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.     

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.     

Walter Moxon and His Thoughts About Language and the Brain

Walter Moxon wrote a well-timed paper in 1866 on aphemia with accompanying right sided hemiplegia. Like many other investigators of this apparent lopsidedness of the articulatory system for human speech, Moxon had to reconcile left hemisphere specialization for this function with the overriding law of symmetry, which for a large sector of the scientific community was a sine qua non of the anatomy and function of high level animal cognition. His reasoning was essentially that since the right dominant hand (and hence the left hemisphere) in some sense led overall bilateral limb movement patterns, that the right side of the tongue would lead whole tongue movement for articulation, the left side following in some mechanical sense. Thus, Moxon could link left hemisphere dominance for handedness as well as for speech. His theory was that “attention” was focused on the left hemisphere during limb movement development, under his assumption that the articulators were limbs as well as the arms and hands. The present paper will examine the professional life of Moxon and his 1866 paper, as well as the scant commentary that it has elicited in the literature on the history of left hemisphere dominance for the human articulatory function.     

Walter Moxon and his thoughts about language and the brain

Walter Moxon wrote a well-timed paper in 1866 on aphemia with accompanying right sided hemiplegia. Like many other investigators of this apparent lopsidedness of the articulatory system for human speech. Moxon had to reconcile left hemisphere specialization for this function with the overriding law of symmetry, which for a large sector of the scientific community was a sine qua non of the anatomy and function of high level animal cognition. His reasoning was essentially that since the right dominant hand (and hence the left hemisphere) in some sense led overall bilateral limb movement patterns, that the right side of the tongue would lead whole tongue movement for articulation, the left side following in some mechanical sense. Thus, Moxon could link left hemisphere dominance for handedness as well as for speech. His theory was that "attention" was focused on the left hemisphere during limb movement development, under his assumption that the articulators were limbs as well as the arms and hands. The present paper will examine the professional life of Moxon and his 1866 paper, as well as the scant commentary that it has elicited in the literature on the history of left hemisphere dominance for the human articulatory function.     

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.     

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.     

Biological and Epistemological Models of Localization in the Nineteenth Century: From Gall to Charcot

In the latter half of the nineteenth century, the localizationist doctrines became closely associated with the memory trace paradigm. The analysis of the texts dealing with the localization and the nature of ‘the loss of articulated speech’ (motor aphasia) by Bouillaud, Lordat, Dax, Broca, Trousseau, Baillarger, Charcot and Wernicke shows how the biological paradigm of localization presented by Gall and based on the notion of organ-function correspondence was transformed into a model based on localizable memory traces. This change resulted in the theoretical unification of the mechanisms of motor and non-motor forms of aphasia. These forms, which the earlier authors tended to separate in their analyses of the underlying mechanisms, were now regarded as involving similar mechanisms related to the loss of mnestic images. The crucial step in this development was taken by Broca who presented the hypothesis that the faculty of coordination of speech movements, which according to his predecessors was the faculty lost in motor aphasia, was actually an intellectual faculty and a specific form of memory, and motor aphasia consequently a selective kind of amnesia. Theorists like Charcot and Wernicke generalized this idea into a comprehensive theory of the nature of localization based on the notion of memory traces. Thus, the localization of function was reduced to the localization of representations. Instead of biological paradigms, this model of localization is rooted in the epistemological tradition of psychology represented by Locke and Condillac, who were primarily interested in the problem of representation. In physiology, this approach usually resulted in attempts at localizing representations instead of functions.     

Beyond descriptive neurology: Broca,cerebral hemodynamics,and cortical function

Pierre-Paul Broca’s studies in neurobiology remain of interest. I review a previously neglected aspect of Broca’s work in which he presages the use of modern scanning techniques. Broca’s goal was to correlate cerebral metabolism to regional cerebral blood flow (CBF) using a novel method, to which he referred as cerebral thermometry. Broca attempted to measure changes in temperatures from the ischemic area and across the watershed regions during a stroke, and the increased CBF produced by performing a cognitive task such as reading aloud. The method involved measurements of local temperatures at specific points about the head with an array of strategically placed thermometers much as EEG electrodes are arrayed to record the electrical activity of the brain. Although his technique was inaccurate and unreliable, the concept of measuring CBF as a diagnostic aid and as a cognitive research tool was prescient. Broca’s limitation was not conceptual but purely technological. Broca’s attempt to measure CBF as a surrogate for cerebral metabolism was conceptually valid but premature because he lacked the technology necessary to do so.     

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.     

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.     

Post Scriptum to the Biography of Monsieur Leborgne

In 1861, Paul Broca presented a case of a patient who had almost completely lost the ability of speech production. This patient is known as “Monsieur Leborgne” alias “Tan.” In describing the history of his disease, Broca reported that Leborgne had spent a total of 21 years in hospitals. The article features new information on the history of Leborgne's hospitalization.     

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.     

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.     

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.     

Patient Tan revisited: a case of atypical global aphasia?

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.     

Edward Harold Fulcher Swain's Vision of Forest Modernity

Edward Harold Fulcher Swain (1883–1970) developed a unique idea about the importance of forests, advocating the creation of a new society based upon forests, and he pursued policies to implement his unique vision of forestry when he served as the Director of Queensland's Forestry Board from 1918 to 1924 and the Forestry Commissioner for New South Wales from 1935 to 1948. Swain's beliefs developed out of a combination of his Australian experiences and connections with foresters in the British Empire and America. When he could not convince Australian elites about the need to create a forest-based society, he asked foresters at the 1947 Empire Forestry Conference in London to assert the primacy of forestry in land management in the British Empire. Many foresters positively received parts of Swain's argument, but his ideas could never be fully implemented in the British Empire because of the dominance of agrarian doctrines of development in post-Second World War colonial planning and the rapid process of decolonization. Swain's life sheds light onto current debates among historians about the origin and legacy of forestry in Australia and the British Empire. His ideas, many that parallel the basic tenets of modern environmentalism, require historians to rethink the relationship between Empire forestry and environmentalism.     

Visa Stupidity

This paper describe the author’s experiences when he has applied for visas in a range of countries, including Germany, the UK, Japan, China and the USA. In 22 years of international travel, he has never been refused a visa, though he has been unable to obtain a visa in time on several occasions, and this has cause him to be unable to attend meetings, even when he is fully funded, and has applied for a visa well in advance.     

Balanced Bilingualism: Patterns of Contact Influence in L1 and L2 Turkic and Bakhtiari Speech in Juneqan,Iran

Most studies on language contact in Iran have focused on the effects of Persian on the country’s minority languages. There are also many cases where large regional languages such as Azeri, Kurdish, Balochi, Lori and Bakhtiari exert an influence on smaller regional languages, and a few studies have appeared on this topic. This paper examines the effects of language contact in the city of Juneqan in Chahar Mahal va Bakhtiari Province, Iran, where the position of two minority languages—Bakhtiari and Qashqai Turkic—appears to be evenly balanced. The analysis is based on a comparison of L1 and L2 speech from two bilingual individuals with a different L1, as found in responses to the Atlas of the Languages of Iran (ALI) questionnaire. Drawing on examples from lexicon, phonology and morphosyntax, the article argues that the equivalent influence of each language on the first- and second-language speech of members of the other language community is likely achieved not by simple equal status, but through the counterbalancing of regional Bakhtiari dominance with majority mother-tongue Turkic population in this city.