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巴黎的春天:1865 年 4 月 4 日至 6 月 13 日,巴黎帝国医学院关于语言本地化的辩论。

A Parisian spring: the debate on language localization at the Imperial Academy of Medicine, Paris, April 4-June 13, 1865.

出版信息

Neurosurg Focus. 2019 Sep 1;47(3):E3. doi: 10.3171/2019.6.FOCUS19256.

Abstract

The localization of articulate language (speech) to the posterior third of the third left frontal convolution-Broca's area-did not occur to Broca as he reported the case of his first aphasic patient in 1861. Initially Broca localized articulate language to both frontal lobes, a position that he maintained for 4 years after publishing his first case. In the interval, the Academy of Medicine in Paris had received a copy of a paper authored in 1836 by Marc Dax, in which Dax claimed that the ability to speak resides within the left hemisphere alone. The Academy of Medicine convened in the spring of 1865 to adjudicate the issue. All of the distinguished speakers argued against Dax's contention by citing the prevailing paradigm, that bilaterally symmetrical organs, such as the eyes and ears, and the hemispheres of the brain, must perform the same function. The lone dissenting voice was that of Jules Baillarger, the discoverer of the laminar organization of the cerebral cortex, whose argument in favor of what he called "Dax's law" was so lucid that it carried the day. During his address to the Academy, Baillarger not only supported left-hemisphere dominance for speech, but for the first time described two forms of aphasia, fluent and nonfluent, now referred to as Wernicke's and Broca's aphasias, respectively, as well as the ability of aphasics to speak during emotional outbursts, to which we now refer as Baillarger-Jackson aphasia. It was 9 days after Baillarger's address that Broca, for the first time, unequivocally localized speech to the left frontal lobe.This paper is based on the author's reading of Dax's and Broca's original texts and of the texts read before the Academy of Medicine meeting held at the National Library of France between April 4, 1865, and June 13, 1865. From these primary sources it is concluded that the Academy of Medicine's debate was the last serious challenge to left-hemisphere dominance for speech and to the localization of articulate language to the left frontal lobe-and that Jules Baillarger played a pivotal role in what was a defining moment in neurobiology.

摘要

言语的定位(言语)到第三个左额前回的后三分之一 - 布罗卡区 - 布罗卡并没有想到,因为他在 1861 年报告了他的第一个失语症患者的病例。最初,布罗卡将言语定位到两个额叶,这个位置在他发表第一个病例后持续了 4 年。在此期间,巴黎医学院收到了 1836 年马克·达克斯(Marc Dax)撰写的一篇论文的副本,其中达克斯声称说话的能力仅存在于左半球。医学院于 1865 年春季召开会议裁决这个问题。所有杰出的发言人都引用了当时的主流观点,即眼睛和耳朵等双侧对称器官和大脑半球,必须执行相同的功能,以此来反驳达克斯的观点。唯一持不同意见的是朱尔斯·贝利尔(Jules Baillarger),他是大脑皮层层状组织的发现者,他的论点支持他所谓的“达克斯定律”,非常清晰,因此获得了胜利。在向学院发表演讲时,贝利尔不仅支持言语的左半球优势,而且第一次描述了两种失语症,即流利性和非流利性,现在分别称为 Wernicke 失语症和 Broca 失语症,以及失语症患者在情绪爆发时说话的能力,现在我们称之为贝利尔-杰克逊失语症。在贝利尔演讲后的第 9 天,布罗卡第一次明确地将言语定位到左额叶。本文基于作者对达克斯和布罗卡原著的阅读,以及在法国国家图书馆举行的 1865 年 4 月 4 日至 6 月 13 日期间举行的医学院会议上阅读的文本。从这些主要来源可以得出结论,医学院的辩论是对言语的左半球优势和言语的定位到左额叶的最后一次严肃挑战,而朱尔斯·贝利尔(Jules Baillarger)在神经生物学的决定性时刻发挥了关键作用。

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