Cerebral anesthesia for localization of speech: the contribution of W. James Gardner.

In 1949, the neurologist Juhn Wada reported the first use of a new procedure for determining the localization of speech and language in neurological patients: examination of the effects on speech and language after injecting a barbiturate, sodium amytal, into the internal carotid artery of each hemisphere in succession. By the 1960's, Wada's Intracarotid Amobarbital Procedure, or IAP, had become the method of choice for identifying the speech-dominant side in one kind of neurological patient, persons with epilepsy who are candidates for surgical resection, and it remains so today. In 1941, however, an American neurosurgeon, W. James Gardner, reported his use of a different anesthetization procedure for speech localization in neurological patients. Instead of injecting sodium amytal through the blood supply, as in IAP, Gardner injected procaine hydrochloride directly into cortical tissue. In this paper, we provide a brief biography of Gardner. We then discuss his method of cortical anesthetization, the theoretical and empirical background guiding his use of this method and his choice of patients, and, finally, the fate of Gardner's method within the scientific community.