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.     

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.     

Localization of Language Function in the Twentieth Century

In the twentieth century the method of identifying pathology in patients with aphasia has fluctuated between localizing and holistic theories. The practical localization of sensation and voluntary movement became a clinical commonplace in the beginning of the century, but the mental component of aphasia made its localization controversial. In Paris before the war, Pierre Marie made the localization of aphasia the centerpiece of his personal feud with Jules Dejerine. After the war Konstantin von Monakow used the phenomenon of recovery from aphasia to support his holistic views of localization. Henry Head, in a 1926 study that remains influential today, took a neo-Jacksonian approach to localization and the physiology of language. Kurt Goldstein led the postwar anti-localizationists, asserting that physicians must look after the whole person and that brain function was inherently unified. Norman Geschwind reflected 1960s physiological thought in analyzing aphasia as a type of disconnection of distinct functional areas. In the twenty-first century the localization of aphasia remains dependent on theory, with competition between holistic and localizing ideas.     

A Review of: “Michael Hagner,Geniale Gehirne. Zur Geschichte der Elitegehirnforschung”

Charcot and Pasteur were scientific contemporaries, but their relationship has not been extensively studied. We analyzed available source documents from the Charcot Library, Bibliothèque Nationale, Institute Pasteur, and Pasteur Library. These documents demonstrate that in spite of geographical proximity, international and local recognition, Charcot and Pasteur largely pursued their careers independent of one another. Although the Paris scientific climate was one of active debate, Pasteur's and Charcot's interactions remained distanced but mutually respectful and did not descend into rivalry or contention. With different primary interests and different etiological views, side by side, they exemplified two models of French medicine at the close of the nineteenth century: medical scientist and scientific physician.     

The man behind the syndrome: Sigvald Refsum

The authors attempt to solve the enigma about the possible aphasia of the Byzantine Emperor Manuel II Palaeologus (1391–1425) in the 3-year period between his first and his second and fatal stroke. The texts of historians and chroniclers reveal that Manuel remained semi-paralyzed at bed and his motor disability alienated him from the state affairs and condemned him to isolation from all embassies and contact with others, except his family. Only the funeral oration of the Bishop Bessarion raises the suspicion of a speechless emperor. All testimonies referring to this infirmity are examined.     

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.     

APHASIA,HISTORY, AND DURESS

This essay celebrates the publication of Duress, explores its concepts and themes, focuses on the way Ann Stoler rejects the notion of historical forgetting and develops a heuristic of “colonial aphasia” in an ethnographic chapter on the emergence of France's Far Right near Marseille in the 1990s. The essay also tracks how postcolonial scholars are using the notion of aphasia, drawing on Stoler's colonial usages in contexts like the Netherlands and Britain as well as using the notion to periodize. Those who came to aphasia before and without Stoler are also present here, and their contributions suggest a range of ways to think through radical, countercultural, and philosophical thought. That Gilles Deleuze and Paolo Virno use aphasia in contrary ways suggests that once aphasia departs from clinical settings, its poetics are rather up for grabs even if contained within activist gestures; both rethink matters of politics, dissent, and language. The example of Kurt Goldstein is also imported to show that clinical aphasia may go with the “detours” of patients, those stricken by war, catastrophe, and these peculiar speech disorders. That “detour” is also a Deleuzian word opens wide a “minor” register to history, speech, and forms of oppression. The semantic spectrum for aphasia in histories of politics and language is wide, from Stoler's colonial version that applies most to the privileged, to Deleuze's poetic transpositions that propose aphasia as an accomplishment, a rebellious refusal of communication. Aphasia has much promise as a historical category in and outside of colonial forms of duress.     

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.