Paul Broca

Remarks on the Seat of the Faculty of Articulated Language,
Following an Observation of Aphemia (Loss of Speech)

Mr. Paul Broca, in 1861, presented his findings with respect to the case of a 50yr old man by the name of Leborgne. Subsequently Leborgne became known as ‘tan’ due to the fact that this was the only word he could speak when he came to the hospice of Bicertre. Broca’s writing describes the patient’s slow decline from the time he was admitted through autopsy.

When Tan was first admitted, his presenting problems were loss of speech (described by Broca as Aphemia) and a gangrenous right leg. Broca reported that Tan, prior to losing his ability to speak, was able to work, speak, and in relatively good health. After Tan’s loss of speaking ability, he continued to exhibit evidence of being intelligent, and was able to communicate ideas through hand gestures. Tan was described by others in the ward as being egotistical, vindictive, bad, not liked, and even being a thief.

Ten years after his loss of speech, Tan began to experience weakening muscles, and eventually paralysis on the right arm and leg. The paralysis also extended to the pharynx making it hard to swallow at times. At this point his mobility suffered to the point he became bedridden. Although confined to the bed, he continued to have full functioning of his left arm and leg. Broca stated that by all appearances and testing that Tan’s sensitivity to external stimuli remained present, although reduced slightly on his right side. The bodily functions appeared normal as well as his ability to hear. Broca determined Tan “was more intelligent than he had to be in order to speak.” (1)
After Tan’s death, Broca performed an autopsy to determine if the speculations of his preliminary diagnosis were correct. The findings confirmed, for the most part, his preliminary diagnosis. All of Tan’s internal organs were healthy with the exception of his brain. His skull was slightly thicker than average, and it was somewhat inflamed. The interesting finding was that the brain was 400g lighter than an average brain of like origin. Broca found a lesion that had softened and expanded to form a large void separating the frontal and temporal lobes. Through mapping the progression from the point of origination he postulated 2 distinct periods of progression. Broca also confirmed a connection between the anatomical and symptomological periods. He believed the Aphemia, or loss of speaking ability was related to first period denoted by the lesion in the frontal lobe.
In the final analysis Broca made it clear that after all he had done, he could not be 100% certain of his findings. He could still not confirm a direct correlation between loss of speech and the location of the lesion.



I found reading the entire writing to be a fascinating experience. Not knowing the details of his personality, I did appreciate the portion that presented itself in the writing.
Broca’s clinical method seems to be a valuable tool in assessing conditions post-mortem. What I appreciated about this situation was his keen interest and careful examination of the patient while the patient was alive. The value in this method is obvious; he pre-diagnosed the condition based on empirical research, and then during the autopsy and the time that follows, he studies the brain in detail to confirm, or at least build a theory based on evidence.

From a Biblical point of view there is no doubt that this method is preferred to extirpation or electrical stimulation. Both of these leave too much room for abuse with extirpation almost being sociopathic behavior in spite of what advances come from it. The Bible clearly states we are created in the image of God, Imago Dei; therefore we have value and worth. If we were only evolved beings, not created in God’s image, we would only instrumental value and our personhood would depend only on what we could contribute. However, being created by God, we have intrinsic value, and to treat someone solely in a utilitarian manner is to not only treat them as less than human, but act as though God did not exist at all.

T