James Lance was born in Wollongong in 1926, in the front bedroom of the family home where he was dragged into the world with forceps by a local general practitioner. His maternal grandfather James Douglas Stewart founded the School of Veterinary Science at the University of Sydney where the J.D. Stewart Building remains. His father's side were merchants originally from Birmingham who settled in Wollongong. The Lance family established the local department store, eventually acquired by David Jones when Jim's father retired.

As a child, Jim suffered from asthma and his parents were advised to send him to the clean air of Moss Vale, to Tudor House. Subsequent schooling at Geelong Grammar School was cut short in 1941 by interstate travel difficulties during the war and so he transferred to The King's School in Parramatta. It was during his teenage years that Jim developed a strong desire to study medicine, and an eagerness to help others.

A meeting with Howard Florey of penicillin fame stimulated Lance's life-long interest in medical research. This was further heightened when he met Peter Bishop who had started the Brain Research Unit at the University of Sydney. Lance described a feeling of enchantment with Bishop's enthusiasm and a career in brain physiology was launched.

Lance foreshortened his senior year as a resident medical officer at Royal Prince Alfred Hospital to commence research for the MD degree. A fellow research student was Jim McLeod, who would mirror Lance's trajectory with the two becoming lifelong friends. Through working with Bishop, Lance developed an interest in human movement and movement disorders.

Bishop introduced the young Lance to the technology needed to undertake physiology experiments, after which the student immersed himself in the corticospinal (pyramidal) tract, the pathway that controls all voluntary movement. Influential outputs followed, with the publication of five papers on the topic, including one in the early 1950s on an attempt to regrow the severed pyramidal tract – attempting to restore movement to paralysed limbs.

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Lance was keen to pursue clinical work, in parallel with his research. He teamed up with George Selby, who was then superintendent of the Northcott Neurological Centre, run by the Returned Serviceman's League for the families of ex-military with neurological problems. He attended Northcott one day a week, gradually developing a grounding in clinical examination. These combined experiences steered Lance towards a career in neurology.

However it was not possible then to train in medical specialties wholly within Australia, and so Lance obtained an appointment as a ship's surgeon to work his way to England on a shilling a month with the sole intention of learning the craft of neurology. He never received his pay – when he attended the offices of the Orient Line in London he was told that in order to claim his shillings, he would have to join the Seamen's Union at the cost of £10.

Undeterred, Lance found employment at Hammersmith Hospital and then as an assistant house physician at the National Hospital for Neurology and Neurosurgery, Queen Square, London, after a series of interviews with the key physicians including Sir Charles Symonds. Lance was assigned to work with Sir Francis Walshe as his houseman. The joy for Lance was not limited to his exposure to the inner workings of clinical neurology, but was combined with Walshe's blistering wit and mischievous turn of phrase.

After his stint in London, Lance returned to Sydney and reconnected with Judy, who he had previously tutored in physiology. So began a great love affair that lasted almost 70 years, producing five children and 19 grandchildren. As Lance would often remark, he led a charmed life.

Lance succeeded Selby as the superintendent of Northcott Neurological Centre, where he soon developed an interest in headache. With skills acquired at Queen Square, Lance went to work analysing the case histories of 500 migraine patients. It was a herculean task, leading to his first major opus, published in the Journal of Neurology, Neurosurgery and Psychiatry (JNNP) in 1960, a paper now recognised as a citation classic.

Although pleased with his progress, there seemed to be limited opportunities to practice solely as a neurologist in Australia. Serendipity intervened, with the establishment of a new medical school at the University of New South Wales. Lance thought that if he could broaden his academic experience at a good centre, he could suggest the establishment of a Division of Neurology.

To this end, he sought out Raymond Adams, who ran the neurology department at Massachusetts General Hospital of the Harvard Medical School. Lance and Adams worked closely together on a number of projects, including a paper on post-hypoxic myoclonus, now known as the Lance-Adams syndrome.

While in America, Lance applied for a senior lectureship at UNSW and was appointed with the brief to establish an academic Department of Neurology at the Prince Henry and Prince of Wales hospitals.

Soon after, the first neurosurgeon was appointed, Alec Gonski. Together Lance and Gonski built Prince Henry from a dilapidated infectious diseases hospital to an international centre of excellence for clinical neuroscience.

A key development in growth at Prince Henry Hospital was the establishment of a headache clinic which was soon filled with patients. Linked to the clinical service, research prospered. Lance focused his attention on the physiology of migraine, which soon led to work on serotonin, and particularly its effects on blood vessels and brain pathways involved in pain.

By turns, this research led to the discovery of the triptans, which have been the world’s most groundbreaking development in the treatment of migraine. These observations led to collaborative studies with Glaxo Laboratories in London and the discovery of sumatriptan, the first of the triptans, which remain the first line of defence in treating acute migraine.

The success of this therapy promoted Glaxo to the peak of the European Stock Exchange, and led to the establishment of the James Lance GSK Clinical Trials Unit within Prince of Wales Hospital. His work on the physiology underlying the symptoms of migraine spurred many generations of clinicians to work in the area.

His scientific books (A Physiological Approach to Clinical Neurology and Mechanism andManagement of Headache, now in its seventh edition) have become classics. While devoted to science, his writings were not all scientific: in 1977 he published a children's book The Golden Trout, books for trainee neurologists and books for the lay public on headache.

During the 1970s, Lance received a visit from Nobel Laureate Sir John Eccles to discuss the mechanisms of spasticity, a common phenomenon following stroke and spinal cord injury. This resulted in a large body of work in motor control that has remained pre-eminent worldwide.

He served as president of the Australian Association of Neurologists, which subsequently set up an award, the James Lance Young Investigator Award, to encourage young specialists into research. He helped launch the Brain Foundation, the largest priming institution for neuroscience research in Australia, which awards the James Lance Award for headache research each year.

Lance's service to the community was recognised with appointment as Commander of the Order of the British Empire in 1977, Officer in the Order of Australia in 1991 and award the Centenary Medal of Federation in 2001.

Jim Lance is survived by wife Judy, five children, Fiona, Sarah, Jenny, Robert and Sophie, 19 grandchildren and a great grandchild.

Matthew Kiernan, David Burke, Sophie Gilliatt, Fiona Waller

Professor James Waldo Lance, October 29, 1926-February 20, 2019.