Cauliflower Brains

"He took too many beatings ... that just made him sort of simple."

--The Battler, Ernest Hemingway

With his shuffling gait, slurred speech and foggy memory, the punch-drunk boxer is a stock character in movies and fiction, a mainstay of many a stand-up comic's nightclub routines. But there is nothing funny about the condition some doctors call "dementia pugilistica." Doctors have known for years that a hard blow to the head can slam the jelly-like brain against the rigid skull and cause permanent damage. Now a trio of British researchers has documented just how serious--and how widespread among boxers--this damage is likely to be. In a study published last month in the journal Psychological Medicine, they report that the pounding suffered by boxers can destroy vital brain tissue, producing not only physical symptoms but psychiatric problems as well.

Conducted by Drs. J.A.N. Corsellis and C. J. Bruton with the assistance of a psychiatric social worker named Dorothy Freeman-Browne, the study is not the first attempt to understand why boxers become punchy. But it is the most extensive. Most previous efforts have concentrated on only one or two fighters.

The British report is based on posthumous examination of 15 brains collected during the past 16 years, and careful study of the fighters' lives as well.

Varied Lot. The boxers, who fought between 1900 and 1940, were a varied lot. Three were amateurs; the other twelve were professionals. Their names were not revealed, but two were onetime world champions, while six more held national or regional titles. They also boxed a good deal more than fighters do today; over half had fought in more than 300 contests.

But the fighters, who died between the ages of 57 and 91, had more in common than their professions. Interviews with relatives and friends, plus reviews of boxing journals and other publications, revealed that all were bothered by physical and mental symptoms after they left the ring. Most developed speech difficulties and a Parkinson's-like syndrome with drooling and tremors. Some also became uncoordinated in their movements and unsteady on their feet.

In most cases, their minds were muddled. Some developed into alcoholics; some acted as if they were drunk even though they never touched liquor. A few became uncontrollably violent.

The reason for these and other disorders became apparent upon autopsy.

All the boxers had suffered serious brain damage. Researchers who examined the boxers' brains found greater degeneration and loss of nerve cells than in those of non-fighters who died at similar ages.

They also found an injury that seems peculiar to pugilists. Three-fourths of the former fighters had fenestrations, or "windows," in the septum, a membranous partition between the two halves of the brain; this can result in hemorrhages. Among non-boxers, only 3% suffered such injuries.

The findings have already provoked an angry outcry from boxing's backers.

The sport, they claim, is far safer today than it was a generation or more ago when Bruton and Corsellis' subjects were in the ring. Moreover, defenders of boxing maintain, soccer and rugby players also run the risk of head injuries. While acknowledging that these arguments are partly accurate, Corsellis is unimpressed. As a result of his work, he would support a move to bar boxing.

For the brain damage is not simply the result of an accumulation of blows --like a boxer's cauliflower ears for example--but the result of one or more damaging blows that may occur by chance. "A single punch, or even many punches to the head," says Dr. Corsellis, "need not visibly alter the structure of the brain." But there is still "the danger that, at an unpredictable moment and for an unknown reason, one or more blows will leave their mark." Present boxing conditions reduce the number of professional fights a boxer is likely to endure. Just by being in the ring, however, he exposes his head to punishment more frequently than other sportsmen. And once brain tissue is destroyed, "it is gone for good."

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