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A History of Neuropsychology


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the morphological substrates for an intellectual faculty, psychological trait, or moral tendency. Thus, Gall reasoned that brain tissue behind the orbits represented organs for word memory and language sense, and their enlargement led to protruding eyes [5]. Gall did not identify organs for writing or reading. His controversial doctrines were popular throughout the 19th century but were opposed by the Catholic Church and by the scientific establishment.

      1861: Broca’s Aphemia

      By remarkable coincidence, a man with similar symptoms was admitted to Broca’s surgical service at the Bicêtre hospital 8 days later. Years before, he had lost his ability to speak, and he was paralyzed on his right side. He died of infection shortly thereafter, and Broca reported clinical and autopsy findings to the Anthropological Society [1]. His patient “understood almost all that one said to him” (p 236), and Broca interpreted this finding as evidence that intelligence was spared. The autopsy showed that “the frontal lobe of the left hemisphere was softened in most of its extent,” particularly affecting “the middle part of the frontal lobe of the left hemisphere” (p 237) [1]. This localization, according to Broca, supported Bouillaud’s view that anterior lobes were affected when speech was lost.

      Alexia and Agraphia in the Wake of Broca’s Discovery

      Ogle described a patient who wrote well after a stroke but whose speech production was sharply limited. The autopsy revealed a small area of softening in the posterior part of the left inferior frontal convolution. This location, according to Ogle, strongly supported Broca’s view of the brain area affected in atactic aphasia (Broca’s aphasia). However, because writing was unaffected, Ogle concluded “that the faculty of speech and the faculty of writing are not subserved by one and the same portion of the cerebral substance” (p 106). Still, the hypothesized speech and writing centers must be “closely contiguous” (p 100), since aphasia and agraphia so frequently occurred together [16].