|Year : 2013 | Volume
| Issue : 1 | Page : 89-91
Pierre Paul Broca: Tribute
Department of Neurosurgery, Former Vice Chancellor, University of Kerala, India
|Date of Web Publication||21-Jun-2013|
Consultant Neurosurgeon, Department of Neurosurgery, Former Vice Chancellor, University of Kerala
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ekbal B. Pierre Paul Broca: Tribute. Arch Med Health Sci 2013;1:89-91
Paul Broca (1824-1880) was a surgeon, a neurologist and an anthropologist, a major figure in the development of medicine and anthropology in the mid-nineteenth century. He was born at Saint-Foy-la-Grande, France into a Huguenot family. After the usual schooling, he took the bachelor's degree at the age of 16, with high honors, in the Faculties of Literature and Science at the college of Sainte-Foy. He had intended to make a career in the military, based upon his talents in the physical sciences, but the death of his sister altered his destiny. With the support of his father, a successful country practitioner who had served in the army in Spain under the first Napoleon, Broca entered the Faculty of Medicine in Paris in 1842.
Continuing his academic advancement in Paris, Broca was appointed anatomy assistant in 1846 and prosector in 1848. The following year he received the MD degree, upon submission of a thesis on the spread of inflammation in relation to the dissemination of tumors. He won the title "Surgeon of the Hospitals," conducted independent researches, and contributed to the scientific literature, a practice he continued without interruption until he died. Subjects discussed included clinical features of bone, cartilage, tumors, and aneurysms. The bulk of his scientific writing, however, concerned a variety of subjects which had some relevance to anthropology.
Broca's breadth of knowledge, his encompassing skills, great erudition and humanism won respect from his pupils in medicine, contemporaries in clinical surgery, and associates in anthropological investigations. During the war of 1870-1871, a major portion of his time was given to the surgical care of the wounded. Broca was appointed assistant professor of surgery in 1853, and, in 1867, the Faculty of Medicine appointed him to the professorship of external pathology. This post was exchanged promptly for the chair of clinical surgery, which provided opportunities to exploit anthropology wherever his inquiring mind led him.
He loved serenity and tolerance. In 1848, he founded the society of "Free Thinkers." Almost alone among the French savants of the time, he was sympathetic to Charles Darwin's idea of evolution by natural selection. T. H. Huxley quoted Broca as saying "I would rather be a transformed ape than a degenerate son of Adam." For these and other views, he was publicly denounced for "materialism" and like Socrates, for corrupting the young.
Earlier, Broca has encountered great difficulty in establishing a society of anthropology in France. The Minister of Public Instruction and the Perfect of Police believed that anthropology must, as the free pursuit of knowledge about human beings, be innately subversive to the state. When permission was at last and reluctantly granted for Broca to talk about science with eighteen colleagues, the Perfect of Police held Broca responsible personally for all that might be said in such meetings "against society, religion, or the government." Even so, the study of human beings was considered so dangerous that a policy spy in plain clothes was assigned to attend all meetings with the understanding that authorization to meet would be withdrawn immediately if the spy was offended by anything that was said. In these circumstances, the Society of Anthropology of Paris gathered for the first time on May 19, 1859, the year of the publication of The Origin of Species. In subsequent meetings of the society, an enormous range of subjects were discussed archeology, mythology, physiology, anatomy, medicine, psychology, linguistics, and history. The first volume of the Bulletins de la Societe d' Anthropologie was published later in the same year. Not only the police but also the clergy opposed the development of anthropology in France, and, in 1876, the Roman Catholic political party organized a major campaign against the teaching of the subject in the Anthropological Institute of Paris founded by Broca.
Broca was a superb brain anatomist and made important investigations of the limbic region, which we now know to be profoundly involved in human emotion. However, Broca is today perhaps best known for his discovery of a small region in the third convolution of the left frontal lobe of the cerebral cortex, a region now known as Broca's Area. Articulate speech, it turns out, as Broca inferred on only fragmentary evidence, is to an important extent localized in and controlled by Broca's Area. It was one of the first discoveries of a separation of function between the left and right hemisphere of the brain. But most important, it was one of the first indications that specific brain functions exist in particular locales of the brain, that there is a connection between the anatomy of the brain and what the functions of brain. Broca reported to the Anatomical Society of Paris in 1861 the brain of his famous case Tan Tan, who had suffered from aphasia and autopsy showed a lesion on the inferior frontal convolution on the left side. He later published his findings in the papers 'On Loss of Speech' and 'On the Seat of the Faculty of Articulate Language.'
Broca was not the first to advance the hypothesis of cerebral localization. Perhaps the greatest contribution prior to Broca's observation was published in 1825 by Brocas' teacher Bouillaud, later professor of clinical medicine at the Charite' and Dean of Faculty of Medicine. Bouillaud assumed from his clinical-pathological studies that derangement or loss speech associated with a lesion of the frontal lobe and was dependent upon the ability to control the movements which form words in speech as well as to retain them in memory. Such a deficiency need not be accompanied by a dysfunction or disturbance of other cerebral functions. Bouillaud's contention was not generally accepted; in fact, it was either forgotten by many or was strongly opposed by a few.
The strength of Broca's argument on an area specific to speech rested with the patient Laborgne, who had lost his ability to speak, and his only utterance was the monosyllable "tan" which came to be his nickname. Ten years following the onset of aphasia, slow paralysis of the right arm and the right leg developed. "Tan" died on April 17, 1861. The brain was hardened intact, without sectioning. The gross pathological findings were reported briefly by Broca in April 1861 before the Anatomical Society of Paris. In reconstructing the structural changes, Broca assumed that degeneration of the cortex began in the left third frontal convolution which accounted for the loss of speech. As the lytic process extended to the left striate body, hemiplegia appeared. Broca referred to the neurological speech deficiency as "aphemia," a term criticized by Trousseau, who preferred the term "aphasia." Broca's concept of cerebral localization was opposed by some, especially by Hughlings Jackson in 1868, and in the early 1900's, by Pierre Marrie, who examined Tan's brain and red scribed the cerebral lesion. He emphasized the extensive damage in the temporal and parietal areas and contended that aphasia involved a loss of intellectual capacity necessary for the formulation of language and could not be localized as precisely to any particular area. Later, writers argued that Tan probably suffered not from Broca's Aphasia but also from Wernicke's Aphasia since his superior temporal gyros also showed pathological changes.
Although the hypothesis of cerebral localization may have been Broca's best known contribution to natural science, his best hours were spent in the anthropology laboratory or at the meetings of the Anthropolical Society. Broca conducted his dissections and measurements, especially of the cranium and brain, with the aid of instruments and essential laboratory tools, of which many were designed and manufactured under his direction. The Memoirs of the Society were published first in 1860, and in 1899, were combined with the Bulletin. The Revue d'Anthropologie, a third publication of the Society, was founded by Broca in 1872, and appeared regularly until he died. In 1876, long after the idea was proposed by Broca, the Anthropological Institute was recognized by the Minister of Public Instruction as a cultural agency.
Although Broca's assignments and responsibilities in the Society and later in the Institute seem to have demanded full-time efforts and activities, he continued his surgical works in the hospital. An original independent thinker and humanist, he believed in educating all women as the only effective means of educating the nation. He was also concerned with the medical care for the poor being a brilliant and compassionate man. He also made extensive studies on the causes of infant mortality in France. Two of the greatest honors bestowed on Broca were his election in 1866 to the French Academy of Medicine and in the year of his death to a lifetime membership in the Senate of the French Republic representing science. 
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