The development and evolution of “cerebral thermometry”: Clinical applications of a nineteenth-century approach to cerebral localization and neurological diagnosis

ABSTRACT

Surface thermometers were developed in the latter half of the nineteenth century. In 1877, Broca, already famous for his contributions to the cerebral localization of nonfluent aphasia, presented his first clinical observations on cranial surface temperatures: In two cases, cranial surface temperatures were decreased over a middle cerebral artery infarction, and increased in surrounding areas, which Broca attributed to “compensatory hyperaemia.” As Broca made apparent in a later report in 1879, he had used a “thermometric crown,” an apparatus consisting of six to eight large-reservoir mercury thermometers strapped against the head. Following Broca’s report, American neurologists reported cases in which cranial surface temperatures were increased either locally over a superficial brain tumor or globally with a cerebral abscess. Despite promising anecdotal reports, contemporaries recognized that significant technical and practical problems limited its accuracy, reliability, and clinical utility. Advocates never demonstrated that this technology provided significant marginal benefit to the medical history and physical examination. The technique fell out of fashion before 1900, though some early advocates promoted it into the early twentieth century. It was ultimately replaced by more effective technologies for cerebral localization and neurological diagnosis.     

Broca’s Aphemia: The Tortuous Story of a Nonaphasic Nonparalytic Disorder of Speech

Broca coined the neologism “aphemia” to describe a syndrome consisting of a loss of the ability to speak without impairment of language and paralysis of the faciolingual territories in actions unrelated to speech, such as protruding the tongue or pursing the lips. Upon examining the brains of patients with aphemia, Broca concluded that the minimum possible lesion responsible for aphemia localized to the posterior left inferior frontal gyrus and lower portion of the middle frontal gyrus. A review of Broca’s writings led us to conclude that (a) Broca localized speech, not language, to the left hemisphere, (b) Broca’s aphemia is a form of apraxia, (c) Broca’s aphemia is not, therefore, a terminological forerunner of aphasia, and (d) Broca was an outspoken equipotentialist concerning the cerebral localization of language. Broca’s claim about the role of the left hemisphere in the organization of speech places him as the legitimate forebear of the two most outstanding achievements of Liepmann’s work, namely, the concepts of apraxia and of a left hemisphere specialization for action.     

Broca’s faculté du langage articulé: Language or Praxis?

De Oliveira-Souza, Moll, and Tovar-Moll (this issue) historically reevaluate that Paul Broca’s aphemia should be considered as a kind of apraxia rather than aphasia. I argue that such a claim is unwarranted, given the interpretation of the faculty of speech Broca derived from his predecessors, Jean-Baptiste Bouillaud and Franz Joseph Gall, and also with a view on the then generally held opinion that the terms aphémie and aphasie were synonyms. I will discuss evidence that patients such as Leborgne, producing only very few words or syllables, suffer from a global aphasia, affecting all modalities, despite Broca’s statement that Leborgne’s comprehension was intact. I also point to Broca’s claim that the faculty of speech, located in the left anterior hemisphere, is independent from hand preference because it is an intellectual and not a motor function, and to his statement that the cerebral convolutions are not motor organs. I finally contend that, in order to determine whether a given language problem should be labeled as aphasia or apraxia, it is crucial to first be clear on the components of old and new models of language production.     

Cortical epileptogenesis and David Ferrier

There was an increasing medical interest in the localization of representation of function in the cerebral cortex after Broca in 1861 identified a cortical area that appeared responsible for expressive speech. By the late 1860s, John Hughlings Jackson—based on clinico-pathological correlations mainly in persons with focal motor seizures—had reasoned that contralateral somatic motor function was represented in another area of the cortex. This localization was supported by Fritsch and Hitzig (1870) in experimental cortical stimulation studies in dogs. These authors also reported producing events resembling contralateral motor convulsing in their animals. Their work, and Jackson’s ideas, prompted David Ferrier, in Great Britain, to begin a program of cerebral cortical stimulation studies in various vertebrate species, trying to locate cortical sites of representation of functions other than expressive speech and motor activity. In his initial report of his investigations (1873), he noted that appropriately sited Faradic stimulation evoked immediate or delayed contralateral focal motor seizures, some of which evolved into generalized convulsions. On this basis he reasoned that focal motor and generalized seizures were expressions of the same disorder; that nearly all epilepsies originated in the cerebral cortex and not in the lower brain stem, as hitherto thought; and that the clinical pattern of epileptic seizure phenomenology depended on the function of the cortical site of origin and the extent and direction of spread of seizure activity in the brain. He not only provided experimental verification for Jackson’s reasoning about epileptic seizure mechanisms but expressed the ideas a good deal more clearly than Jackson ever managed to do. Ferrier’s achievement in this regard has tended to escape notice, lost sight of because of the great importance of his investigations into localization of cerebral function.     

Authors’ Response

Broca’s first patient presented in support of a relationship between a lesion of the frontal lobe and aphasia was patient Tan. Although Pierre Marie refers to this case as “indisputably aphasia of Broca,’” the clinical diagnosis of Tan’s aphasia has not been re-examined in light of current clinical criteria. Superficially, the patient’s extremely limited verbal output and intact comprehension appear to fit with the diagnosis of Broca’s aphasia, but a more thorough examination of the onset, evolution and nature of the patient’s speech symptoms suggests alternate interpretations. Contemporary evidence in support of a robust relationship between stereotypical utterances and Global aphasia suggests that patient Tan may have suffered from a Global rather than Broca’s aphasia.     

William Rutherford Sanders (1828–1881) and his neurologically fertile years (1865–1868)

ABSTRACT

William Rutherford Sanders (1828–1881) was an Edinburgh physician who occupied the Chair of Pathology at the University of Edinburgh from 1869 to 1881. All of his published output between 1865 and 1868 was concerned with neurology. In arguing that a patient did not have paralysis agitans, Sanders (1865) employed the term “Parkinson’s disease” for the first time in the English-language literature to distinguish between the disorder that Parkinson (1817) termed “paralysis agitans” and other types of shaking palsies. He contributed a major chapter on the same topic to Russell Reynolds’s A System of Medicine (1868). Sanders also investigated the innervation of the palate and facial muscles (1865), and in 1866 recorded the autopsy findings in two cases of aphasia. Here, for the first time in the English-language literature, he described findings that supported Broca’s location of the representation of speech to a particular area of the left cerebral hemisphere.     

A reappraisal of the controversy of Dax and Broca

Paul Broca is unanimously recognized as the founder of neuropsychology. Helis development of the scientific method to map mental functions onto brain topographpy has been enormously influential. Nevertheless, Dax's paper on the left hemisphere dominance for speech was written and published before Broca explicitely proposed the same theory. Probably, Broca was aware of the paper prior to 1865, but he never acknowledged Dax's original theoretical contribution. On the contrary, he always claimed to be the first to espouse the theory of left hemisphere dominance for language and never quoted Marc Dax (Broca, 1877 p 536), 'I do not like dealing with the questions of priority concerning myself. That is the reason why I did not mention the name of Dax in my paper'. In our opinion, the weight of evidence reported here suggests that the theory of the left hemisphere dominance for speech must be attributed equally to Dax and Broca, and henceforth should be called 'the theory of Dax-Broca'.     

Broca and Charcot’s Research on Jacques Inaudi:The Psychological and Anthropological Study of a Mental Calculator

In the nineteenth century, French scientific institutions became interested in young “mental calculators,” arithmetical prodigies able to quickly and accurately perform complex mental calculations. The first scientists to study mental calculators were phrenologists who sought to prove the existence of a calculating organ in the frontal lobe. Paul Broca introduced one such mental calculator, Jacques Inaudi, to the Anthropological Society of Paris in 1880. Broca attributed extraordinary faculty for mental calculation to memory functioning (the psychological hypothesis) rather than physiological difference (the phrenological hypothesis). In 1892, prominent French Academy of Sciences member Jean-Martin Charcot produced a noteworthy study of Inaudi on the organization’s behalf. Charcot observed that Inaudi called upon auditory memory rather than visual memory in his mental calculations, unlike most mental calculators who preceded him. Like Broca, Charcot was skeptical of the phrenological hypothesis, though he noted that Inaudi’s skull was markedly plagiocephalic. Interestingly, anthropological examination of Inaudi is consistent with the themes of modern cognitive neuroscience. Thus, Charcot seems to have anticipated present research on the localization of mental calculation and memory for numbers.     

Paul Broca’s search for Basque skulls: The full story

Paul Broca surmised that the short and broad—brachycephalic—skulls of the earliest European settlers had become longer and narrower—dolichocephalic—in modern populations due to the blending of different races. Swedish anatomist Anders Retzius had two brachycephalic skulls said to be from contemporary Basque individuals, a claim suited to test Broca’s hypothesis. Broca worked with fellow anatomist and surgeon Pedro González Velasco, the founding father of Spanish anthropology, to gather a large number of Basque skulls. In its time, this was the most fascinating collection owned by the Anthropological Society of Paris. This article explains how Broca and Velasco were able to gather such a sizeable array of specimens, which they had collected at a location known at first by the code name of “Z.” Although Broca finally concluded that the origin of the Retzius skulls could not be determined, his research was to spark anthropologists’ interest in the language and origins of the Basque people.     

Brown-Séquard and cerebral localization as illustrated by his ideas on aphasia

Brown-Séquard's concept of localization was built on the phenomena of inhibition and dynamogenesis, constituting a dynamic system in which reflex mechanisms, that played a part not only in the spinal cord but in the brain as well, were considered of particular importance. The use of this concept is considered in Brown-Séquard's discussion of the subject of cerebral localization, and especially of aphasia. The origin and development of Brown-Séquard's ideas on aphasia from 1861 onwards are discussed, as is the part he possibly played in the transfer of knowledge from Paris to London (Broca and Jackson). In the 1870's Brown-Séquard debated on cerebral localization with Charcot before the Société de Biologie. Opposing the cluster theory of localization, Brown-Séquard developed the theory of "réseau de cellules anastomosées", a kind of network theory in which scattered cells subserving the same function are connected by nerve fibers. This was to him a plausible theory, with which he was able to explain the fact that damage in several locations may produce the same effect, and, to account for observations that some functions remain unimpaired despite extensive brain-injury. Although Brown-Séquard's arguments were not always valid, because they were based on imprecise observations, his dynamic model, nowadays, seems valuable. He influenced "anti-localizers" such as Goltz, but also Jackson and probably Von Monakow and Sherrington.     

Gustave Dax and his fight for recognition: an overlooked chapter in the early history of cerebral dominance

The year 1865 was revolutionary in neuroscience. In this year, three papers were published on the topic of cerebral dominance for speech. These papers were authored by Paul Broca, Marc Dax, and Gustave Dax, and they contributed to a priority debate that cannot be easily resolved. Gustave Dax claimed that his long dead father had written a memoir and presented it orally in Montpellier in 1836, thus making him the first person to write about cerebral dominance. He also claimed that he was the second person to write on the subject, the first to support his father's claims, and the first to try to localize the center for speech in just one part the left hemisphere, the middle (temporal) lobe. Paul Broca, however, was now getting much of the credit for these discoveries. To set the record straight, Gustave published several letters. This paper presents translations of Gustave's letters of 1866, 1875, and 1877, as well as the historical note written by Raymond Caizergues in 1879, and recreates the events that triggered the younger Dax's anger.     

时代、文化资本与支配权:对张謇创办南通博物苑的再思考

面对19世纪末中国空前的民族危机和剧遽社会变迁,张謇选择了"实业救国"、"教育救国"的道路。南通博物苑作为张謇教育事业的重要组成部分,是其教育救国思想的具体体现。张謇在南通博物苑创办过程中实现了资本的文化化和文化的资本化双重过程:一方面,将经济资本转化为文化资本;另一方面,又将文化资本转化为其象征资本的一部分,使其获得更大社会权力,从而能够按照自己的政治理想对地方社会进行塑造。张謇对于作为文化资本的南通博物苑的支配主要体现在三个方面:藏品内容及知识系统的构建、博物馆教育作用的树立及对参观者的规范。张謇对文化资本的支配表面上是其个人意志的体现,由其政治理念所驱动;而深究,终不免受时代和机构属性等因素的制约与影响。     

Neuro-anniversary 2002

Abstract

The impetus to pursue the study of ocular motility in sleeping adults was derived from a previous study conducted by the author on infants. He noted through visual observation alone that there was an approximate twenty minute interlude of complete ocular quiescence during each hour of sleep. This period of quiescence was termed ‘No Eye Movement Period’ or ‘N.E.M. Period’, and it was the intent of the author to ascertain what effect age would have on the distribution of N.E.M. periods during sleep. In the latter part of 1951, the first continuous all‐night recording of ocular motility in sleep using a combined EEG and EOG technique was conducted on the author's eight year old son. Instead of N.E.M. Periods, what he found were approximately twenty minute periods of vigorous ocular activity including saccadic‐like eye movements. Although he ultimately termed these epochs as ‘REM Periods’, his initial intent was to name them ‘Jerky Eye Movement Periods’ or ‘JEM Periods’. Ironically, some three decades later he found that a mathematical measure of jerkiness was a better discriminator than velocity in distinguishing REMs from waking saccades. Kleitman, who was the thesis advisor, played the role of skeptic during the REM discovery and demanded unassailable proof of the existence of REM. His feelings had to be ambivalent inasmuch as the REM state, with its concurrent activated cerebral cortex, negated his own theory that sleep was a completely passive phenomenon.     

Said,Auerbach, and the Return to Philological Hermeneutics

ABSTRACT

This essay explores the relationship between Edward Said’s well-known contrapuntal reading of history and Erich Auerbach’s Ansatzpunkt, or point of departure, as a means of entering a given hermeneutic circle. Although Auerbach occupied an increasingly prominent place in Said’s critical thought, his engagement with the work of the German philologist has been largely ignored or downplayed. In this essay I take the figure of exile, which is so central to Said’s scholarship and which he explicitly links with the intellectual mission of critique, as a point of departure for a deepened exploration of Said’s critical method—a method developed in critical dialogue with Auerbach’s work. Building on the existing literature, I argue that Auerbach offers more than simply a way for Said to problematize identity politics and to challenge the dogmatism of received notions of home and political belonging. More than this, I argue that the German philologist provides Said with a way to reconfigure the dialectic between history and literature; to develop his contrapuntal approach to reading history; and to rethink the parameters of a historicist humanism that, in turn, enables him to reactivate the critical potential of philological hermeneutics.     

Shakespeare as a method. Carl Schmitt’s reading of Othello and Hamlet

While in the 1960s Allan Bloom suggested to read William Shakespeare’s works through the prism of political philosophy, a decade earlier Carl Schmitt used the works of English poet in a reverse way: he read political philosophy and history through Shakespeare. Deprived – under the influence of Leo Strauss – from the possibility of considering Thomas Hobbes a decisionist thinker, Schmitt in his ‘Hamlet or Hecuba’ used Shakespeare’s most famous work to interpret origins of disappearance of the state of emergency from English soil. Shakespeare was seen by Schmitt as a writer who captured the Sixteenth and seventeenth century changes in thinking about sovereignty and the state. Interestingly, Schmitt did not use Shakespeare as method for the first time: in first decades of twentieth century, in his diary, he made ‘Othello’ a prism through which he read his love life. Because the author of ‘The Concept of the Political’ is one of the less methodologically cohesive writers of twentieth century, his usage of Shakespeare twice, in different circumstances, is interesting. In an article, author links ‘Hamlet or Hecuba’ with Schmitt’s geopolitical works and presents Shakespeare’s works as the coherent method of interpretation in Schmitt’s philosophy of decisionism.     

From the logic of ideas to active-matter materialism: Priestley’s Lockean problem and early neurophilosophy

ABSTRACT

Empiricism is a claim about the contents of the mind: its classic slogan is nihil est in intellectu quod non fuerit in sensu, “there is nothing in the mind (intellect, understanding) which is not first in the senses.” As such, it is not a claim about the fundamental nature of the world as material. I focus here on in an instance of what one might term the materialist appropriation of empiricism. One major component in the transition from a purely epistemological claim about the mind and its contents to an ontological claim about the nature of the world is the new focus on brain–mind relations in the eighteenth century. Here I examine a Lockean trajectory as exemplified in Joseph Priestley’s 1777 Disquisitions Relating to Matter and Spirit. However, Locke explicitly ruled out that his inquiry into the logic of ideas amounted to a “physical consideration of the mind.” What does it mean, then, for Priestley to present himself as continuing a Lockean tradition, while presenting mental processes as tightly identified with “an organical structure such as that of the brain” (although he was not making a strict identity claim as we might understand it, post-Smart and Armstrong)? One issue here is that of Priestley’s source of “empirical data” regarding the correlation and indeed identification of mental and cerebral processes. David Hartley’s theory in his 1749 Observations on Man was, as is well known, republished in abridged form by Priestley, but he discards Hartley’s “vibratory neurophysiology” while retaining the associationist framework, although not because he disagreed with the former. Yet Hartley was, at the very least, strongly agnostic about metaphysical issues (and it is difficult to study these authors while bracketing off religious considerations). One could see Locke and Hartley as articulating programs for the study of the mind which were more or less naturalistic (more strongly so in Hartley’s case) while avoiding “materialism” per se; in contrast, Priestley bit the (materialist) bullet. In this paper I examine Priestley’s appropriation and reconstruction of this “micro-tradition,” while emphasizing its problems.     

'The purity of the blood': Poncet de la Grave,pronatalism and empire

This article will analyze key publications of Guillaume Poncet de la Grave (1725-1803), formerly the monarchy’s representative to the Admiralty Court, who worked during the Ancien Régime to restrict immigration to France, particularly that of people of color. He was also a passionate advocate for French imperial expansion. After the Revolution, in his political tract Réflections on the Unmarried, he expressed his anxiety over a declining French birthrate and a desire to have the state monitor marriage, sexuality, and reproduction in order to increase legitimate births. In this work he identified threats to what he referred to as ‘the purity of the blood’ within and without France, and proposed to the Republic legislation designed to eliminate them. Poncet de la Grave’s career has been largely neglected but his former position merits a closer look at his political writing, which expressed significant, constant objectives that demonstrate thematic continuity over a tumultuous time. French fears of depopulation and national ‘degeneration’ were still strong at the turn of the century, and remain of great interest to historians eager to understand how they were discussed in the context of great historical change.     

The Archbishop of Canterbury,the Episcopal Bench,and the Passage of the 1911 Parliament Act

The passage of the 1911 Parliament Bill ended the power of the British house of lords to veto any legislation passed by the house of commons. Henceforth, it could only delay the passage of a measure. The bill was carried by a mere 17 votes and friction between Unionists who took up die‐hard opposition, advised abstention, or actively sought to aid passage was bitter. The role which the archbishop of Canterbury played in canvassing the episcopal bench and helping to ensure final passage of the bill has not attracted much attention. Prior to the debate, the archbishop advised abstention but did not dissuade others from encouraging bishops to support the bill to help ensure passage. Before the vote, therefore, ‘die‐hards’ opposing any concession to the government, ‘hedgers’ advising Unionist abstention in the vote, and ‘rats’, Unionists willing to vote for the bill to ensure passage despite personal reservations, attempted to sound out and pressure the bishops in their direction. At the debate, the archbishop changed his mind and decided he must support the bill in order to avoid a greater crisis, and 12 other bishops joined him in the government lobby, helping to create the final majority of 17 by which the measure passed. Consideration of the role of the bishops adds to the understanding of the mechanics by which the bill passed, amidst considerable intrigue, pressure and acrimony, as well as further illuminating the extent and intensity of the divisions within the Unionist party at this critical moment.