Hughlings Jackson and Broca on Aphasia, 1868

Marjorie Perlman LorchThe June issue of Brain, 131(6), includes an “occasional paper” by Marjorie Perlman Lorch that reexamines the supposed debate between Paul Broca and John Hughlings Jackson at the 1868 meeting of the British Association for the Advancement of Science (BA).

This meeting has been identified as a turning point in favour of Broca’s position on the cerebral localization of language. A return to original sources from key witnesses reveals that the opinion of the British practitioners was generally against Broca’s views. Close examination of contemporaneous materials suggests that no public debate between Jackson and Broca occurred. However, the public discussion after Broca’s presentation records notable concerns over both theoretical issues of localization of function and the status of exceptional clinical cases. A significant stage in the development of current views on the organization of language in the brain is revealed in the accounts of the BA meeting in August 1868 and successive responses to these events in the British press over a period of years.

This latest article contributes to an extensive literature on the history of aphasia. Some of these papers are referenced below the fold.


  • Lorch, M. P. (2008). The merest Logomachy: The 1868 Norwich discussion of aphasia by Hughlings Jackson and Broca. Brain, 131(6), 1658-1670.

Related Readings

  • Benton, A. (1984). Hemispheric dominance before Broca. Neuropsychologia, 22(6), 807-811. Reviews early medical literature in the 18th and 19th centuries that contains considerable evidence for a specific association between speech disorder and disease of the left hemisphere. The diverse reasons for the failure of clinicians to perceive the association are discussed, and the approach of the French physician M. Dax (1865) to the question, which led him gradually to the conviction that aphasia was the product of left hemisphere disease, is described.
  • Benton, A. & Anderson, S. W. (1998). Aphasia: Historical perspectives. In M. T. Sarno, ed., Acquired aphasia (3rd ed.) (pp. 1-24). San Diego, CA: Academic Press. Presents historical perspectives on aphasia, including aphasia in Greek and Roman medicine and in the Renaissance, and 17th and 18th century contributions. A history of aphasia from 1800-1860 discusses advances in clinical knowledge, theoretical formulation, and neuropathology, while a history of aphasia from 1861-1900 discusses Paul Broca and Carl Wernicke’s contributions and the associationist and cognitive schools. Early 20th century, modern (after 1935), and contemporary developments are outlined including a series of technological advances that provided unprecedented opportunity for testing models of brain and language.
  • Brown, J. W. & Chobor, K. L. (1992). Phrenological studies of aphasia before Broca: Broca’s aphasia or Gall’s aphasia? Brain and Language, 43(3), 475-486. Reviews the history of aphasia localization prior to P. Broca (1861) and argues that F. Gall (1825) provided the 1st complete descriptions of an expressive aphasia with a proposed brain localization. The significance of Broca’s case studies lies in the association of motor aphasia with focal pathology in the frontal lobe.
  • Eliasberg, W. G. (1950). A contribution to the prehistory of aphasia. Journal of the History of Medicine, 5, 96-101. That the problem of aphasia occupied students before Broca (1861) is evidenced by the present author (1) with Spaulding’s letter (1772) giving an introspective account of his own aphasic disorder which set in on the occasion of meeting complex and conflicting demands of a linguistic character made upon him (talking, writing, etc.) and (2) with Moses Mendelssohn’s purely psychological theory of Spalding’s aphasia formulated in the same year (1772) to the effect that unconscious and emotional conflicts were largely responsible.
  • Gainotti, G. (1999). Development of the concept of aphasia. In G. Denes & L. Pizzamiglio, eds, Handbook of clinical and experimental neuropsychology (pp. 135-154). Hove, England: Psychology Press/Erlbaum. Describes the history of the development of aphasia. The author begins by describing the principle of localization and the associationist model, including Broca and the birth of scientific aphasiology. The author then describes unitary interpretations of aphasic disintegration, the empirical classification and D. H. Geshwind’s neuroassociationism, and A. R. Luria’s interpretative system and the theory of cortical analysers. The author concludes by discussing linguistic interpretations of aphasia.
  • Jacyna, S. (2007). The contested Jacksonian legacy. Journal of the History of the Neurosciences, 16(3), 307-317. John Hughlings Jackson has since the early twentieth century occupied the position of the doyen of British neurology. Among those who knew him personally and claimed allegiance to his legacy were the leading neurological practitioners, Henry Head (1861-1940) and Samuel Alexander Kinnier Wilson (1878-1937). In terms of their professional profiles and attitudes Head and Kinnier Wilson had much in common. They however interpreted the Jacksonian legacy in divergent ways that illustrate how the content and import of Jackson’s views were subject to interpretation and to contestation among those who claimed to be his disciples.
  • Kaitaro, T. (2001). Biological and epistemological models of localization in the nineteenth century: From Gall to Charcot. Journal of the History of the Neurosciences, 10(3), 262-276. Examines localizationist doctrines, which in the 19th century became closely associated with the memory trace paradigm. Analyses of “the loss of articulated speech” (motor aphasia) by Bouillaud, Lordat, Dax, Broca, Trousseau, Baillarger, Charcot, and Wernicke shows how Gall’s biological paradigm, based on organ-function correspondence, was transformed into a model based on localizable memory traces. This resulted in the theoretical unification of motor and non-motor forms of aphasia. These forms, which the earlier authors separated in analyzing underlying mechanisms, were now regarded as involving similar mechanisms related to the loss of mnestic images. Broca took a crucial step by hypothesizing that coordination of speech movements, which his predecessors felt was lost in motor aphasia, was actually an intellectual faculty and a form of memory, and motor aphasia a selective amnesia. Charcot and Wernicke generalized this idea into a theory 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 is rooted in the epistemological tradition of psychology represented by Locke and Condillac, who were primarily interested in representation.
  • Lorch, M. P. (2004). The unknown source of John Hughlings Jackson’s early interest in aphasia and epilepsy. Cognitive and Behavioral Neurology, 17(3), 124-132. The National Hospital for Paralysis and Epilepsy in London (founded 1859) was the scene of great discoveries in the new specialty of neurology, carried out in great part by John Hughlings Jackson (1834-1911). The clinicians Jonathan Hutchinson and Charles Edward Brown-Sequard are typically identified as Jackson’s mentors. This paper discusses the previously neglected role of Jabez Spence Ramskill (1824-1897), founding physician of the National Hospital. Ramskill appears to have been significant in providing the opportunity and context that led Jackson to develop his theories concerning higher cerebral function disorders. As assistant physician to Ramskill at the National Hospital, Jackson was provided with a vast caseload of epileptic, hemiplegic, and aphasic patients. Ramskill and Jackson both published papers on aphasia in the London Hospital Reports in 1864. Consideration of the similarities and differences between these 2 papers highlight significant issues in the clinical and theoretical development of understanding language organization in the brain. The early writings of Jackson and case notes of Ramskill document a close link between the 2 and indicate the debt that Jackson had to Ramskill for providing him with the opportunities to develop his original ideas on epilepsy and aphasia.
  • Prins, R. & Bastiaanse, R. (2006). The early history of aphasiology: From the Egyptian surgeons (c. 1700 BC) to Broca (1861). Aphasiology, 20(8), 762-791. According to many aphasiologists the scientific study of aphasia dates back to the second half of the 19th century when Broca and Wernicke described the two classical forms of aphasia that now bear their names. About 100 years later, Benton and Joynt presented a historical overview of the literature on aphasia from the Hippocratic writings (c. 400 BC) to 1800. Since this seminal review (Benton & Joynt, 1960) there has been a growing interest in the history of aphasiology, resulting in many papers (cf. the Journal of the History of the Neurosciences) and even books (e.g., Eling, 1994; Finger, 2000; Jacyna, 2000) about hitherto unknown writings about aphasia. The aim of this paper is to present a new, updated, and extensive review of the early history of aphasiology, starting with the earliest observation of “speechlessness” in an Egyptian papyrus (c. 1700 BC) and ending with Broca’s discovery of the “speech centre” in 1861. By presenting and discussing passages taken from major contributions to aphasiology in the past 3500 years, this literature survey offers a review of the clinical observations and theoretical analyses of aphasic phenomena preceding the pioneering article by Broca in 1861. Although many forms and symptoms of aphasia were described and a few theoretical explanations of its nature had been advanced before 1800, significant hypotheses about the localisation of aphasia were not formulated until the period 1800-1860. Based on his (otherwise misguided) “phrenological” theory, Gall (in Gall & Stuart, 1806) was the first to localise language in the frontal cortex. This hypothesis was then tested and supported by neuropathological data collected by Bouillaud (1825) who not only localised language in the frontal lobes, but also made the fundamental distinction between “a general faculty of language” and “the faculty of articulated speech”, thus preparing the ground for Broca’s famous discovery in 1861.
  • Review of L’aphasie de Broca. (1908). Psychological Bulletin, 5(8), 275-282. Reviews the book, L’aphasie de Broca by François Moutier (1908). In a volume of 774 pages, Moutier spreads before us the material on which Pierre Marie based his “Revision de la question de l’aphasie.” Moutier gives first a history of the precursors of Broca and the period of Broca and renders the graphic ‘schemes’ of aphasia from the simplest to the more elaborate one of Langdon, and a review of the effect of Marie’s articles. Moutier then takes up the really very frail anatomical material of Broca, and next the apparently corroborative cases of the classics (taking full advantage of the opportunity to show up the shamefully careless and uncritical character of so many aphasia-reports). The second part of the book deals with the clinical analysis of the nature and symptoms of Broca aphasia. The greater part of the book consists of abstracts of 387 pertinent cases of the literature, and a report of 25 cases of their own with autopsy, and 19 without autopsy, material which will be reviewed elsewhere. The bulk of the older cases is inconclusive and a painful evidence of the looseness of most of the recorded aphasia-material. Moutier had a difficult task in bringing up the rear of facts in the onward march of such a brilliant dialectic and polemic plea as were the three articles of his master. The actual material has rather weakened the argument and one’s confidence in the accuracy of the work of Marie’s helpers. The problem of aphasia and apraxia is and will be the main entering wedge into the problem of cerebral activity of a psychological order, and it cannot be sacrificed to clinico-anatomical convenience.
  • Rizzuto, A.-M. (1990). The origins of Freud’s concept of object representation (“Objektvorstellung“) in his monograph “On aphasia”: Its theoretical and technical importance. International Journal of Psycho-Analysis, 71(2), 241-248. Explores Freud’s (1891 [1953]) conception of the process of representing the body in the cerebral cortex in On Aphasia and the significance of this conceptualization for his theory and technique. Freud’s use of empirical evidence to challenge the position that a representation is localized in the nerve cell is described.
  • Roe, D. & Finger, S. (1996). Gustave Dax and his fight for recognition: An overlooked chapter in the early history of cerebral dominance. Journal of the History of the Neurosciences, 5(3), 228-240. 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, M. Dax, and G. 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 R. in 1879, and recreates the events that triggered the younger Dax’s anger.
  • Ryalls, J. (1984). Where does the term “aphasia” come from? Brain and Language, 21(2), 358-363. Broca’s original term for the disturbance of the faculty of speech was aphemia. It was A. Trousseau, a Parisian clinician, who, in 1864, rejected Broca’s aphemia for aphasia since the modern Greek root for aphemia refers to reputation or fame. Broca responded by noting that the ancient Greek root for aphemia differed in meaning from the modern Greek root. Trousseau’s word may have been more readily accepted because he had a larger clinical following with wider, and perhaps more prominent, connections in the medical world.
  • Selnes, O. A. & Hillis, A. (2000). Patient Tan revisited: A case of atypical global aphasia? Journal of the History of the Neurosciences, 9(3), 233-237. Notes that P. Broca’s 1st patient presented in support of a relationship between a lesion of the frontal lobe and aphasia was patient Tan. Although P. 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 more recent clinical criteria. It is argued that 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. The authors conclude that 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.

See also

  • Kantor, J. R. (1947). The brain in the history of science. In J. R. Kantor, ed., Problems of physiological psychology (pp. 76-91). Bloomington, IN: Principia Press. Like all history, the history of psychology bears the deep impress of its writers. Those who write on the history of Physiological Psychology (P.P.) take the position that they are tracing through ideas of brain function as definite scientific developments. Usually they begin with the Bell-Magendi law which differentiates between sensory and motor functions of nerves, a differentiation presumed to occur also in the brain. This procedure is followed through by repeating the story of Broca’s discovery of the locus of the speech function. Then Fritsch and Hitzig receive due credit for their studies on the electrical stimulation of the cortex. Thus an elaborate story is built up, to climax in cortical localization of sense qualities, association, memory, and thought. Though the foundations of the story are certainly laid down upon definite observation, the structure erected thereon consists mostly of the gossamer of traditional opinions. This chapter looks at the function conception and the ideological stages of brain function.
  • Thomas, R. K. (2007). Recurring errors among recent history of psychology textbooks. American Journal of Psychology, 120(3), 477-495. Five recurring errors in history of psychology textbooks are discussed. One involves an identical misquotation. The remaining examples involve factual and interpretational errors that more than one and usually several textbook authors made. In at least 2 cases some facts were fabricated, namely, so-called facts associated with Pavlov’s mugging and Descartes’s reasons for choosing the pineal gland as the locus for mind-body interaction. A fourth example involves Broca’s so-called discovery of the speech center, and the fifth example involves misinterpretations of Lloyd Morgan’s intentions regarding his famous canon. When an error involves misinterpretation and thus misrepresentation, I will show why the misinterpretation is untenable. [Discussed at AHP here.]


About Jeremy Burman

Jeremy Trevelyan Burman is a senior doctoral student in York University’s Department of Psychology, specializing in the history of developmental psychology and its theory (especially that pertaining to Jean Piaget). Prior to returning to academia, he was a producer at the Canadian Broadcasting Corporation.