Samuel Alexander Kinnier Wilson

Samuel Alexander Kinnier Wilson was born in New Jersey, USA. His father was the Reverend James Kinnier Wilson, a native of Ireland and a Presbyterian priest who died when Samuel was but one year of age. The family then moved back to their home in Edinburgh. He was educated at George Watson's College, Edinburgh, where his exceptional language skill earned him several prizes for Greek and Latin. He subsequently paid his way through his medical studies at the University of Edinburgh by teaching these disciplines.

After graduating M.B. from the University of Edinburgh in 1902 Wilson became house physician at the Royal Edinburgh Infirmary with Sir Byrom Bramwell (1847-1931), and it was here he gained his lifelong interest in neurology. In 1903 he gained his B.sc. in physiology with honours, and that year went to Paris to work with Pierre Marie (1853-1940), before working for one year with Joseph Babinski (1857-1932) at the Bicêtre. After a short visit to Leipzig he returned to London, where in 1904 he came to the National Hospital for Nervous Diseases, Queen Square. Commencing as a house physician, he became registrar and pathologist, and up to honorary physician. Here he spent most of his professional life, with a group of neurologists that included Sir William Richard Gowers (1845-1915), John Hughlings Jackson (1835-1911), Henry Charlton Bastian (1837-1915) and Sir Victor Alexander Haden Horsley (1857-1916).

Samuel Wilson in July 1912 won great repute and received the gold medal of the University of Edinburgh for a 211 page doctoral thesis entitled "Progressive lenticular degeneration: A familial nervous disease associated with cirrhosis of the liver". Although Westphal-Strümpell's pseudosclerosis had already been described, as Wilson himself pointed out, they did not discuss the lenticular or hepatic aspects, thus they failed to recognise the two major signs of the disorder.

At this time he was 33 years of age and employed as a registrar at the National Hospital, Queen Square, London. In the following year Wilson published an article on the same topic in the journal Brain. He described four affected persons whom he had studied, giving autopsy details in three and adding information concerning two further patients for whom details were available. He enumerated his conclusions, making the erroneous point that "the condition was often familial but not congenital or hereditary"!

Wilson's paper introduced the term "extrapyramidal" into neurology and focused attention upon the importance of the basal ganglia. Following his exposition his name became attached to the disorder, which was also known as "hepatolenticular degeneration". Wilson insisted on referring to the condition as Kinnier Wilson Disease. The American neurologist Derek Ernest Denny-Brown (1901-1981) once asked Wilson about his opinion on the essential criteria of "hepatolenticular degeneration". Wilson eyed him with some circumspection and starting to walk away, asked "Do you mean Kinnier Wilson's disease?" Although a skilled histologist, he took little interest in laboratory work, and most of his numerous papers concerned clinical neurology.

He was the epitome of Queen's Square neurology, and his discovery led to his appointment as professor of neurology at King's College Hospital - the first chair of this discipline in England. He also established practice as a clinician in Harley Street, were Charlie Chaplin was one of his patients.

Samuel Wilson was a legendary teacher, a quick witted man with a keen if ironic sense of humour, and possessing that element of "hamishness" which seems to be essential in demonstrating neurological problems. He was said to exceptionally stimulating both for students and younger colleagues.

"Wilson was committed to his work, ambitious and enthusiastic to a degree that would have shocked a young doctor of today. After two of his patients had been released from hospital he kept survey of their whereabouts like a vulture awaiting death. To his great concern one of them went to Switzerland as the end was close. But the local doctor was cooperative and sent Wilson a telegram when the patient had died. Wilson did not hesitate for a moment, counted his money and found them just sufficient for a trip to Zurich. In Zurich he himself conducted the autopsy - and made the findings that confirmed his theories.

When making rounds with Foster Kennedy at the Bellevue Hospital, New York, he spent an inordinate time examining a patient with lateral medullary syndrome but with signs that were inconsistent with the anatomy - he turned suddenly to the patient and asked "Will you see to it that I get your brain when you die?" Only someone like Wilson could get away with that type of behaviour.

At times he seemed distant, but his humour and judgment are illustrated by this advice he gave based upon his experience:

1. Never show surprise.
2. Never say the same thing twice to a patient,
3. Never believe what the patient said the doctor said.
4. Be decisive in your indecision.
5. Never take a meal with your patient.

We thank Neill Wilson for information submitted. Samuel Alexander Kinnier Wilson was his great uncle.

• Progressive lenticular degeneratio. A familial nervous disease associated with cirrhosis of the liver.
  Doctoral dissertation. Brain, Oxford, 1912, 34: 295-507.
• Über progressive lenticulare Degeneration.
  Handbuch der Neurologie, volume 5; Berlin, 1914.
• Some problems in neurology. No. 2. Pathological laughing and crying.
  Journal of Neurology and Psychopathology, 1922, 3: 134-139.
• Modern Problems in Neurology. London, 1928.
• Neurology.
  Posthumous. Edited by A. N. Bruce. 2 parts, London, E. Arnold & Co., 1940. 2nd edition, 1954.