Localization of Language Function in the Twentieth Century

Abstract

In the twentieth century the method of identifying pathology in patients with aphasia has fluctuated between localizing and holistic theories. The practical localization of sensation and voluntary movement became a clinical commonplace in the beginning of the century, but the mental component of aphasia made its localization controversial. In Paris before the war, Pierre Marie made the localization of aphasia the centerpiece of his personal feud with Jules Dejerine. After the war Konstantin von Monakow used the phenomenon of recovery from aphasia to support his holistic views of localization. Henry Head, in a 1926 study that remains influential today, took a neo-Jacksonian approach to localization and the physiology of language. Kurt Goldstein led the postwar anti-localizationists, asserting that physicians must look after the whole person and that brain function was inherently unified. Norman Geschwind reflected 1960s physiological thought in analyzing aphasia as a type of disconnection of distinct functional areas. In the twenty-first century the localization of aphasia remains dependent on theory, with competition between holistic and localizing ideas.