Volume 1

Aphasia and kindred disorders of speech / by Henry Head.

  • Head, Henry, 1861-1940.
Date:
1926
Catalogue details

Licence: In copyright

Credit: Aphasia and kindred disorders of speech / by Henry Head. Source: Wellcome Collection.

    45/576 (page 25)
    This patient died on November 8th, 1861, and the autopsy revealed the following condition. All the sutures were ossified, and the walls of the skull were a little thickened, but not harder than usual. The dura mater was not thickened, and appeared to be unaffected. There was a considerable quantity of serous fluid in the cavity of the arachnoid. The pia mater was neither thickened nor congested. The whole brain with its membranes weighed 1136 grammes, far below the average, and scarcely equal to the minimum weight of that of an adult male of normal men¬ tality. This was due not only to general senile atrophy but to distinct wasting of the left hemisphere. When the brain was placed on the table, it was evident that a super¬ ficial lesion occupied the left frontal lobe immediately below the anterior extremity of the fissure of Sylvius. At this level the surface of the hemi¬ sphere was sunken and through the transparent pia mater could be seen a collection of serous fluid, occupying an area almost equal to that of a franc. The third frontal convolution was completely cut in half and had suffered a loss of substance extending over about 15 mm. This excavation was continuous on the one side with the fissure of Sylvius, at the level of the insula. In the other direction it encroached on the second frontal convolution, which was profoundly eaten away, though the innermost portion remained for a thickness of 2 mm.; this minute tongue alone maintained the continuity of the convolution. The first and also the ascending frontal convolution were perfectly normal. Broca concludes, “In this patient, therefore, the aphemia was the result of a profound, but accurately circumscribed lesion of the posterior third of the second and third frontal convolutions.” Its origin was probably apoplectic, for it must be remembered that the patient lost his speech suddenly, and haematin crystals were discovered on microscopical examination at the site of the lesion. These communications produced the greatest excitement in the medical world of Paris. They were specially selected for comment by the Secretary of the Societe anatomique, in his Annual Report for the year 1861. Bouillaud and his son-in-law, Auburtin, greeted Broca as a convert to their doctrines. Localisation of speech became a political question; the older Conservative school, haunted by the bogey of phre¬ nology, clung to the conception that the brain “acted as a whole”; whilst the younger Liberals and Republicans passionately favoured the view that different functions were exercised by the various portions of the cerebral hemispheres. During the next few years every medical authority took one side or other in the discussion.