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)

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.