Aphasia and Lordat and Broca and Neuroscience and lost words

In the summer of 1825 a professor of anatomy and physiology at Montpellier in France, Jacques Lordat, experienced a long illness. As Stephen Jacyna tells the story in his fascinating book Lost Words: Narratives of Language and the Brain, 1825-1926, Lordat observed a certain "heaviness" in his head and "became conscious that when I wished to speak I did not find the expressions I required." When he was visited by someone after his recovery, he found that he couldn't respond to the visitor's inquiry after his health. He said to himself, "So it is true that I can no longer speak." His voice returned at a later time, and he often spoke of this experience, using the word alalia (Greek for "without speech") to describe his former condition. The OED refers to the first mention of alalia in 1840.

By 1870 the condition of being unable to speak was known as aphasia (also from the Greek meaning "speechless"). Rather than being a problem of rather uncertain derivation, aphasia by 1870 had been identified as a problem that had a neurological basis. By that time Paul Broca related the loss of articulate language to a "lesion located in a defined area of the cerebral cortex, in the posterior part of the third frontal convolution." The mere mention of Broca's "discovery" of the "location" of the power of speech is, for Jacyna, a window into a complex history of narrative, neuroscience and psychology.

Narrative

One of the marks that you are swimming in postmodern seas is the profusion of terms relating to "discourse," or "narrativity" or "discourse strategies" in the "literature" under investigation. Often I have fled from such studies, believing (probably rightly) that the study is 90% or more jargon and 10% substance. But here Jacyna, who is dependent on the progenitors of postmodern literary theory, especially Nietzsche and Foucault, skillfully uses their theory to illumine the linguistic world of medical reports and "speech" about "speechlessness" in the 19th century. That is, medical specialists were confronted with the reality, which had no doubt existed for centuries, of speechlessness, and one of their strategies for dealing with this issue was through writing reports. Written reports require rhetorical strategy, such as which words to use, which observations to accentuate, which ways to describe the medical procedures used to diagnose and treat the issue. Thus, the first meaning of narrative refers to the stories told by third party observers of the aphasiac. This is a central concern of Jacyna.

In addition, narrative refers to the stories told by the sufferers of this condition. Yet, these narratives were not brought out until the 1990s, perhaps an indication that even our academic culture, for all its commitment since the 1960s to letting the "little person" tell his or her story, didn't really hear the inarticulate or voiceless cries of aphasiacs until just a few years ago. Yet, when those narratives are limned by Jacyna, he finds people who were terrified, embarrassed, frightened, infantilized and dehumanized by this loss of speech. Thus, one sees the need not simply to study the narratives of physicians and medical professionals as well as those of sufferers, but to compare and contrast these narratives.

Neuroscience

The story of aphasia is, moreover, a story of the development of science in the 19th century. If it is true, as I would contend, that there really is not any present but only a series of past moments, then the history of these moments is what constitutes knowledge today. Therefore, there is no such thing as science or medicine, but there is the history of each or, at least, a historiography of each. As Jacyna explains it, "The aphasiological text therefore also possesses an anthropological import: it constitutes a moment in the emergence of a natural science of man (p. 9)." The "natural science of man," then does not inhere in the structure of the universe; it is posited in time. What is posited in time can also be changed, denied, developed in time.

Aphasiological studies beginning in the mid 19th century show that the most basic "of man's representational powers--the ability to form concepts and to employ words--is rooted in his material nature (p. 11)." The implications of this last sentence are vast. All dichotomies between the cultural and biological are then suspect. The entire structure of German university education in the 19th century divided the "natural sciences" (Naturalwissenschaften) from the "sciences of man" (Geisteswissenschaften). Now that it could be shown that the most fundamental aspect of human cultural genius, speech, had a biological or "natural sciences" rootage, our most basic category of knowledge differentiation is suspect.

Psychology

By psychology I refer not only to the interior feelings of aphasiacs, whose narratives only became available in the late 20th century, but to the way that the power of narrative, possessed by the medical establishment, takes away the individual humanity of those suffering from language loss and makes them into an "aphasiac." Perhaps medical science claims that the reason for its progress is precisely the ability to generalize, to talk about "patient A" or "patient B," with few defining characteristics of the individual under consideration. But I wonder if the future of the history of medicine, itself a young discipline, will be to discover the individuality of the patient and, in so discovering that individuality, revolutionize the study of medicine. Since I don't really know what the statement I have just written actually means, I will stop here, with gratitude to Jacyna for a most illuminating book.