[Aphasia: debates].

Abstract

Quarrels over aphasia are no recent phenomena and have not always been explicit. Lordat and Gall can be cited in this respect as well as Dax and Bouillaud. Reference is also made to Broca-Dax and Trousseau-Lordat. The creation of the Chair in honour of Charcot, which contributed so greatly (thanks to Charcot himself, the others Masters and their students) to the birth of neurology, then to that of the neurological sciences and eventually to that of the neurocognitive sciences. Next, the most explicit of quarrels on aphasia is dealt with, namely that in which, during three meetings of the French Society of Neurology in 1908, Joseph Jules Dejerine and Pierre Marie crossed swords. Their duel in the Bois de Boulogne in 1893 having fortunately been cancelled, it was in 1908 merely a battle of words. Fulgence Raymond was soon to retire. Dejerine and Pierre Marie each put forward their proposal to the Society for a discussion program and Dejerine's was accepted following a vote. The meeting on 11th June, in accordance with the program proposed by Dejerine, was largely restricted to clinical facts. Fulgence Raymond was not present. Dejerine always spoke first, but some of the replies from Pierre Marie received a degree of approval from the audience. It was during this meeting that Achille Souques, the future founder of the history of neurology, cleverly defended the ideas of Pierre Marie. A little later, Dejerine went on the defensive and agreed to a change in the program along the lines suggested by Pierre Marie: he then presented his ideas on the manifest clinical difference between Broca's aphasia and that of Wernicke. After Souques, Edouard Brissaud also came to the rescue of Pierre Marie by mentioning the Leborgne case published by Broca in the spring 1861. Matters were unresolved and André-Thomas, the future founder of neuropaediatrics, produced a highly intelligent deference of his Master Dejerine. Gilbert Ballet and Ernest Dupré also came down largely on his side. The meeting of 9th July (27th anniversary of the Charcot Chair) was dedicated to cerebral anatomy and the "quadrilateral". The subject of Dejerine's questionnaire was again raised. Accompanied by Georges Guillain, Fulgence Raymond was present on this occasion (but refrained from speaking). This time the star was Augusta Dejerine Klumpke, born on a Spanish sand dune now known as San Francisco, U.S.A. Mrs Dejerine contested the "lenticular zone" and gave it a quite different dimension by proving that its anterodorsal part included associative axons originating in or projecting to Broca's area, the remainder of the "Pierre Marie quadrilateral" being called into question. Brissaud was impressed by the performance of Madame Dejerine, and Pierre Marie found himself in an awkward position. His student François Moutier, present at his request, discussed his own clinical cases and then, on the subject of "Lelong's" brain' (autumn 1861), let it be known that Broca had scratched it with his finger nails while removing the meninges. André-Thomas and Georges Guillain took part in the discussion. At the last meeting, on 23rd July, Brissaud was absent. Fulgence Raymond was again present but remained silent. The only subject on the agenda was "physiological pathology", but several points that had not been resolved on the 9th July were brought up again. On this occasion, Pierre Marie opened the debate and adopted a very cautious approach. However, his patience eventually ran out and he replied sharply to the comments of Dejerine on "images of language" and those of Dupré on "mental representations". Metaphorically speaking, it might be said that the gold medal was not awarded, Augusta Dejerine Klumpke took the silver, Dupré and André-Thomas shared the bronze, and Souques and Moutier each deserved a special mention. It might also be suggested that in 1908 the Society sketched out to a large extent the programme for research on aphasia for the century to come. (ABSTRACT TRUNCATE