Spiegel and Wycis – The Early Years

The field of human stereotactic surgery was introduced by Ernest A. Spiegel and Henry T. Wycis by a historical paper in Science in 1947. Spiegel was a conservative Vienna trained experimental neurologist who fled the Nazis to Temple Medical School in Philadelphia. Wycis was a huge flamboyant but brilliant neurosurgeon who started as Spiegel's student and then became his collaborator. They described a Horsley-Clarke apparatus that could be used in human stereotactic surgery. It relied on internal cerebral landmarks, which made it accurate enough to be used in humans. The fields of human neurophysiology, pneumoencephalography, radiology, and electrophysiology had advanced enough to provide for the first time the required technology. At the time of their initial publication, they had probably already performed surgery for psychiatric illness, pain, movement disorders, and aspiration of tumor cysts. The first decade after their publication was a remarkably productive time for them and the other pioneers who entered the field.