The conflicts of Ray Adams and Joe Foley with Abe Baker: The neurology and neuropathology of liver failure (1949–1963) and the founding of the American Academy of Neurology (1948)

ABSTRACT

This article examines disagreements among three giants of twentieth-century American neurology: Raymond Adams, Joseph Foley, and Abraham Baker. The disagreements Adams and Foley had with Baker concerned two issues: (1) the neurologic and neuropathological manifestations of liver failure with hepatic encephalopathy as expounded from the late 1940s to the early 1960s, and (2) the founding of the American Academy of Neurology in 1948 as an inclusive medical society under the principal leadership of Baker. The conflicts are examined from transcribed meeting debates (1949–1963), salient original publications (1949–1963), public addresses of protagonists touching on these issues (1971, 1984), and oral histories and less formal interviews of the protagonists and their associates (1979–2014). Contributing to these conflicts were contrasting personalities and outlooks on American neurology in the mid-twentieth century. Adams and Foley prevailed with their characterization of the neurologic and neuropathologic features of liver failure, whereas Baker triumphed with the need for and importance of an inclusive neurological society that would develop continuing medical education for neurologists at a national level, garner federal financial support for neurology training programs, and facilitate the development of neurology as a strong, independent medical discipline in the United States.

KEYWORDS:

• Abraham Baker
• hepatic encephalopathy
• history of neurology—twentieth century
• Joseph Foley
• liver disease
• Raymond Adams

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ Adams and Foley estimated that they had examined more than 100 additional cases of hepatic encephalopathy at least once. Although they contributed to their evolving clinical profile of hepatic encephalopathy, these results were not formally incorporated into their report.

² Foley mentioned this in conversation with Douglas Lanska in 2011. Daroff mentioned it during his 2014 oral history interview, with this belief likely originating from his own prior conversations with Foley.

³ Foley was the eighth president of the AAN (1963–1965) and the 101st president of the ANA (1975). Adams was the 93rd president of the ANA (1967) but did not hold office in the AAN.