History of Neurology WEST COAST NEUROLOGY THE 3

History of Neurology WEST COAST NEUROLOGY: THE 3 BOB’S OF UCSF • ROBERT WARTENBERG MD • ROBERT FISHMAN MD • ROBERT B LAYZER MD Richard J. Barohn, MD Gertrude and Dewey Ziegler Professor of Neurology The University of Kansas Medical Center

• Born in Garten (German border of Russia) Robert Wartenberg, MD (1887 -1956) • Schooling: Gymnasium in Stuttgart • Medical studies: Univ of Kiel, Munich, Freiburg, and Rostock (grad 1919) • Mentors: Hocke (Freiburg), Cassier (Berlin), Nonne (Hamburg), Foerster (Breslau) • 1925: Fellow Rockefeller Foundation- England/France/USA (Boston under Cushing) • 1928: Privatdozent in Freiburg • 1933: Head Neurology Clinic Freiburg • 1935: Fled Nazi Germany to USA & UCSF • rose through academic ranks • 1952: UCSF, Clinical Professor of Neurology • 1954: UCSF, Professor Emeritus

Robert Wartenberg, MD (1887 -1956) • Link to golden age of descriptive neurology in Europe • Wartenberg’s Eponymy’s o Disseminated sensory neuropathy of Wartenberg o Wartenberg syndrome or cheiralgia paraesthetica – radial sensory neuropathy o Sign of Wartenberg – abduction of 5 th finger in ulnar nerve palsy o Phenomenon of Wartenberg – deviation of jaw of opposite side when touch cornea-also cornea mandibular reflex o Roulette Wartenberg - sensory testing device

Robert Wartenberg, MD (1887 -1956) • Books: • Examinations of Reflexes and Diagnostic Test of Neurology (1945) • Diagnostic Tests of Neurology (1953) • Neuritis, Sensory Neuritis, Neuralgia (1958)

Wartenberg’s Sign Associated Movement of the Thumb • Patients palm up on examiners hand • Flex fingers against examiners fingers • Normally – no thumb movement • Pyramidal lesion – thumb abduct, flex, cross palm in opposition • Variant - hook top of patient’s index finger against examiners

Wartenberg Wheel A Wartenberg Wheel, also called a Wartenberg Pinwheel or Wartenberg Neurowheel, is a medical device for neurological use. Robert Wartenberg designed the wheel to test nerve reactions (sensitivity) as it rolled systematically across the skin.

• Born in NYC • College: Columbia, age 16 Robert Fishman, MD (1924 -2012) • Medical school: University of Pennsylvania • Accelerated US Army program in WWII • Graduated in 1947, age 22 • Internship: Yale then MGH • Residency: Columbia, Neurology • Co-residents: D. Ziegler & L. Rowland • Mentor/chair: H Houston Merritt • Korean War - Walter Reed Hospital • Chief Resident & Faculty, Columbia • Studied blood-brain barrier & CSF physiology and biochemistry • 1966: UCSF-Chair Neuro until 1992 • President of AAN, AUPN, ANA, ABPN • 1993 -1997: Editor of Annals of Neurology

Lewis “Bud” Rowland, Dewey Ziegler & Robert Fishman, 2003 . Robert Fishman & Dewey Ziegler

Robert Fishman, MD (1924 -2012) • Books: • Cerebrospinal Fluid in Diseases of the Nervous System (1980 1 ST ed. , 2 nd ed. 1992) • Was continuation of H. Houston Merritt’s book - Cerebrospinal Fluid (1938) Fishman, R. 1992 Merritt, HH. 1938

• Born in Cleveland, OH • College: Harvard Robert B. Layzer, MD (1931 -P) • Studied French, History, Literature, and acted in Harvard Theater Group • Won the Garrison Poetry Prize • Medical School: Harvard • Residency: Columbia, Neurology • Fellowship: Columbia, Neuromuscular Disease • Fellow under Lewis Rowland • Faculty: Columbia • 1967: moved to UCSF Neurology dept. after Dr. Fishman • Neuromuscular faculty there his whole career • Publications on Periodic Paralysis, Muscle Energy Metabolism, & Motor Unit Hyperactivity State • Book: Neuromuscular Manifestation of System Disease (1985 – last edition)