Pierre Paul Broca.

Abstract

Pierre Paul Broca. Illustration by Venita Jay, MD, FRCPC. T 19th century French surgeon Pierre Paul Broca left an indelible mark in medicine with his observations on aphasia, language dominance, and cerebral localization. Broca is also remembered for his contributions to anthropology, which include valuable studies of human skulls and the founding of the Societe d’Anthropologie. Broca (1824–1880) was born at Sainte-Foy-la-Grande near Bordeaux, France, on July 28, 1824. He was educated in Bordeaux and Paris, and received his medical degree in 1848. Broca’s remarkable career would revolve around 2 lasting interests—medicine and anthropology. He excelled in both, as a professor of surgery at the Bicetre in Paris and as a noted anthropologist dealing with a plethora of subjects, including the Cro-Magnon man and Neolithic trephination. Broca also founded the world’s first anthropological society and his own school and institute of anthropology. The first cortical localization that became widely accepted linked fluent, articulate speech to the frontal lobes. Cortical localization of speech was a much-debated issue in the early and mid-19th century, and many scientists had presented data for and against this theory before Broca’s epoch presentation in 1861. In the early part of the 19th century, Franz Joseph Gall addressed the issue of localization of speech to a specific area of the brain. Gall placed the faculty of memory of words in the frontal lobes, based primarily on his observation of skull shape. Jean Baptiste Bouillaud also believed in the localization of speech to the frontal region. In 1836, Marc Dax suggested that speech disturbances were due to lesions of the left hemisphere, but his hypothesis remained unknown for 30 years until his son, Gustave Dax, presented his father’s work in 1863 and published it in 1865. Broca’s concepts on speech localization were initially based on the study of a single patient, Monsieur Leborgne, who was affected by epilepsy and who had lost the ability to speak. Leborgne was able to comprehend and communicate by gestures, but his speech was limited to the monosyllable ‘‘tan,’’ and he thus came to be nicknamed ‘‘Tan.’’ Tan also had right hemiparesis. On April 11, 1861, Tan was admitted to Broca’s surgical service for cellulitis of the right leg. He was examined also by Ernest Auburtin,