Mystery Brain Condition: Acute Hydrocephalus (1840) by David D. Davis

By Maya Smith

In 1840, British physician David Danial Davis (1777–1841) published Acute Hydrocephalus, or Water in the Head, which gave a detailed description of a condition that puzzled physicians for centuries. The book serves as a view into nineteenth century medicine, revealing a moment when physicians were actively debating how to understand and treat disease of the brain, but lacked the scientific tools that would later transform neurology. Davis’s work is compelling, not because it revolutionized medicine, but because it reveals how doctors reasoned, argued, and treated patients in a time of uncertainty.

Davis was a well-respected physician who trained at the University of Glasgow and later became a professor of obstetrics at University College London [1]. Although he was best known for his work in childbirth and women’s health, his interest in childhood disease led him to study hydrocephalus, a condition often seen in infants. His book reflects both his clinical experience and his engagement with larger medical debates. Rather than writing a general textbook, Davis produced a focused study that sought to define the disease, identify its cause, and advocate for specific treatments.

In the book, Davis begins by describing symptoms and stages of the disease, outlining a progression that includes fever, headaches, vomiting, and neurological decline. These observations are drawn from bedside medicine, which was one of the primary clinical tools available to doctors before modern diagnostic tools were developed. Davis attempts to create a recognizable clinical picture so that other physicians could identify the illness in their own patients.

He then turns to what he claims to be the “predisposing causes” [2] of hydrocephalus, arguing that the condition arises from inflammation. At this point in the book, Davis starts to become more argumentative. Davis insists that earlier physicians misunderstood the disease by failing to recognize its inflammatory nature. In doing so, he participates in a long-standing medical tradition of debating authoritative interpretations. Like many of his peers, he supports his claims by referencing earlier medical writers, showing how knowledge was built through dialogue with the past, rather than through experimental science alone.

The final section of the book focuses on treatment, and it is here that Davis’s ideas are most revealing of his historical context. He advocates therapies such as bloodletting, emetics, and mercury-based medicines, all of which were common practices in early nineteenth century medicine. Davis clearly believed that hydrocephalus could be treated, even cured, if approached correctly as an inflammatory disease. The disagreement in his work lies in how the disease should be understood and managed, not in whether the disease was treatable. While some doctors may have viewed the condition as less responsive to intervention, Davis’s confidence in his treatment reflects broader medical beliefs of the time.

To modern readers, these treatments may seem ineffective or even harmful, but they were grounded in prevailing theories of disease. Without knowledge of cerebrospinal fluid or advanced imaging techniques, physicians like Davis relied on observable symptoms and passed down foundations of inflammation and humoral imbalance. His work exhibits both the strengths and limitations of this approach: careful observation allowed for detailed clinical descriptions, but incorrect preconceived assumptions led to misguided treatments.

Placing Davis’s book in a larger historical context highlights both continuity and change in medical knowledge. Earlier understandings of hydrocephalus can be traced back to ancient physicians such as Galen, whose writings shaped medical thought for centuries [3]. Ancient doctors recognized fluid buildup in the head, but disagreed about its nature and location. Davis inherited this legacy, building on centuries of speculation while attempting to refine it through clinical observation.

At the same time, Davis wrote before major discoveries would transform the field. The nineteenth century saw growing interest in anatomy and physiology, including the study of cerebrospinal fluid, but a full understanding of hydrocephalus and effective surgical treatments would not emerge until much later [4]. As later historical analyses of neurosurgery show, reliable interventions such as shunting procedures were only developed in the twentieth century [5]. In this sense, Davis’s book occupies a middle ground of advanced ancient theories, but far from modern science.

Despite its detail and ambition, Acute Hydrocephalus does not appear to have been a transformative text in the history of medicine. There is little evidence that Davis fundamentally changed how hydrocephalus was understood or treated. Instead, his work represents a careful and thoughtful contribution to an ongoing conversation. For historians and students, this is exactly what makes the book valuable. It provides insight into how doctors thought about disease before modern neuroscience. It shows the reliance on case studies, the importance of debate, and the persistence of treatments that we now recognize as ineffective. Perhaps most importantly, it humanizes the history of medicine by revealing the uncertainty and experimentation that shaped medical practice.

In examining Davis’s work alongside both earlier and later sources, the evolution of knowledge of hydrocephalus can be seen. From ancient descriptions, to nineteenth century theories, to modern surgical solutions, the history of this condition reflects broader changes in how medicine understands the body. Davis’s book, placed in the middle of this timeline, offers a look into a profession striving for greater understanding, but still inhibited by the limits of its time.

This post was written for the course HIST H364/H546 The History of Medicine and Public Health. Instructor: Elizabeth Nelson, School of Liberal Arts, Indiana University Indianapolis. 

References

[1] William Munk, “David D Davis | RCP Museum.” Rcp.ac.uk. 2019. https://history.rcp.ac.uk/inspiring-physicians/david-d-davis.

[2] David Daniel Davis, Acute Hydrocephalus, Or, Water in the Head. Philadelphia: Adam Waldie, 1840.

[3] Isabella Bonati, “A History from GraecoRoman Sources.” Early Science and Medicine 27, no 4. (2022): 333–350. https://doi.org/10.2307/48807810.

[4] Aleksandar Milojević, Branka Radojčić, and Igor Ð Meljnikov, “Hydrocephalus – History of Surgical Treatment over the Centuries.” SANAMED 7, no 2 (2012): 119-125. https://sanamed.rs/sanamed_pdf/sanamed_7_2/HYDROCEPHALUS.pdf.

[5] A Aschoff, P Kremer, B Hashemi, and S Kunze. “The Scientific History of Hydrocephalus and Its Treatment.” Neurosurgical Review 22 (1999): 67–93; discussion 94-95. https://doi.org/10.1007/s101430050035.