Victor W. HENDERSON
Departments of Health Research a& Policy and of Neurology & Neurological Sciences, Stanford University, Stanford, California, USA
vhenderson AT stanford.edu

The National Hospital for the Paralysed and Epileptic, established at Queen Square in 1860, holds a special place in the history of neurology. Two early members of the Queen Square staff, Hughlings Jackson (1835–1911) and Charlton Bastian (1837–1915) developed strong interests in aphasia in the years after Paul Broca’s epochal reports on the loss of articulate language from lesions of the frontal lobe. Their views could scarcely have differed more. Beginning in 1864, Jackson explored the relation between loss of speech and right hemiplegia in patients who had suffered cerebral embolism.

For Jackson, disorders of speech encompassed almost all varieties of intellectual expression, a perspective quite different from Broca’s, and Jackson eschewed the concept of delimited cortical centers. Ten years later, referring to Broca’s area in the left frontal lobe, he proclaimed that “I do not localize speech in any such small part of the brain. To locate the damage which destroys speech and to locate speech are two different things.” Bastian’s Queen Square staff appointment followed Jackson’s by five years. Bastian eschewed the more holistic approach to language taken by his senior colleague, describing separate auditory and visual perceptive centers that subserved speech and reading comprehension.

He was one of the first investigators to consider disorders of reading, and his discussions on this topic antedated better recalled works by Kussmaul and others. Bastian’s views on language centers later expanded to include two specialized regions within the left frontal lobe, a “glosso-kinaesthetic centre” for speech movements and a “cheiro-kinaesthetic centre” for writing movements. Interestingly, both were conceptualized as sensory rather than motor. He was a prolific and influential writer on topics of aphasia. However, later in his career Bastian’s interests veered increasingly from the medical mainstream, and today his contributions are less recalled than those of Jackson.

12th Annual Meeting of the International Society for the History of the Neurosciences   (ISHN)
Los Angeles, California, USA, 19-23 June 2007