Mind, Brain and Adaptation in the Nineteenth Century: Cerebral Localization and Its Biological Context from Gall to Ferrier
by
Robert M. Young
[ Contents | Preface | Introduction | Chapter: | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | Bibliography ]
8
DAVID FERRIER: LOCALIZATION OF
SENSORY-MOTOR PSYCHOPHYSIOLOGY
On the whole, then, it seems impossible to allow that Dr. Ferrier has done more than take a first step towards discovering the relation of different parts in the brain; nor is it possible to say thus far that much psychological insight is likely to be gained upon the new line of inquiry. Certainly, although he gives us in chapter xi a view of 'the hemispheres considered psychologically' which is much above the level of common physiological opinion, it does not appear to depend specially upon his own investigations. And that we are now put in the way to obtain a truly scientific phrenology, embodying what was true in the old phrenological doctrine (the notion of definite organ for definite function) but based, as that was not, upon exact anatomical and physiological inquiry in relation to exact psychological analysis-this, which is becoming a fond conviction with many, is, to say the least, a very premature hope. In some respects, the old phrenology was itself more scientific than that which would now be substituted for it.
George C. Robertson, 1877.
Unless our laboratory results are to give us artificialities, mere scientific curiosities, they must be subjected to interpretation by gradual reapproximation to conditions of life.
John Dewey, 1900.
Ferrier's Localizations
It took time to persuade the critics of the validity of Fritsch and Hitzig's findings. Tests were conducted throughout the 1870's, and commissions consisting of noted physiologists reported favourably from New York, Boston, and Italy.[1] New objections by Burden-Sanderson in England were overcome by a French exponent of the new physiology, François-Franck.[2] The literature on cerebral localization after 1873 became so extensive that contemporary reviewers listed hundreds of references and made no pretence of providing exhaustive reports.[3] 0nce the principle of cerebral localization was established, it provided a paradigm within which searching for centres became, and to a large extent has remained, a part of normal science.[4] Unlike
1 Jefferson, 1960, p. 127.
2 Ibid., pp. 127-8.
3 Dodds, 1878; Bastian, 1880; Mills 1890; Ferrier, 1890; Bateman, 1890; and Foster, 1890 (Part III), provide extremely useful contemporary reviews. Cf. Jefferson, 1960.
4 Cf. Kuhn, 1962.
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many important discoveries in science, the appreciation and exploitation of Fritsch and Hitzig's findings, were in no way delayed. Almost without exception the articles and texts which appeared in the 1870's, 80's, and 90's convey the atmosphere of 'electric excitement' engendered by their discovery.
A great deal of classical work on the cerebral hemispheres followed in the next few years, and centres for various functions were mapped by workers in Germany, France, Italy, and especially England. The principal figures supporting localization in this period were Hitzig, Munk, François-Frank, Luciani, Beevor, Schafer, Horsley, and David Ferrier. New and more precise techniques of stimulation and ablation developed apace and were used to extend the initial findings on motor functions, and to discover cerebral areas related to sensation. Johannes Mueller's doctrine of specific nerve energies (which related to specific senses in the peripheral nervous system) was extended to the brain, and centres for vision, hearing, touch, olfaction, and taste, were more or less established over the next two decades, although the centres for taste and smell remained uncertain, and there was considerable debate over particular sensory centres between the two principal contributors to these developments-Ferrier and Munk. Ferrier had mentioned the possibility of localizing sensory centres in his first papers[1] and the first edition of his book had a thirty page section on the topic. Ten years later the second edition had a section almost three times as long.[2]
The work of these investigators was informed by the growing appreciation of the implications of the theory of evolution. Thus, one finds them taking comparative anatomy quite as seriously as Gall did (and as Flourens did not), and the concept of continuity of nervous structures and functions became a basic assumption. Their writings contain specific findings with reference to the increase in cortical control (encephalization of functions) as the evolutionary scale is ascended toward higher primates and man.
The work of David Ferrier was at the centre of these developments and prototypical of the new physiology. Ferrier's experiments (first published in 1873) were the first to confirm Fritsch and Hitzig's. Where they had found five localized centres for various movements in the dog, he soon found in the monkey fifteen different areas where movement could be elicited by electrical stimulation. His ablation work contributed to the localization of each of the sensory functions
1 Ferrier, 1873, pp. 50, 55-6; 1874a, pp. 2, 80, 97, 127, 134-5.
2 Ferrier, 1876, pp. 163-98; 1886, pp. 268-345.
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mentioned above. The significance of Ferrier's work for neurophysiology can be glimpsed from the fact that Sir Charles Sherrington dedicated his classical lectures on The Integrative Action of the Nervous System (1906) to Ferrier: 'In token recognition of his many services to the experimental physiology of the nervous system.' In fact, Sherrington's first publication was an examination of the brains which Ferrier and Goltz had presented in 1881 on the issue of cerebral localization. The work of Ferrier was thus one of the bases of Sherrington's whole new emphasis in the study of neurophysiology, involving the use of the concepts of integration, evolution, and reflex as guiding principles. In his obituary notice on Ferrier for the Royal Society, Sherrington points out that Ferrier had been the main figure in proving the concept of cerebral localization, placing it at the centre of neurological interest,[l] and providing the basis for a 'scientific phrenology'.[2]
In spite of the ambiguities in his writings before 1870, there can be no doubt that Jackson's conceptions were the principal inspiration of Ferrier's research. In his first paper Ferrier describes the object of his experiments as the testing of Jackson's theory that localized and unilateral epilepsies are caused by irritation or discharging lesions of the cortex. He sets out to confirm these deductions by 'artificial reproduction of the clinical experiments performed by disease’.[3] He concludes that his results confirm Jackson's theories,[4] and says later that he considers Jackson the source of the revival of interest in cerebral localization. 'The doctrine of cerebral localization has in recent years assumed quite a new aspect, and differs so much from older speculations in the kind of evidence on which its rests, as to be essentially a new growth. Hughlings-Jackson made the first decided steps in this direction.’[5] He acknowledges that Jackson's views were based on the 'rude experiments of disease', a circumstance which precluded exact localizations. 'But to Hughlings-Jackson belongs the credit of having first indicated the motor functions of certain regions of the cortex, and given a rational explanation of the phenomena of unilateral cerebral convulsions.’[6] Ferrier's lavish acknowledgement of his debts to Jackson is reminiscent of Jackson's statements about Spencer. In his first paper to the Royal Society, Ferrier prefaces a reference to a paper by Jackson on aphasia with the following remark: 'Without being sure of agreeing
1 Sherrington, 1928, p. x.
2 Ibid., p. xiii. Cf. Sherrington, 1937, p. 303.
3 Ferrier, 1873, pp. 30, 85. Cf. Ferrier, 1874a, pp. 1, 14; Ferrier, 1886, p. 223; Ferrier, 1874b, p. 49.
4 Ferrier, 1873, pp. 85-7. Cf. Ferrier, 1874b, p. 44.
5 Ferrier, 1878, p. 14.
6 Ibid.
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with this distinguished writer in all his views on this subject, I must express my sense of the great obligations I am under to the philosophical doctrines he has long taught, both as regards the initiation of this research and the interpretation of its lessons.'[l] It was therefore natural that when Ferrier published his classical monograph, he said 'to Dr Hughlings Jackson who from a clinical and pathological standpoint anticipated many of the more important results of recent experimental investigation into the functions of the cerebral hemispheres this work is dedicated as a mark of the author's esteem and admiration'.[2]
Ferrier is less enthusiastic in acknowledging his debts to Fritsch and Hitzig. He gives as his second reason for undertaking his experiments the intention of following up their discovery of the electrical excitability of the hemispheres,[3] and cites his findings as confirming and extending theirs.[4] In his report to the Royal Society, he acknowledges that his method was suggested by their experiments.[5] However, the referees (Michael Foster and George Rolleston) felt that he had made insufficient reference to their work, and T. H. Huxley was called in as a third referee 'for the purpose of ascertaining my opinion whether Dr Ferrier has or has not done sufficient justice to the labours of his predecessors in the same field of investigation'.[6] Huxley concluded that he had not, and Ferrier added a more explicit acknowledgement of their priority in both method and findings.[7] Neither Foster nor Huxley was satisfied, Hitzig complained bitterly, and the referees feared for the reputation of the Royal Society and even of English science.[8] Ferrier preferred to omit the experiments on dogs rather than to make the requested changes,[9] and consequently only his experiments on monkeys were published.[10] After this unfortunate episode, Ferrier's references to Fritsch and Hitzig were more generous,[11] and by 1890 he was prepared to say that 'The whole aspect of cerebral physiology and pathology was revolutionized by the discovery, first made by Fritsch and Hitzig in 1870, that certain
1 Ferrier, 1874a, p. 129 (back).
2 Ferrier, 1876, p. v.
3 Ferrier, 1873, p. 30.
4 Ibid., pp. 31-2, 39, 49, 77.
5 Ferrier, 1874a, p. 2.
6 Rolleston et al., 1874, RR. 7. 302.
7 Ibid.; Ferrier, 1874a, pp. 2, 53 (red ink additions).
8 Rolleston et al., 1874, RR. 7. 302; RR. 7. 301. Huxley closed his report with the following: 'In conclusion I particularly desire that these remarks may not be supposed to diminish the value of the original results obtained by Dr Ferrier-which appear to me to be very great-especially in respect of the experiments on monkeys.' (Ibid., RR. 7. 301.)
9 Ibid., RR. 7. 305.
10 Ferrier, 1875a, 1875b. The two other sets of referees' reports on papers by Ferrier in the Royal Society also complain that he failed to make adequate acknowledgement of the work of his predecessors. (Rolleston, et al., 1874, RR. 12. 103.)
11 See Ferrier, 1874b, p. 45; Ferrier, 1875b, p. 433; Ferrier, 1876, pp. xv, 146-8; Ferrier, 1878, p. 15.
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definite movements could be excited by the direct application of electrical stimulation to definite regions of the cortex cerebri in dogs.'[l]
Ferrier's work was central to the classical period of cerebral localization in the last three decades of the nineteenth century. In his classical monograph on The Functions of the Brain he makes explicit the method and the assumption which guided his work. He reviews the difficulties involved in making inferences concerning man from animal studies and from the clinic, but he continues:
Notwithstanding these difficulties and discrepancies, many of which will be found, on careful examination, to be more apparent than real, experiments on animals, under conditions selected and varied at the will of the experimenter, are alone capable of furnishing precise data for sound inductions as to the functions of the brain and its various parts; the experiments performed for us by nature, in the form of diseased conditions, being rarely limited, or free from such complications as render analysis and the discovery of cause and effect extremely difficult, and in many cases practically impossible. The discovery of new methods of investigation opens up new fields of inquiry, and leads to the discovery of new truths. The discovery of the electric excitability of the brain by Fritsch and Hitzig has given a fresh impetus to researches on the functions of the brain, and thrown a new light on many obscure points in cerebral physiology and pathology.[2]
And the assumption: every movement and every sense in a higher animal is produced by a specific part of the brain, in a manner which must still be the subject of extensive research.[3]
Ferrier conducted his original experiments at the West Riding Lunatic Asylum and published his results in the Report of that institution for 1873.[4] He was able to produce convulsions experimentally, thus confirming Jackson's speculations by the artificial reproduction of the phenomenon of epilepsy.[5] He also produced precise movements of individual muscles and groups of muscles by the electrical stimulation of localized cortical centres in dogs, rabbits, cats, and guinea pigs. Thus, he confirmed the motor significance of the grey matter of the
1 Ferrier, 1890, p. 17.
2 Ferrier, 1876, pp. xiv-xv.
3 Thorwald, 1960, pp. 39-40.
4 The West Riding Lunatic Asylum is interesting in its own right, since it was an early example of the combination of clinical and experimental work. See Viets, 1938. Its director, James Crichton-Browne, apparently invited Ferrier there to do his research, and Ferrier acknowledges his debt (Ferrier, 1874a, p. 136). Hollander claims that Crichton-Browne was an adherent to phrenology and that he invited Ferrier to conduct his experiments in order to test phrenology. (Hollander, n.d., I, 405-6.) I have seen no support for this claim in Ferrier's writings or in the many volumes of reminiscences which Crichton-Browne wrote. However, Crichton-Browne does mention phrenology often, and Hollander (Ibid.) quoted some flattering references to Gall and Spurzheim. Crichton-Browne later joined with Ferrier and Jackson to found the neurological journal Brain.
5 Ferrier, 1873, p. 85.
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cerebral cortex.[1] In addition to the implications of his findings for physiology and clinical neurology, Ferrier planned to use his techniques to ‘attempt to artificially excite conditions similar to normal psychic or volitional stimuli'.[2] The hope held out by these findings was that ‘we may ultimately be enabled to translate into their psychological signification and localize phrenologically the organic centres of various mental endowments'.[3]
His initial publications caused an immediate sensation. The work was conducted in the spring and reported to the British Association in September by his former teacher, Professor Rutherford:
These researches mark the commencement of a new era in our knowledge of brain function. Of all the studies in comparative physiology there will be none more interesting, and few so important, as those in which the various centres will be mapped out in the brains throughout the vertebrate series. A new, but this time a true, system of phrenology will probably be founded upon them: by this however, I do not mean that it will be possible to tell a man’s faculties by the configuration of his skull; but merely this; that the various mental faculties will be assigned to definite territories of the brain, as Gall and Spurzheim long ago maintained, although their geography of the brain was erroneous... these investigations constitute the most important work which has been accomplished in physiology for a very considerable time past.[4]
Ferrier's findings were noted by the retiring President of the Royal Society in December: 'In Anatomy, the most striking subject appears to be Professor Ferrier's experimental discussion of the actions of different parts of the brain, explained at the late Meeting of the British Association.’[5] His findings were communicated to the Royal Society the following March. He was nominated as a candidate for election the same year and elected in 1867. The Royal Society also granted him money to extend his researcher to the brains on monkeys. He gave the Croonian Lectures in 1874 and again the following year. When his monograph appeared in 1876, George Croom Robertson (in his review in Mind), referred to it as ‘this eagerly looked for work’[6] and noted that it was classical.
His physiological results have been obtained with great skill, and, whatever may be said against his interpretations, they are at once clearly conceived and forcibly argued. It is little to say of both that they must henceforth be
1 Ferrier, 1873, p 90
2 Ibid., p. 72. Cf. Ferrier, 1874a, p. I
3 Ibid., p. 76. Ferrier's findings are considered in greater detail in Young, 1968.
4 Rutherford, 1874, p. 122.
5 Airy, 1873, p. 9.
6 Robertson, 1877, p. 92
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reckoned with, by psychologists as well as physiologists, for any doctrine of the brain in relation to mind.[l]
By 1881, the lines were clearly drawn between Ferrier's views supporting localization and those of Goltz, who advocated cortical equipotentiality. The result of the confrontation between them, at the Seventh International Medical Congress in London, was that Ferrier carried the day with his more precise methods and dramatic findings.[2] Ferrier's success in demonstrating the experimental reproduction of localized motor dysfunctions by cerebral lesions is epitomized by the remark Charcot is reported to have made on seeing one of Ferrier's monkeys limping about the room with unilateral paralysis of the arm and leg: 'It is a patient!'[3] Ferrier's work was equally significant in establishing centres for the sensory modalities on the basis of ablation experiments.[4]
The developments which culminated in Ferrier's work had led from Broca's clinico-pathological localization of the speech centre (1860) to Fritsch and Hitzig's demonstration of cerebral excitability and localized motor functions (1870), and the experimental localization of sensory functions by the mid 1880's. By the close of the century the main cortical centres for motor functions and the various sensory modalities in mammals were established to the general satisfaction of workers in the field. By 1901, the most complete compendium of knowledge in philosophy and psychology defined cerebral localization as 'the doctrine that various parts of the brain have relatively distinct functions'.[5] The theory that certain psychical and physiological functions are limited to definite areas of cortex is, 'in its broadest form . . . thoroughly substantiated by anatomical, pathological, and experimental data'.[6] In 1902, the Encyclopedia Britannica reflected the orthodoxy of the 'new phrenology' and recalled its beginnings: 'the principles of cerebral localization are, after all, only a scientific statement of matters that are of general belief. We are all more or less phrenologists'.[7]
Ferrier's Conception of the Functions of the Brain
Ferrier's conception of the function of the brain is a corollary of the theories of Bain, Spencer, and Jackson, for which he provided the experimental evidence.
1 Robertson, 1877, p. 92.
2 MacCormac, 1881, 1, 218-242d. Cf. the wholly accurate dramatization of this confrontation in Thorwald, 1960, Chapter 1.
3 Thorwald, 1960, pp. 37-9. Cf. Viets, 1938.
4 Ferrier, 1876, pp. 163-98; Ferrier, 1886, pp. 268-345; Ferrier, 1890, pp. 38-126.
5 Baldwin, 1901, II, 15.
6 Ibid. See above p. 11.
7 Anon, 1902, p. 710.
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It must follow from the experimental data that mental operations in the last analysis must be merely the subjective side of sensory and motor substrata. This view has been repeatedly and clearly enunciated by Hughlings-Jackson, with whose physiological and psychological deductions from clinical and pathological data I frequently find myself in completed accordance.[1]
In the second edition, he adds, 'For the cerebral hemispheres consist only of centres related respectively to the sensory and motor tracts, which connect them with the periphery and with each other'.[2] Ideas are revived associations of sensations and movements,[3] thought is internal speech,[4] and intellectual attention is ideal vision.[5] In short, all conceptions of function are reducible to sensation, motion, and association. Ferrier's work represents the final extension of the Bell-Magendie paradigm to the most rostral part of the neuraxis-the cerebral cortex-and its use as an all-embracing explanatory conception in both physiology and psychology:
In order to make these sweeping claims for his findings, Ferrier had to attribute psychological significance to the simple phenomena which he observed on stimulation and ablation. In his experiments on motor functions, this involved two stages: the muscular contractions elicited on stimulation were interpreted as coordinated, purposive actions; these, in turn, were interpreted as the overt manifestations of complex psychological functions.
Many of the movements such as those of the hands, the legs, the facial muscles and the mouth have the aspect of purpose or volition and are of the same nature as those which the animal makes in its ordinary intelligent action.[6]
Thus in monkeys capable of highly complex and differentiated movements of the hands and feet, we find in the brain a comparatively large region presiding over these movements. For it is found on irritation, that combined muscular actions, which, in their individuality and totality, are such as the animals make in carrying out their desires and purposes, are capable of being excited at will, by stimulation of various localised centres in this region.[7]
He reports the same findings in lower organisms, although their less-specialized movements have less differentiated centres.[8] He considers
1 Ferrier, 1876, pp. 256-7.
2 Ferrier, 1886, p. 426.
3 Ibid., pp. 437
4 Ibid., p. 462.
5 Ibid., pp. 463-4
6 Ferrier, 1874a, p. 95.
7 Ibid., pp. 117-18. Cf. Ferrier, 1874b, pp. 47-9, where Ferrier elaborates his conception of a voluntary motor centre (and provides a diagram which shows the corpus striatum as a centre for coordination of voluntary movements).
8 Ferrier, 1874a, pp. 117-18.
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these regions the 'centres for voluntary initiation of the same movements as result from faradization'.[1]
These centres, however, have another signification in so far as they form the motor substrata of mind. Besides being centres for the accomplishment of acts of volition, they form the organic centres for the memory of accomplished acts. The centres for articulation besides their function of setting in action the complex and delicate movements involved in articulate speech, have the power of permanently recording the results of their functional activity.[2]
By similar, though indirect, reasoning, he concludes that the sensory centres are the 'seat of the sensory memory or organic basis of ideation'.[3] The frontal regions gave no response to stimulation, but on ablation the animals behaved in a way which Ferrier felt resembled dementia.[4] He concluded that the frontal lobes were the probable 'substrata of those psychical processes which lie at the foundation of the higher intellectual operations'.[5]
It should be stressed that Ferrier's localizations were neither the fulfilment of Gall's hopes nor those of Flourens. His relations with Gall's views will be considered presently. Though he agrees with Flourens in a superficial way, his alternative scheme eliminated the hiatus which Flourens and his followers had been at pains to preserve.
Intelligence and will have no local habitation distinct from the sensory and motor substrata of the cortex generally. There are centres for special forms of sensation and ideation, and centres for special motor activities and acquisitions, in response to and in association with the activity of sensory centres; and these in their respective cohesions, actions, and interactions form the substrata of mental operations in all their aspects and all their range.[6]
The above was written in 1886. In his first report to the Royal Society (1874), Ferrier was cautious but hopeful about the possibility of drawing sweeping inferences from simple motions.
One would not be justified in fixing on the centres of the zygomatic muscles as the seat of a hypothetical faculty of mirth or such like. The complexity of even the simplest mental conception renders the localization of faculties in the phrenological sense a mere chimera. We must not however shut out the
1 Ferrier, 1874a, pp. 95-7.
2 Ferrier, 1874b, pp. 55-6.
3 Ibid., p. 57. Cf. Ferrier, 1874a, p. 97.
4 Ferrier, 1874a, pp. 101, 103, 123. Cf. Ferrier, 1878, p. 6.
5 Ferrier, 1886, p. 467.
6 Ibid.; cf. p. 436.
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possibility that the comparative development of special regions may be taken as an index of a capacity for certain acquirements-as an instance, it may be said that a considerable development of the region of Broca's convolution may be, ceteris paribus, taken as an index of a capacity for the acquisition of languages. Whether this is so or not is a subject which will require careful scientific investigation. The line of research is one which is likely to lead to valuable results, and may form the basis of a scientific phrenology.[1]
However, it is clear from his later writings (and the example given above) that he progressively drew on the theories of Bain, Spencer, and Jackson and interpreted alterations in simple sensory and motor phenomena as the basis for a comprehensive psychophysiology or, in the jargon of the times, a 'New Phrenology'.[2]
Some Practical and Conceptual Implications of Classical Localization
Whereas the only immediate practical fruit of Gall's work was the pseudo-science of phrenology (with its dubious character delineations), the concepts and findings of Broca, Fritsch and Hitzig, Ferrier, and Jackson led directly to the development of modern neurosurgery. The significance of their work has been dramatized by an historian of medicine, Jürgen Thorwald, and his description vividly conveys the issue through the eyes of those involved:
As we saw it, the problem of cerebral surgery was not so much the opening of the cranium and exposure of the brain; neither was it the removal of a tumour, but the localizing of the tumour before operation. The trouble spot was concealed beneath the cranium. None of the diagnostic methods of the time could establish its position so clearly that the skull could be directly entered at the right spot. Pain was distributed over whole sections of the brainpan and could not serve as an indicator of the site of a tumour. Here was the gulf that had to be bridged.
In the light of this problem it is clear why the experiments and arguments of Fritsch, Hitzig, and Ferrier meant so much. . . . If it were true that some small part of the brain were the fixed controlling organ of every muscle and every sense, and if it were also true that this functional centre
1 Ferrier, 1874a, pp. 133-4. Cf. the remarkably 'phrenological' conclusion of his monograph (1886, pp. 467-8).
2 This was the phrase used by Bastian and Wundt, among many others, and became the usual way of referring to the localizers in the period up until about 1910. The last of the ‘old’ phrenologists, of course, attempted to use Ferrier's own reasoning as a means of appropriating his findings to their theories. (See Williams, 1894, pp. 176-92, and the writings of Hollander. It has been noted-above p. 44 that A. R. Wallace accepted this interpretation. Wallace, 1901, Chapter 16.)
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occupied a particular and unvarying place in the brain, then it should be possible to deduce from the paralysis or other affliction of the body the site of the abnormality in the brain, the location of, say, a tumour. It should then be possible to attack the disease by surgery aimed at the precise spot where excision was required.[l]
Ferrier had pointed out in his first paper on cerebral localization that his findings could be instructive for diagnosis and exact localization of the seats of lesions.[2] As soon as he had reported his initial findings, he began investigating their clinical implications by interpreting some cases from the West Riding Lunatic Asylum.[3] Although he was considerably handicapped by the poor specification of the sites of lesions,[4] his paper provided the model which future clinical localizers would use. He also suggested the application of these principles to intracranial surgery.
It was this reasoning that led Professor William Macewen, at Glasgow, to undertake some of the earliest operations inside the cranium in modern times.[5] In 1879 he removed a swelling from one of the coverings of the brain which had been producing convulsions. He performed this and several other operations successfully, basing his localizations on Ferrier's reasoning. The first deliberate operation for cerebral tumour occurred in 1884, after Ferrier had forcefully reiterated his views in 1883.[6] The patient, a man named Henderson, had been progressively paralysed on the left side and suffered severe headaches. Using Ferrier's localization patterns, it was decided that the tumour was in the region of the hand and finger centres and not more than two inches in diameter. The operation was performed by Dr Rickman Godlee, a nephew of Lister, who was practised in the relatively new techniques of asepsis. Dr Hughes Bennett had conceived the operation and directed it, but he was not a surgeon. In fact, at that time there were no surgeons at the new National Hospital, Queen Square, where the operation was performed. Ferrier was present at the operation, in which the surgeon cut into the cerebral substance and removed the tumour. It had been feared that the patient would die when the knife entered the cerebral substance. He improved and could move his left leg, although his arm was worse. Unfortunately, although the operation was a success the patient died of surgical infection, which has been attributed to ineffective methods of treating his headaches before the operation. The
1 Thorwald, 1960, pp. 12-13.
2 Ferrier, 1873, pp. 30, 87-8, 95.
3 Ferrier, 1874b.
4 Ibid., pp. 30-1.
5 Jefferson, 1960, pp. 132-49.
6 Sherrington 1937, pp. 302-4.
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operation eliminated his headaches and demonstrated the practicability of neurosurgery based on local diagnosis.[1]
The modern science of localizing neurosurgery was thus a lineal descendant of Gall's principle of cerebral localization. From the enormous study of cerebral localization, physicians have derived a body of observations which allow them to diagnose and localize brain lesions with a degree of refinement that has not been equalled in the study of any other organ. It has become possible to predict with accuracy the local involvement of a few square millimeters of the most intricate cerebral or spinal tissue.[2]
Having indicated these dramatic practical fruits of cerebral localization, I am bound to mention that the history I have traced has been decidedly biased. In fact, the localization of lesions is the only major tenet of the concept of cerebral localization that has not been challenged on experimental, logical, or conceptual grounds by some of the most eminent investigators of the functions of the nervous system. It has recently been argued that 'Instead of speaking of cerebral localization, we should be satisfied with the less prejudiced, less involved, and more cautious concept of vulnerability of a given function or behaviour to regional lesions'.[3]
I have shown the demise of Flourens' objections. But, even in the classical period which I have reviewed, the work of F. L. Goltz stood as a constant challenge to the work of Fritsch and Hitzig, Munk, and Ferrier. Hughlings Jackson became progressively opposed to the rigidity of the prevailing view, and the flowering of his concepts in Sherrington's investigations lent plasticity, variability, and complexity to the relatively simple concepts that prevailed before. The same complexities arose in the clinical aphasia tradition. Henry Head calls the period from 1906 onward-following the preeminence of the diagram-makers and the iconoclastic work of Pierre Maric — simply 'chaos'.[4] The concept faculty of articulate language had fallen long before. In fact, the very article quoted above as the high water mark of acceptance of the theory of cerebral localization stresses its diagnostic and surgical applications and adds, 'but it has much less significance for the proper construction of mental processes than has sometimes been supposed'.[5]
1 See Ballance, 1921; Thorwald, 1960; Ferrier, 1878.
2 Riese and Hoff, 1950-51.
3 Riese, 1959, p. 148. Cf. Walshe, 1957.
4 Head, 1926, I, Chapter VI.
5 Baldwin, 1901, II, 16.
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Gall and Ferrier
In contrasting Ferrier's The Functions of the Brain with Gall's work of the same title, written fifty years earlier, one finds the balance between physiological and psychological statements reversed. Gall's work is almost wholly concerned with the description and analysis of the faculties (functions) and the attempt to arrive at methods and criteria for discovering the fundamental variables in experience and behaviour. Ferrier devotes only ten per cent. of his text to what he calls 'the subjective aspect [of] the functions of the brain'.[l] Most of his monograph is devoted to the 'physiological aspects', and he concluded that these consist of 'a system of sensory and motor centres. In their subjective aspect the functions of the brain are synonymous with mental operations, the consideration of which belongs to the science of psychology'.[2] All Ferrier felt that was needed to convert his physiological findings into psychologically significant statements was the assumption of psychophysical parallelism (which he adopted from Bain, Spencer, and Jackson) and the phrase 'subjective aspect'.
If Gall was naïve in believing that the organization and physiology of the brain correspond with his faculties in a simple one-to-one fashion, Ferrier was equally so in suggesting that the primary sensory and motor areas could explain psychological functions in a simple manner. He had localized sensory and motor areas, but he had not provided a psychophysiology which accounts for the adaptations of organisms to their environments. As Zangwill says, 'Whatever its role in the production of muscular activity, the motor cortex cannot be regarded as the seat of any function recognisable to the student of behaviour.’[3]
The experimental sensory-motor psychophysiology which had been founded on the concepts of Bain and Spencer was on a very firm physiological basis. It had been built up by a progressive extension of the Bell-Magendie law-a certain fact about the nervous system-and then united with the concept of cerebral localization. However, cerebral localization had become scientific only by abandoning the goal which Gall had laid down in the beginning of his work: to relate the significant variables in the character and behaviour of men and animals to the functioning of the brain. The sensory-motor school was undoubtedly correct in rejecting Gall's faculty psychology as an inadequate explanation of psychological phenomena. But, in grounding itself on a secure physiological basis, the sensory-motor tradition cut itself off from the
1 Ferrier, 1886, p. 424.
2 Ibid.
3 Zangwill, 1963, p. 337.
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approach to psychology which was the most important aspect of Gall's work and which had been extended in Spencer's conception of psychology as a biological science. In rejecting Gall's answers, it lost sight of the significance of his questions and of the possibilities inherent in the biological, adaptive view shared by Gall and Spencer. Insufficient attention was paid to what the sensory-motor elements should be required to explain. In default of significant questions, the only answers that were forthcoming were about sensory modalities and muscular movements. The sensory-motor analysis was therefore psychologically insignificant and led only to a partial understanding of the primary projection areas of the somatic cortex. The role of many of these for normal behaviour has yet to be determined. Questions about adaptive, biologically significant functions had to be asked anew by other branches of biology which developed independently from the ideas of Bain, Spencer, and Darwin. The problem that Ferrier's work left for the twentieth century was that of retaining scientific rigour, while regaining contact with biologically significant functions.
Gall and Ferrier can be seen as extremes on a continuum of possible approaches in brain and behaviour research. Gall stresses functions as adaptive and as related to character, personality, mastery of the environment, social intercourse, and intellectual, artistic, and mechanical achievement. He lets his adaptively conceived and naturalistically derived functions dictate to the brain. His conception of its functioning involves no direct physiological knowledge. Ferrier, on the other hand, sacrifices the significance of functions to physiological accuracy. His view reduces all the functions which Gall determined by observing behaviour, to the two categories of sensation and motion. His data are derived solely from direct experimentation on the brain and observation of the phenomena produced. Further progress in the field would have to mediate between these extremes. If the functions were to be conceived adaptively, the underlying physiology would have to be worked out. If the physiology was to be investigated as carefully as Ferrier did, it would have to be related to the independent findings of psychologists and ethologists. Future hope lay in bringing these extremes of function and physiology into closer communication. Gall sacrificed one for the sake of the other; Ferrier is the complementary case. Neither will do alone. Though Gall was unable to follow his own advice, the modern investigator is in a much better position to do so.
Whoever would not remain in complete ignorance of the resources which cause him to act; whoever would seize, at a single philosophical glance, the
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nature of man and animals, and their relations to external objects; whoever would establish, on the intellectual and moral functions, a solid doctrine of mental diseases, of the general and governing influence of the brain in the states of health and disease, should know, that it is indispensable, that the study of the organization of the brain should march side by side with that of its functions.[1]
1 Gall, 1835, II, 45-6.