White matter—Maximien Parchappe and the integration of articulate language

ABSTRACT

The Imperial Academy of Medicine of Paris met in the spring of 1865 to discuss the localization of speech. One of the participants was Maximien Parchappe (1800–1866), an alienist whose research interests lay in the cerebral cortex. This article addresses Maximien Parchappe’s concept that the cognitive elements of language—such as the translation of thoughts into words, the will to express them, and the means to do so—reside within the cortical gray matter, and that they are integrated through white-matter fibers. In so doing, Parchappe anticipated Carl Wernicke’s linking of the posterior aspects of the dominant frontal and temporal lobes in verbal expression, and Jules Dejerine’s linking of the angular gyrus and Wernicke’s area in the understanding of written language. Functional imaging has revived interest in language as a network of neuronal aggregates and has given new relevance to Parchappe’s concept of the functional organization of language.     

An Element of Thought: Phosphorus and Mental Philosophy in the Nineteenth Century

Georges Cabanis (17571808), through his writings on the relation of the physical and moral, or psychological, aspects of man, left a legacy that made the study of mental activity a part of physiology. His views on the importance of phosphorus to the function of the brain thrust that element into a prominent stream of research that involved many investigators in several countries. Although that particular stream eventually dried up, its influence remained: by the beginning of the twentieth century basic medical science had become well set on studies of the mind-body relationship.     

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.     

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.     

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

ABSTRACT

Surface thermometers were developed in the latter half of the nineteenth century. From the 1850s through the 1880s, collaborations between physicians, research scientists, and instrument makers produced clear improvements in the technology to measure cranial surface temperatures, with development of self-registering mercury surface thermometers resistant to pressure and little influenced by ambient temperature, apparatus for recording cranial surface temperatures from multiple stations simultaneously, and development of thermoelectric apparatus. Physiologic studies of cranial surface thermometry were conducted over a quarter century from 1861 to 1886. Beginning in the 1860s Albers in Bonn, Germany, and Lombard at Harvard and later in England systematically investigated surface temperatures on the head using surface thermometers and thermoelectric apparatus; they demonstrated that head temperatures were variable over time and across individuals and were not clearly influenced by thinking or muscular contraction but were influenced by ambient air temperature. In 1880 Amidon in the United States claimed that cranial surface thermometry during exertion produced localized increases in surface temperature on the contralateral scalp in a specific pattern (“external motive areas”) indicating underlying brain areas responsible for each movement. Amidon’s results were not reproduced by experienced physiologists in England or France. Contemporaries recognized that significant technical and practical problems limited the accuracy and reliability of cranial surface thermometry. Physiological studies of cranial surface thermometry ended in the mid 1880s, although some clinicians who were early advocates promoted its use in clinical contexts into the early twentieth century.