The Society of British Neurological Surgeons (SBNS) was founded in December 1926. To celebrate its 100th anniversary in 2026, this history of neurosurgery in the UK and Ireland has been written by Jonathan Pollock, a neurosurgeon and current archivist of the SBNS. His seven historical chapters are supplemented with an eighth chapter on ‘Current Trends and Future Perspectives’ courtesy of seven neurosurgeons. The history which unfolds is a fascinating one. From the absolute prohibition of breaching the dura, dating to antiquity, to the sophisticated techniques now deployed is undoubtedly a remarkable story of progress and achievement.
The development of anaesthesia and antisepsis in the nineteenth century, combined with their application to experimental physiological studies on the animal brain, proved to be the critical stimuli to the inception of human brain surgery. Of the pioneers, the works of William Macewen in Glasgow and Victor Horsley in London are rightly emphasised, although it is the operation by Rickman Godlee in November 1884, the only craniotomy he ever undertook, which retains its almost mythical place as the initial successful localisation and removal of an intracerebral lesion, perhaps because this event impinged on the public as well as the professional consciousness.
Nevertheless, neurosurgery remained for many years largely a subdivision of general surgery rather than an autonomous discipline. Harvey Cushing in the USA looms large because of his influence on practice in the UK in the interwar years, stemming from the number of UK surgeons who undertook some of their training with him in Boston before returning with the wish to devote all their clinical time to neurosurgery.
War was also a significant factor on neurosurgery and neurosurgeons. I was particularly gripped by the story of William Henderson and Martin Nichols who, attending casualties in Belgium in 1940, remained with their patients as the Germans advanced and spent the rest of the conflict as Prisoners of War. The establishment of neurosurgery as a discipline was facilitated by the setting up of multiple units during the Second World War, work in which Hugh Cairns played a significant administrative role. These were both mobile units, sent to various theatres of war, and home units, part of the Emergency Medical Service. Of the latter, perhaps the best known was located at St Hugh’s College Oxford (annoyingly the text often renders this incorrectly as ‘St Hughes College’). These units subsequently evolved into the post-war regional centres for civilian neurosurgical practice.
One might argue that the overall account presented is linear, progressive, “Whiggish” even, but the author does not shy away from occasional less heroic aspects of the history, such as the widespread adoption of leucotomy in its various techniques as a form of psychosurgery.
The author must be commended for having crafted a highly readable account, splendidly illustrated, thoroughly referenced, and occasionally leavened with anecdotes and personal recollections. The book will appeal not only to neurosurgeons but also to anyone with an interest in the history of the clinical neurosciences, a worthy successor to Tom King’s earlier (2017) work A history of the Society of British Neurological Surgeons 1926 to circa 1990.
