eight gentlemen to write separate treatises on the subject. In 1833, he published the fourth
Bridgewater Treatise The Bridgewater Treatises (1833–36) are a series of eight works that were written by leading scientific figures appointed by the President of the Royal Society in fulfilment of a bequest of £8000, made by Francis Henry Egerton, 8th Earl of Bridg ...
, ''The Hand: Its Mechanism and Vital Endowments as Evincing Design''. Charles Bell published four editions of ''The Hand''. In the first few chapters, Bell organizes his treatise as an early textbook of comparative anatomy. The book is full of pictures where Bell compares "hands" of different organisms ranging from human hands, chimpanzee paws, and fish feelers. After the first few chapters, Bell orients his treatise around the significance of the hand and its importance in its use in anatomy. He emphasizes that the hand is as important as the eye in the field of surgery and that it must be trained.


Legacy

A number of discoveries received his name: * Bell's (external respiratory) nerve: The long thoracic nerve. *
Bell's palsy Bell's palsy is a type of facial paralysis that results in a temporary inability to control the facial muscles on the affected side of the face. In most cases, the weakness is temporary and significantly improves over weeks. Symptoms can vary f ...
: a unilateral
idiopathic An idiopathic disease is any disease with an unknown cause or mechanism of apparent spontaneous origin. For some medical conditions, one or more causes are somewhat understood, but in a certain percentage of people with the condition, the cause ...
paralysis Paralysis (: paralyses; also known as plegia) is a loss of Motor skill, motor function in one or more Skeletal muscle, muscles. Paralysis can also be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory d ...
of facial muscles due to a lesion of the
facial nerve The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of ta ...
. * Bell's phenomenon: A normal defense mechanism—upward and outward movement of the
eye An eye is a sensory organ that allows an organism to perceive visual information. It detects light and converts it into electro-chemical impulses in neurons (neurones). It is part of an organism's visual system. In higher organisms, the ey ...
which occurs when an individual closes their eyes forcibly. It can be appreciated clinically in a patient with paralysis of the
orbicularis oculi The orbicularis oculi is a sphincter-like muscle in the face that closes the eyelids. It arises from the nasal part of the frontal bone, from the frontal process of the maxilla in front of the lacrimal groove, and from the anterior surface and b ...
(e.g.
Guillain–Barré syndrome Guillain–Barré syndrome (GBS) is a rapid-onset Paralysis, muscle weakness caused by the immune system damaging the peripheral nervous system. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation ...
or
Bell's palsy Bell's palsy is a type of facial paralysis that results in a temporary inability to control the facial muscles on the affected side of the face. In most cases, the weakness is temporary and significantly improves over weeks. Symptoms can vary f ...
), as the
eyelid An eyelid ( ) is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. "Palpebral ...
remains elevated when the patient tries to close the eye. * Bell's spasm: Involuntary twitching of the
facial muscles The facial muscles are a group of striated skeletal muscles supplied by the facial nerve (cranial nerve VII) that, among other things, control facial expression. These muscles are also called mimetic muscles. They are only found in mammals, alth ...
. *
Bell–Magendie law In anatomy and neurophysiology, this is the finding that the anterior spinal nerve roots contain only motor fibers and posterior roots only sensory fibers and that nerve impulses are conducted in only one direction in each case. The nature and th ...
or Bell's Law: States that the anterior branch of
spinal nerve A spinal nerve is a mixed nerve, which carries Motor neuron, motor, Sensory neuron, sensory, and Autonomic nervous system, autonomic signals between the spinal cord and the body. In the human body there are 31 pairs of spinal nerves, one on each s ...
roots contain only motor fibers and the posterior roots contain only sensory fibers., p. 92. Charles Bell House, part of
University College London University College London (Trade name, branded as UCL) is a Public university, public research university in London, England. It is a Member institutions of the University of London, member institution of the Federal university, federal Uni ...
, is used for teaching and research in surgery.


References


Further reading

* Bell, C., ''The Hand. Its Mechanism and Vital Endowments as Evincing Design''; Bridgewater Treatises, W. Pickering, 1833 (reissued by
Cambridge University Press Cambridge University Press was the university press of the University of Cambridge. Granted a letters patent by King Henry VIII in 1534, it was the oldest university press in the world. Cambridge University Press merged with Cambridge Assessme ...
, 2009; ) * Berkowitz, Carin. ''Charles Bell and the Anatomy of Reform.'' Chicago: The University of Chicago Press, 2015.


External links


Sir Charles Bell engravings

Anatomia 1522–1867
' digital collection, Thomas Fisher Rare Book Library, University of Toronto * {{DEFAULTSORT:Bell, Charles 1774 births 1842 deaths 19th-century Scottish people Medical doctors from Edinburgh People educated at the Royal High School, Edinburgh Alumni of the University of Edinburgh Fellows of the Royal Society of Edinburgh Fellows of the Royal Society Members of the Royal Swedish Academy of Sciences Philosophers of religion British neurologists British neuroscientists Scottish anatomists 19th-century Scottish medical doctors Scottish physiologists Scottish surgeons Academics of the University of Edinburgh Scottish medical writers People of the Scottish Enlightenment Authors of the Bridgewater Treatises Committee members of the Society for the Diffusion of Useful Knowledge