A Parisian spring: the debate on language localization at the Imperial Academy of Medicine, Paris, April 4–June 13, 1865

Abstract

The localization of articulate language (speech) to the posterior third of the third left frontal convolution—Broca’s area—did not occur to Broca as he reported the case of his first aphasic patient in 1861. Initially Broca localized articulate language to both frontal lobes, a position that he maintained for 4 years after publishing his first case. In the interval, the Academy of Medicine in Paris had received a copy of a paper authored in 1836 by Marc Dax, in which Dax claimed that the ability to speak resides within the left hemisphere alone. The Academy of Medicine convened in the spring of 1865 to adjudicate the issue. All of the distinguished speakers argued against Dax’s contention by citing the prevailing paradigm, that bilaterally symmetrical organs, such as the eyes and ears, and the hemispheres of the brain, must perform the same function. The lone dissenting voice was that of Jules Baillarger, the discoverer of the laminar organization of the cerebral cortex, whose argument in favor of what he called “Dax’s law” was so lucid that it carried the day. During his address to the Academy, Baillarger not only supported left-hemisphere dominance for speech, but for the first time described two forms of aphasia, fluent and nonfluent, now referred to as Wernicke’s and Broca’s aphasias, respectively, as well as the ability of aphasics to speak during emotional outbursts, to which we now refer as Baillarger-Jackson aphasia. It was 9 days after Baillarger’s address that Broca, for the first time, unequivocally localized speech to the left frontal lobe.This paper is based on the author’s reading of Dax’s and Broca’s original texts and of the texts read before the Academy of Medicine meeting held at the National Library of France between April 4, 1865, and June 13, 1865. From these primary sources it is concluded that the Academy of Medicine’s debate was the last serious challenge to left-hemisphere dominance for speech and to the localization of articulate language to the left frontal lobe—and that Jules Baillarger played a pivotal role in what was a defining moment in neurobiology.