and encephalic, where the spinal group related to paralyses caused by damage to the spinal cord; the peripheral group comprised disorders that occur when multiple parts of the nervous system fail simultaneously; and the encephalic group comprised partial paralyses caused by a failure of the central nervous system, possibly related to failure of the blood supply or a syphilitic condition. Gull's main work on paraplegia was published between 1856 and 1858. Along with the French neurologist Charles-Édouard Brown-Séquard, his work enabled paraplegic symptoms to be understood in context with the prevailing, limited understanding of spinal cord pathology, for the first time. He presented a series of 32 cases, including autopsies in 29 instances, to correlate the clinical and pathological features. He acknowledged, however, that nothing was more difficult than "the determination at the bedside, of the causes". Pathologically softening and inflammation were sometimes evident, but in many instances no obvious aetiology was found. One might have to seek for 'atomical' as distinguished from 'anatomical' causes, he speculated. He described two types of partial lesions, one confined to a segment of the spinal cord, the other extending longitudinally in one of its columns. He noticed and was puzzled by degenerations of the posterior columns that could cause an 'inability to regulate motor power'. Gull recognised girdle pain as seldom absent from extrinsic compression, often signifying meningeal involvement. Paralysis of the lower extremities could, he thought, be consequent upon diseases of the bladder and kidneys ('urinary paraplegia'). The bladder infection was the source of inflammatory phlebitis extending from pelvic to spinal veins. Meningitis with myelitis was found and attributed to exposure to cold or fatigue. In five traumatic cases, the vertebral column was often but not invariably fractured and could compress the cord. He recorded one instance in a 33-year-old woman of a thoracic disk prolapse compressing the cord, without evident trauma. Tumours also figured in seven of his 32 patients; two were metastatic from kidney and lung. Two had intramedullary cervical tumours, and one, a Guy's Hospital nurse, probably had a cystic astrocytoma. Earlier work by the Irish physician Robert Bentley Todd (1847), Ernest Horn, and Moritz Heinrich Romberg(1851) had described Tabes dorsalis and noted atrophy of the spinal cord, but in an important paper, Gull also stressed the involvement of the posterior column in paraplegia with sensory ataxia [12]. Quotes "Fools and savages explain; wise men investigate." William Withey Gull