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'.     

Baudelaire's “Teacher”: Joseph de Maistre and Le Spleen de Paris

For a total of twenty years (1856–76), Gustave Flaubert corresponded with a woman whom he would never meet and who had first written to him to express her admiration for his novel, Madame Bovary. These forty-five letters are among the most fascinating and important that he was to write, reflecting on his life, on art and esthetics, and on his determined dedication to the practice of writing. The letters to Marie-Sophie Leroyer de Chantepie occupy a central role in Flaubert's Correspondence, between the long series of letters he wrote to two other women, Louise Colet and George Sand. They are all dominated by the idea of the centrality of art, literature, and the activity of writing, and of the subordinate status of all other experiences and interests.     

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.     

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.     

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.     

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.     

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.     

“A Man of Fashion Never Has Recourse to Proverbs”: Lord Chesterfield's Tilting at Proverbial Windmills

Many scholars have claimed that proverbs largely dropped from polite speech during the eighteenth century in England. Often quoted in this context is Lord Chesterfield's advice to his son that proverbs are merely the "rhetoric of the vulgar man" and "a man of fashion never has recourse to proverbs and vulgar aphorisms." This article challenges the former assumption and shows that Chesterfield himself regularly used proverbs in his letters, and used them to great effect.     

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 Discovery of Motor Cortex and its Background

In 1870 Gustav Fritsch and Edvard Hitzig showed that electrical stimulation of the cerebral cortex of a dog produced movements. This was a crucial event in the development of modern neuroscience because it was the first good experimental evidence for a) cerebral cortex involvement in motor function, b) the electrical excitability of the cortex, c) topographic representation in the brain, and d) localization of function in different regions of the cerebral cortex. This paper discusses their experiment and some developments in the previous two centuries that led to it including the ideas of Thomas Willis and Emanuel Swedenborg, the widespread interest in electricity and the localizations of function of Franz Joseph Gall, John Hughlings Jackson, and Paul Broca. We also consider the subsequent study of the motor cortex by David Ferrier and others.     

The discovery of motor cortex and its background

In 1870 Gustav Fritsch and Edvard Hitzig showed that electrical stimulation of the cerebral cortex of a dog produced movements. This was a crucial event in the development of modern neuroscience because it was the first good experimental evidence for a) cerebral cortex involvement in motor function, b) the electrical excitability of the cortex, c) topographic representation in the brain, and d) localization of function in different regions of the cerebral cortex. This paper discusses their experiment and some developments in the previous two centuries that led to it including the ideas of Thomas Willis and Emanuel Swedenborg, the widespread interest in electricity and the localizations of function of Franz Joseph Gall, John Hughlings Jackson, and Paul Broca. We also consider the subsequent study of the motor cortex by David Ferrier and others.     

Exactly As People Tell,or an Ethnography of the (In)Visible Things of Mayajigua

This paper explores some of the consequences of using archival materials produced by an anthropologist's informants. What happens when a resident from a rural area of Cuba is hired to write about the “world”, a term used by Carl L. Withers, in which he, his relatives and his neighbours live? By reading letters and other papers sent during the late 1940s, and kept by Withers for more than thirty years, my hypothesis is that his informants took seriously their capacity to create something other than a simple “testimony”. Withers's principal informant, created himself, his neighbours, strange beings and the world in which they cohabited as a certain type of artefact, as “data”.     

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.     

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.     

‘’Tis Not in the Power of Words to Tell What My Heart Feels in Favour of You’; or,What the Ossulston Diary Does Not Reveal

Charles Bennet, 2nd Baron Ossulston is largely known through his diary of his daily social encounters, which was first analysed for its political import by Clyve Jones. A further set of documents in the Bennet family papers deepens our understanding of Ossulston's life and his social milieu among the aristocracy under Queen Anne. The love letters sent to him from a Mrs Sarah Sidney throughout 1710 reveal much about life in the aristocratic hothouse of St James's Square. They also show how the ‘ministerial revolution’ of that year was seen by two politically conversant figures at the margins of the royal court. This relationship was long-lasting and has been a hitherto unknown aspect of Ossulston's life, which may help explain some of his attitudes.     

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.     

‘My Freind who Writes for Me’: Scribes and Scribal Relationships in the Letters of Seamen, 1793–1815

This article examines the use of scribes in letters of one group of men during a specific period: British Royal Navy servicemen below the rank of commissioned officer during the French Revolutionary and Napoleonic Wars, 1793–1815. The letters of one such seaman in particular, Richard Greenhalgh, are unusual in that he himself could write, but preferred to have someone to write for him, as is shown by many references to ‘his freind who writes for me’. Contrasts between the scribe’s style of writing and that of Greenhalgh are noticeable, especially after Greenhalgh and his scribe were parted by being sent to serve on different ships. The letters also reveal the relationship between writer and scribe, and the writer’s family and his scribe. The letters contain messages to be passed between a network of family and friends on board ship and on shore, strengthening ties between them, vital in wartime to the morale of the seamen and for the reassurance of those at home. References found in other surviving letters demonstrate the use of scribes by different seamen, also seamen acting as scribes for shipmates, adding to knowledge of scribal culture among this social group.     

The Third Man: Robert Dunn’s (1799–1877) Contribution to Aphasia Research in Mid-Nineteenth-Century England

Throughout his medical career, Robert Dunn (1799–1877) published a number of clinical cases with postmortem reports involving acquired language disorders, with the first noted in 1842. He developed a physiologically informed approach to psychological function during the 1850s along with a group of notable colleagues Benjamin Collins Brodie, Henry Holland, Thomas Laycock, John Daniel Morell, and Daniel Noble. He was also active in ethnographic research on human origins and racial diversity. As such, Dunn represents an interesting player in the developing fields of neurology, psychology, and anthropology in England in the latter part of the nineteenth century. These various strands converged at the meeting of the British Association of the Advancement of Science in 1868, where Dunn shared the program of lectures on the cutting-edge topic of aphasia with Paul Broca (1824–1880) and John Hughlings Jackson (1835–1911). Dunn’s ideas developed over a longer time frame than his younger colleagues and as such represent a unique blending of concepts from the earlier work of Franz Josef Gall (1758–1828) and Jean-Baptiste Bouillaud (1798–1881) to the perspectives on language organization in the brain developed after 1861.     

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.