arate board. The institute, as the hospital's research arm, continued to be the responsibility of the board of governors of McGill University. Close dayto-day relations are maintained with the Royal Victoria Hospital, which still provides many services, including med-
ical and surgical consultations; the MNH, in turn, provides neurology and neurosurgical services and runs specialty outpatient and emergency clinics. The demand for teaching, research and patient care continues. New faces and new teams appear, eager to apply
their skills as the old guard stands aside and applauds. Now we look forward to the opening late in 1977 of a fine new building, the Penfield Pavilion (Fig. 1). Wilder Penfield had a dream, and he saw his dream fulfilled.E
Surgical treatment of epilepsy THEODORE B. RASMUSSEN,* MD, MS, FRCS[C]
Wilder Penfield's interest in epilepsy began early in his medical career and led to his well known studies on the histologic aspects of the healing of brain wounds.1 A need for better understanding of the role of glial cells in this process led to his fruitful period of study in Madrid with Pio del RioHortega and Ram6n y Cajal in 19242. and, after his return to New York City, to subsequent studies with William Cone on oligodendroglia and microglia." His interest in the surgical treatment of epilepsy began with a short period of association and study in Breslau with Otfried Foerster in 1928. This introduced him to the possibility of relieving focal post-traumatic epilepsy by excising the brain cicatrix and the adjacent irritable cerebral cortex.' Details of the first four patients undergoing operations to relieve focal epilepsy in Montreal were reported in 1930." Penfield's role in the development of the surgical approach to the treatment of epilepsy parallels in several aspects Harvey Cushing's role in the development of the surgical treatment of brain tumours a generation earlier. Both surgeons began their work in these fields when many physicians in the Western world had serious reservations as to the potential benefits of definitive surgical approaches to these clinical problems. Both of these neurosurgical pioneers from the beginning carried out detailed studies and analyses of each patient's clinical problem from both pathologic and physiologic standpoints. Penfield's paper in 193311 on the cerebral localization of epileptic manifestations was the first of a long series on cortical function as revealed by clinical and operative studies. These were carried out on patients with a variety of seizure problems who came to the Montreal Neurological Institute (MNI) in steadily increasing numbers. 'Professor of neurosurgery, McGill University; and former director, Montreal Neurological Institute
Both Cushing and Penfield meticulously documented for each patient the history, clinical findings, surgical findings, detailed gross and microscopic features of specimens, postoperative course and follow-up results. Observations at the operating table led to Penfield's early interest in the possible importance of variability in the cerebral circulation in epilepsy,12-14 as well as to his many contributions to cortical function in the human brain. Both men introduced important technical refinements in the techniques of the surgical procedure. Electric stimulation of the cerebral cortex in patients undergoing craniotomy under local anesthesia increased the safety of cortical excisions near the sensorimotor and speech areas and added to knowledge of localization of function in the human cerebral cortex.'517 Penfield was quick to appreciate the potential role of electroencephalography in the study of patients with epilepsy. He brought Herbert Jasper to the MNI in 1938 to develop the application of this new technique in the clinic, the operating room and the laboratory.1822 The technique of subpial resection of cortical areas was developed to minimize the cicatrix resulting from the cortical excision and thus reduce the seizure tendency resulting from the surgical procedure. Like Cushing, Penfield appreciated the importance of "keeping the score" and of the lessons to be learned from repeated analysis of the patients' records and findings as the years pass.2327 Until the fledgling science of electroencephalography proved its value in the operating room and in the routine clinical investigation of the epileptic patient, Penfield believed that cortical resection was indicated only if an obvious gross lesion of the brain was disclosed in the expected location at operation or if the patient's habitual seizure or aura was reproduced by electric stimulation of the cortex. Thus, no cortical resection was made in 20% of the craniotomies carried out for
seizures in the first decade, 1928 to 1937. Such negative explorations accounted for 5 % of the craniotomies carried out for focal epilepsy during the next decade, 1938 to 1947, and they disappeared by 1956 as preoperative electroencephalography and cortical recordings in the operating room provided increasingly accurate identification of the epileptogenic areas of the cortex. Several of Penfield's earliest operations for seizures were carried out in the temporal region and several excisions of the temporal lobe cortex were carried out in each of the early years. Awareness of the importance of temporal lobe epilepsy as the most frequent of all focal types of epilepsy, however, developed only gradually as electroencephalography became increasingly effective in the investigation of epileptic patients and with the gradual accumulation of psychic and automatic responses to cortical stimulation of the temporal lobe during operations carried out under local anesthesia.21'22'.'2831 The importance of birth compression in producing temporal lobe epilepsy was reported in 1953.32 Penfield's last paper specifically concerned with the surgical treatment of epilepsy appeared in 1967... His publications, covering 40 years and ranging widely over the field of epilepsy, have stimulated a great variety of clinical and experimental investigations in this fascinating and complex field. It is largely as a result of Penfield's painstaking and scholarly studies that cortical resection has gradually earned a secure place in the treatment of medically refractory focal epilepsy and is now being carried out in an increasing number of major neurosurgical centres around the world. The surgical treatment of epilepsy constitutes one of Penfield's principal scientific monuments and has continued to be one of the main fields of interest of the neurosurgical staff of the Montreal Neurological Hospital. As a result, the "surgical seizure series" started by
CMA JOURNAL/JUNE 18, 1977/VOL. 116
1369
Penfield's pioneering craniotomies in 1928 has grown to include over 2200 operations in nearly 2000 patients, and continues to provide new knowledge about the way the human brain functions in health and disease. References I. PEN FIELD WG: Meningocerebral adhesions. A histological study of the results of cerebral incision and cranioplasty. Surg Gynecol Obseet 39: 803, 1924 2. Idem: Microglie et son rapport avec la d6g6n6ration microgliale dans un gliome. Tray Lab Recherches Biol Univ Ma rid 22: 277, 1924 3. Idem: Oligodendroglia and its relation to classical neuroglia. Brain 47: 430, 1924 4. Idem: Phagocytic activity of microglia in the central nervous system. Proc NY Pathol Soc 25: 71, 1925 5. RfO-HORTEGA P
DEL,
PENFIELD
W:
Cerebral
cicatrix: the reaction of neuroglia and microglia to brain wounds. Bull Johns Hopkins Hosp 41: 278, 1927 6. PENFIELD W, CONE W: Acute swelling of oligodendroglia: a specific type of neuroglia change. Arch Neurol Psychiatry 16: 131, 1926 7. PENFIELD WG: The acute regressive changes of neuroglia (ameboid glia and acute swelling of oligodendroglia). J Psychol Neurol 34: 204, 1926 8. Idem: The mechanism of cicatrical contraction in the brain. Brain 50: 499, 1927
9. FOERSTER 0, PENFIELD W: The structural basis of traumatic epilepsy and results of radical operation. Brain 53: 99, 1930 10. PENFIELD W: The radical treatment of traumatic epilepsy and its rationale. Can Med Assoc J 23: 189, 1930 11. PENFIELD W, GAGE L: Cerebral localization of epileptic manifestations. Arch Neurol Psychiatry 30: 709, 1933 12. PENFIELD W: The evidence for a cerebral vascular mechanism in epilepsy. Ann Intern Med 7: 303, 1933 13. Idem: Las effets des spasmes vasculaires dans l'6pilepsie. Union Med Can 63: 1275, 1934 14. Idem: The circulation of the epileptic brain.
Rex Pubi Assoc Rex Nerv Ment Dis 18: 605,
1938 15. PENFIELD W, BOLDREY E: Somatic motor and sensory representation in the cerebral cortex of man as studied by electrical stimulation. Brain 60: 389, 1937 16. PENFIELD W, RASMUSSEN T: Further studies of the sensory and motor cortex of man. Fed Proc 6: 452, 1947
17. Idem: The Cerebral Cortex of Man, New
York, Macmillan, 1951 18. PENFIELD W, ERIcKsON
Cerebral Localization,
TC:
Epilepsy and
Springfield,
IL, CC
Thomas, 1941 19. JASPER H, PENFIELD W: Electroencephalograms in post-traumatic epilepsy: preoperative and postoperative studies. Am J Psychiatry 11: 365, 1943 20. PENFIELD W, JASPER H: Highest level sei-
zures. Proc Assoc Rex Nerv Ment Dix 26: 252, 1947
21. FEINDEL W, PENFIELD W:
Localization of
discharge in temporal lobe automatism. Arch Neurol Psychiatry 72: 605, 1954
22. PENFIaLD W, JASPER H: Epilepsy and the
Functional Anatomy of the Human Brain, Boston, Little, 1954
23. PENFIELD W: Epilepsy and surgical therapy.
Arch Neurol Psychiatry 36: 449, 1936 24. PENFIELD W, STEELMAN H: The treatment of focal epilepsy by cortical excision. Ann Surg 126: 740, 1947 25. PaNFIELD W, FLANIGAN H: Surgical therapy of temporal lobe seizures. Arch Neurol Psychiatry 64: 491, 1950 26. PENFIELD W, PAINE K: Results of surgical therapy for focal epileptic seizures. Can Med Assoc J 73: 515, 1955 27. PENFIELD W: Pitfalls and success in surgical treatment of epilepsy. Br Med J 1: 669, 1958
28. Idem: Psychical seizures. Br Med 1 2: 639, 1946 29. PENFIELD W, BALDWIN M: Temporal lobe
seizures and the technique of subtotal temporal lobectomy. Ann Surg 136: 625, 1952 30. PENFIELD W: Temporal lobe epilepsy (Hunterian lecture). Br I Surg 41: 337, 1954 31. Idem: The role of the temporal cortex in
certain psychical phenomena. Br Ment Sci 101: 451, 1955
32. EARLE KM, BALDWIN M, PENFIELD W: In-
cisural sclerosis and temporal lobe seizures produced by hippocanipal herniation at birth. Arch Neurol Psychiatry 69: 27, 1953
33. PENFIELD W: Epilepsy, the great teacher: the progress of one pupil. Acta Neurol Scand
43: 1, 1967
Impact on medical neurology FRANCIS L. MCNAUGHTON,* M SC, MD, CM, FRCP[C]
It is difficult in a short space to do justice to Wilder Penfield's many contributions to medical neurology because so many things he achieved have been of significance to neurology and to neurologists everywhere. Throughout his career he was widely regarded as a skilled neurosurgeon, but I would claim him rather as the complete neurologist. True, he had the bold, direct approach to problems and the manual skills that we usually associate with a surgeon, but for him neurosurgery was merely one technical aspect of his work. As Cushing would say, he was a neurologist who did his own operating. Among Penfield's early papers that helped to establish his reputation are those on the cytology of the nervous system, on brain tumour classification and on experimental brain scars. He later published studies on intracranial pain, on the nerve supply of intracranial structures and on surgical methods for the relief of intractable headache. He also became greatly interested in the nervous control of the cerebral circulation and the possible role of *Emeritus professor of neurology, McGill University
vascular spasm in provoking epileptic seizures. This work led to pioneering studies of cerebral circulation, which has become a vast and exciting area of research since those early days. There is no doubt that Penfield's greatest contribution to neurology grew from his years of concentrated research on epilepsy, which began immediately after his arrival in Montreal in 1928 and continued, with scarcely any interruption, for over 40 years. His interest was stimulated from the beginning by the writings of Hughlings Jackson on epilepsy and the functional anatomy of the brain, as well as by Otfried Foerster's surgical experience in treating post-traumatic epilepsy. Penfield's work established a firm basis for the modern diagnosis and neurosurgical treatment of focal types of epilepsy, particularly those involving the temporal lobe, and brought new hope for the patient with seizures. In studying and treating such patients he not only increased our understanding of epilepsy but also added greatly to our knowledge of the normally functioning brain through his fresh observations on memory, speech and consciousness. Some of his writings have already
1370 CMA JOURNAL/JUNE 18, 1977/VOL. 116
become neurologic classics. Two such are "The Cerebral Cortex of Man",1 with coauthor Theodore Rasmussen, and "The Excitable Cortex in Conscious Man",2 his Sherrington lecture of 1958. His "magnum opus.., "Epilepsy and the Functional Anatomy of the Human Brain",3 written with Herbert Jasper, records the observations and thinking of an unusual team of investigators, consisting of Wilder Penfield, the surgeon-neurologist, and Herbert Jasper, the pioneering neurophysiologist, as well as their many devoted coworkers. These are some of the significant ways in which Wilder Penfield has influenced the course of neurology in the 20th century. But perhaps his most creative contribution, his legacy for the future, lies in what he called "this continuing fabulous enterprise". He was referring, of course, to the institute that he founded. References 1. PENFIELD W,
RASMUSSEN
T:
The Cerebral
Cortex of Man, New York, Macmillan, 1951 2. PENFIELD W: The Excitable Cortex in Conscious Man, Liverpool, Liverpool U Pr, 1958 3. PENFIELD W, JASPER H:
Epilepsy and the
Functional Anatomy of the Human Drain, Boston, Little, 1954
ical and surgical consultations; the MNH, in turn, provides neurology and neurosurgical services and runs specialty outpatient and emergency clinics. The demand for teaching, research and patient care continues. New faces and new teams appear, eager to apply
their skills as the old guard stands aside and applauds. Now we look forward to the opening late in 1977 of a fine new building, the Penfield Pavilion (Fig. 1). Wilder Penfield had a dream, and he saw his dream fulfilled.E
Surgical treatment of epilepsy THEODORE B. RASMUSSEN,* MD, MS, FRCS[C]
Wilder Penfield's interest in epilepsy began early in his medical career and led to his well known studies on the histologic aspects of the healing of brain wounds.1 A need for better understanding of the role of glial cells in this process led to his fruitful period of study in Madrid with Pio del RioHortega and Ram6n y Cajal in 19242. and, after his return to New York City, to subsequent studies with William Cone on oligodendroglia and microglia." His interest in the surgical treatment of epilepsy began with a short period of association and study in Breslau with Otfried Foerster in 1928. This introduced him to the possibility of relieving focal post-traumatic epilepsy by excising the brain cicatrix and the adjacent irritable cerebral cortex.' Details of the first four patients undergoing operations to relieve focal epilepsy in Montreal were reported in 1930." Penfield's role in the development of the surgical approach to the treatment of epilepsy parallels in several aspects Harvey Cushing's role in the development of the surgical treatment of brain tumours a generation earlier. Both surgeons began their work in these fields when many physicians in the Western world had serious reservations as to the potential benefits of definitive surgical approaches to these clinical problems. Both of these neurosurgical pioneers from the beginning carried out detailed studies and analyses of each patient's clinical problem from both pathologic and physiologic standpoints. Penfield's paper in 193311 on the cerebral localization of epileptic manifestations was the first of a long series on cortical function as revealed by clinical and operative studies. These were carried out on patients with a variety of seizure problems who came to the Montreal Neurological Institute (MNI) in steadily increasing numbers. 'Professor of neurosurgery, McGill University; and former director, Montreal Neurological Institute
Both Cushing and Penfield meticulously documented for each patient the history, clinical findings, surgical findings, detailed gross and microscopic features of specimens, postoperative course and follow-up results. Observations at the operating table led to Penfield's early interest in the possible importance of variability in the cerebral circulation in epilepsy,12-14 as well as to his many contributions to cortical function in the human brain. Both men introduced important technical refinements in the techniques of the surgical procedure. Electric stimulation of the cerebral cortex in patients undergoing craniotomy under local anesthesia increased the safety of cortical excisions near the sensorimotor and speech areas and added to knowledge of localization of function in the human cerebral cortex.'517 Penfield was quick to appreciate the potential role of electroencephalography in the study of patients with epilepsy. He brought Herbert Jasper to the MNI in 1938 to develop the application of this new technique in the clinic, the operating room and the laboratory.1822 The technique of subpial resection of cortical areas was developed to minimize the cicatrix resulting from the cortical excision and thus reduce the seizure tendency resulting from the surgical procedure. Like Cushing, Penfield appreciated the importance of "keeping the score" and of the lessons to be learned from repeated analysis of the patients' records and findings as the years pass.2327 Until the fledgling science of electroencephalography proved its value in the operating room and in the routine clinical investigation of the epileptic patient, Penfield believed that cortical resection was indicated only if an obvious gross lesion of the brain was disclosed in the expected location at operation or if the patient's habitual seizure or aura was reproduced by electric stimulation of the cortex. Thus, no cortical resection was made in 20% of the craniotomies carried out for
seizures in the first decade, 1928 to 1937. Such negative explorations accounted for 5 % of the craniotomies carried out for focal epilepsy during the next decade, 1938 to 1947, and they disappeared by 1956 as preoperative electroencephalography and cortical recordings in the operating room provided increasingly accurate identification of the epileptogenic areas of the cortex. Several of Penfield's earliest operations for seizures were carried out in the temporal region and several excisions of the temporal lobe cortex were carried out in each of the early years. Awareness of the importance of temporal lobe epilepsy as the most frequent of all focal types of epilepsy, however, developed only gradually as electroencephalography became increasingly effective in the investigation of epileptic patients and with the gradual accumulation of psychic and automatic responses to cortical stimulation of the temporal lobe during operations carried out under local anesthesia.21'22'.'2831 The importance of birth compression in producing temporal lobe epilepsy was reported in 1953.32 Penfield's last paper specifically concerned with the surgical treatment of epilepsy appeared in 1967... His publications, covering 40 years and ranging widely over the field of epilepsy, have stimulated a great variety of clinical and experimental investigations in this fascinating and complex field. It is largely as a result of Penfield's painstaking and scholarly studies that cortical resection has gradually earned a secure place in the treatment of medically refractory focal epilepsy and is now being carried out in an increasing number of major neurosurgical centres around the world. The surgical treatment of epilepsy constitutes one of Penfield's principal scientific monuments and has continued to be one of the main fields of interest of the neurosurgical staff of the Montreal Neurological Hospital. As a result, the "surgical seizure series" started by
CMA JOURNAL/JUNE 18, 1977/VOL. 116
1369
Penfield's pioneering craniotomies in 1928 has grown to include over 2200 operations in nearly 2000 patients, and continues to provide new knowledge about the way the human brain functions in health and disease. References I. PEN FIELD WG: Meningocerebral adhesions. A histological study of the results of cerebral incision and cranioplasty. Surg Gynecol Obseet 39: 803, 1924 2. Idem: Microglie et son rapport avec la d6g6n6ration microgliale dans un gliome. Tray Lab Recherches Biol Univ Ma rid 22: 277, 1924 3. Idem: Oligodendroglia and its relation to classical neuroglia. Brain 47: 430, 1924 4. Idem: Phagocytic activity of microglia in the central nervous system. Proc NY Pathol Soc 25: 71, 1925 5. RfO-HORTEGA P
DEL,
PENFIELD
W:
Cerebral
cicatrix: the reaction of neuroglia and microglia to brain wounds. Bull Johns Hopkins Hosp 41: 278, 1927 6. PENFIELD W, CONE W: Acute swelling of oligodendroglia: a specific type of neuroglia change. Arch Neurol Psychiatry 16: 131, 1926 7. PENFIELD WG: The acute regressive changes of neuroglia (ameboid glia and acute swelling of oligodendroglia). J Psychol Neurol 34: 204, 1926 8. Idem: The mechanism of cicatrical contraction in the brain. Brain 50: 499, 1927
9. FOERSTER 0, PENFIELD W: The structural basis of traumatic epilepsy and results of radical operation. Brain 53: 99, 1930 10. PENFIELD W: The radical treatment of traumatic epilepsy and its rationale. Can Med Assoc J 23: 189, 1930 11. PENFIELD W, GAGE L: Cerebral localization of epileptic manifestations. Arch Neurol Psychiatry 30: 709, 1933 12. PENFIELD W: The evidence for a cerebral vascular mechanism in epilepsy. Ann Intern Med 7: 303, 1933 13. Idem: Las effets des spasmes vasculaires dans l'6pilepsie. Union Med Can 63: 1275, 1934 14. Idem: The circulation of the epileptic brain.
Rex Pubi Assoc Rex Nerv Ment Dis 18: 605,
1938 15. PENFIELD W, BOLDREY E: Somatic motor and sensory representation in the cerebral cortex of man as studied by electrical stimulation. Brain 60: 389, 1937 16. PENFIELD W, RASMUSSEN T: Further studies of the sensory and motor cortex of man. Fed Proc 6: 452, 1947
17. Idem: The Cerebral Cortex of Man, New
York, Macmillan, 1951 18. PENFIELD W, ERIcKsON
Cerebral Localization,
TC:
Epilepsy and
Springfield,
IL, CC
Thomas, 1941 19. JASPER H, PENFIELD W: Electroencephalograms in post-traumatic epilepsy: preoperative and postoperative studies. Am J Psychiatry 11: 365, 1943 20. PENFIELD W, JASPER H: Highest level sei-
zures. Proc Assoc Rex Nerv Ment Dix 26: 252, 1947
21. FEINDEL W, PENFIELD W:
Localization of
discharge in temporal lobe automatism. Arch Neurol Psychiatry 72: 605, 1954
22. PENFIaLD W, JASPER H: Epilepsy and the
Functional Anatomy of the Human Brain, Boston, Little, 1954
23. PENFIELD W: Epilepsy and surgical therapy.
Arch Neurol Psychiatry 36: 449, 1936 24. PENFIELD W, STEELMAN H: The treatment of focal epilepsy by cortical excision. Ann Surg 126: 740, 1947 25. PaNFIELD W, FLANIGAN H: Surgical therapy of temporal lobe seizures. Arch Neurol Psychiatry 64: 491, 1950 26. PENFIELD W, PAINE K: Results of surgical therapy for focal epileptic seizures. Can Med Assoc J 73: 515, 1955 27. PENFIELD W: Pitfalls and success in surgical treatment of epilepsy. Br Med J 1: 669, 1958
28. Idem: Psychical seizures. Br Med 1 2: 639, 1946 29. PENFIELD W, BALDWIN M: Temporal lobe
seizures and the technique of subtotal temporal lobectomy. Ann Surg 136: 625, 1952 30. PENFIELD W: Temporal lobe epilepsy (Hunterian lecture). Br I Surg 41: 337, 1954 31. Idem: The role of the temporal cortex in
certain psychical phenomena. Br Ment Sci 101: 451, 1955
32. EARLE KM, BALDWIN M, PENFIELD W: In-
cisural sclerosis and temporal lobe seizures produced by hippocanipal herniation at birth. Arch Neurol Psychiatry 69: 27, 1953
33. PENFIELD W: Epilepsy, the great teacher: the progress of one pupil. Acta Neurol Scand
43: 1, 1967
Impact on medical neurology FRANCIS L. MCNAUGHTON,* M SC, MD, CM, FRCP[C]
It is difficult in a short space to do justice to Wilder Penfield's many contributions to medical neurology because so many things he achieved have been of significance to neurology and to neurologists everywhere. Throughout his career he was widely regarded as a skilled neurosurgeon, but I would claim him rather as the complete neurologist. True, he had the bold, direct approach to problems and the manual skills that we usually associate with a surgeon, but for him neurosurgery was merely one technical aspect of his work. As Cushing would say, he was a neurologist who did his own operating. Among Penfield's early papers that helped to establish his reputation are those on the cytology of the nervous system, on brain tumour classification and on experimental brain scars. He later published studies on intracranial pain, on the nerve supply of intracranial structures and on surgical methods for the relief of intractable headache. He also became greatly interested in the nervous control of the cerebral circulation and the possible role of *Emeritus professor of neurology, McGill University
vascular spasm in provoking epileptic seizures. This work led to pioneering studies of cerebral circulation, which has become a vast and exciting area of research since those early days. There is no doubt that Penfield's greatest contribution to neurology grew from his years of concentrated research on epilepsy, which began immediately after his arrival in Montreal in 1928 and continued, with scarcely any interruption, for over 40 years. His interest was stimulated from the beginning by the writings of Hughlings Jackson on epilepsy and the functional anatomy of the brain, as well as by Otfried Foerster's surgical experience in treating post-traumatic epilepsy. Penfield's work established a firm basis for the modern diagnosis and neurosurgical treatment of focal types of epilepsy, particularly those involving the temporal lobe, and brought new hope for the patient with seizures. In studying and treating such patients he not only increased our understanding of epilepsy but also added greatly to our knowledge of the normally functioning brain through his fresh observations on memory, speech and consciousness. Some of his writings have already
1370 CMA JOURNAL/JUNE 18, 1977/VOL. 116
become neurologic classics. Two such are "The Cerebral Cortex of Man",1 with coauthor Theodore Rasmussen, and "The Excitable Cortex in Conscious Man",2 his Sherrington lecture of 1958. His "magnum opus.., "Epilepsy and the Functional Anatomy of the Human Brain",3 written with Herbert Jasper, records the observations and thinking of an unusual team of investigators, consisting of Wilder Penfield, the surgeon-neurologist, and Herbert Jasper, the pioneering neurophysiologist, as well as their many devoted coworkers. These are some of the significant ways in which Wilder Penfield has influenced the course of neurology in the 20th century. But perhaps his most creative contribution, his legacy for the future, lies in what he called "this continuing fabulous enterprise". He was referring, of course, to the institute that he founded. References 1. PENFIELD W,
RASMUSSEN
T:
The Cerebral
Cortex of Man, New York, Macmillan, 1951 2. PENFIELD W: The Excitable Cortex in Conscious Man, Liverpool, Liverpool U Pr, 1958 3. PENFIELD W, JASPER H:
Epilepsy and the
Functional Anatomy of the Human Drain, Boston, Little, 1954
