Hull, England, United Kingdom
|Fig 1. Franz Joseph Gall. By Zéphirin Félix Jean Marius Belliard. Via Wikimedia.|
For many reasons the work of Gall, when stripped of its excrescences, constituted an important landmark in the history of neurology.
In the times of Galen, the location of the mind and spirit was imprecisely thought to reside in the brain’s ventricles and pineal. In the second century AD, Aretaeus of Cappadocia distinguished between the paralyses of motion and sensation, and explained how apoplexy and injuries to the brain produce paralysis on the opposite side, but cord lesions caused ipsilateral paralysis.1 This was a clear beginning of localization of brain dysfunction in disease, which continued through the Middle Ages. The Czech neurophysiologist Georg Prochaska (1749-1820) had realized: “the different parts of the mind seem to require different parts of the cerebrum and cerebellum for their functions . . . Each part of the intellect has its organ in the brain: perception, judgment, imagination and memory.”
Franz Joseph Gall (1758-1828)(Fig 1) and Johann Caspar Spurzheim (1776-1832)(Fig 2) advanced this idea.
Gall was born in Tiefenbronn in Germany’s Northern Black Forest; he studied medicine at Strasbourg and Vienna, where he received his degree in 1785. Impressed as a child by apparent correlations between unusual talents in his friends and variations in their facial or cranial appearance, he set out to evolve a new method by which he claimed that external craniological signs could localize mental faculties. He said:
I recall my early observations and immediately suspected, what I was not long in reducing to certainty, that the difference in the form of heads is occasioned by a difference in the form of the brain.
|Fig 2. Johann Gaspar Spurzheim. Source.|
Gall with Spurzheim suggested that each mental faculty had its location in an organ found in a definite region of the surface of the brain, the size or development of which matched the development of the particular faculty. The study of the external skull (craniology) was as an index to their position and degree of development.
He examined the cranio-facial morphology of persons of every class and character: idiots, the insane, criminals, peasants, intellectuals, and artists, and in this pursuit visited many lunatic asylums and prisons. An excellent anatomist, using his own pioneering techniques he studied at necropsy the brains and skulls of people whose characters and habits he had previously observed. From this he proposed that every human trait had its location within the brain, evident in the bumps and shapes of the head that would therefore show the character and personality of the subject.2
Gall was a popular lecturer and Spurzheim an accomplished demonstrator of dissections. Gall identified twenty-seven such organs (Spurzheim thirty-five), but their mistake was in relating them to the bumps or contours of the skull, the basic thesis of phrenology—a term introduced not by Gall but by Spurzheim. A British Medical Journal anonymous leader in October 1965 cogently noted: “That a valid biological theory can be based at first on erroneous data is one of the paradoxes of scientific discovery.”
Johann Gaspar Spurzheim (1776 –1832)3 was a German physician whom Gall had taken on as assistant to perform dissections in 1800, but they later parted. Spurzheim lectured in Paris, London, and Boston. Spurzheim published The Anatomy of the Brain (translated into English 1826) and was elected LRCP London and MD Paris. Though attracting large audiences for years, with Gall he was debunked in 1815 for “thorough quackery,” amongst others by Dr. John Gordon in the Edinburgh Review.
|Fig 3. “Cutting off the entities…” Franz Joseph Gall and Johann Caspar Spurzheim examining a patient. Watercolor painting. Wellcome Collection. Public Domain Mark.|
Craniology (phrenology) attracted many supporters throughout Europe. In its heyday no fewer than twenty-nine societies propounded the cult of phrenology.4 But it also incurred the wrath of the savants as a threat to religious beliefs. Gall was charged with charlatanism and unfairly became an object of disdain (Figs 3 & 4). In 1805, he was forced to leave Vienna. After two years of travel, he arrived in Paris accompanied by his co-worker, Spurzheim. In 1810, they published the first volume of the Anatomie et physiologie du système nerveux, their most important contribution to neuroanatomy and the first major statement of phrenology.5
It provoked such opposition that the Paris Academy of Sciences, acting on order of the Emperor Bonaparte, asked Marie-Jean-Pierre Flourens (1794–1867) to investigate the matter. Flourens’ experiments were crude and mostly in birds6 but he dismissed Gall’s work, concluding: “The cerebral cortex functions as an indivisible whole . . . an ‘essentially single faculty’ of perception, judgment and will . . . the last refuge of the soul”: the concept of “cerebral equipotentiality.”
However, many of Gall’s general ideas of functional localization of intelligence, sensation, and motor function eventually proved correct,4,7 even if his bumps were without significance.
Henry Rollin, an accomplished psychiatrist and elegant writer, said that Gall’s career had an almost uncanny resemblance to that of the Viennese Franz Anton Mesmer (1734- 1815), founder of hypnosis, who enriched our language with the words “mesmeric,” “mesmerize,” and “mesmerism.” Both had a profound effect on psychological and psychiatric thought in the nineteenth century. Like Mesmer, Gall was scorned by the Academies des Sciences. Phrenology suffered the same fate as Mesmerism.7 Its replacements in fashionable medicine were at first the equally unscientific practices of magnetism and hypnotism.
|Fig 4. Phrenological cartoon 1873. © The Trustees of the British Museum. Source.|
Even Gall’s most persistent opponent, Flourens, admitted that it was Gall who correlated variation in function with localized anatomical areas of the brain and thus confirmed the view that brain was the organ of the mind.
It would be a mistake to underestimate Gall’s importance in the history of functional localization.4 His phrenology was flawed but his attempt to correlate observable signs with localized function was sound in principle. With Spurzheim he did provide an impetus for the subsequent development of the crucial concept of cerebral localization. They afforded an important stimulus to the intimate recording and correlation of anatomical-clinical data.
Localization after Gall
The idea of relating structure to function was developed, amongst others, by Richard Bright in 1831;8 he plainly recorded that affection of speech related to the posterior portion of the left hemisphere. In France in the early nineteenth century, Jean-Baptiste Bouillaud (1796–1881) and his son-in-law Auburtin located language in the frontal lobes. They acknowledged the import of Gall’s work. Greater precision and refined details stemmed from Robert Bentley Todd (1809–1860) in his Diseases of the Brain and Other Affections of the Nervous System (1854), and from Hughlings Jackson’s painstaking clinical observation and his exact chronicling of clinical data.9 Advances were made in Paul Broca’s controversial paper on motor aphasia in Bullétin de Société d’Anthropologie de Paris in 1861,10,11 and the oft-quoted experimental works of Fritsch and Hitzig. Sir David Ferrier, influenced by Bain and Spencer, tested and verified Hughlings Jackson’s many prescient ideas of cerebral localization.12 By producing focal movements and focal epileptic attacks by passing Faradic current across the cortex, Ferrier proved localization of cerebral functions. From what had been an area of clinicopathological ignorance, he was the first to map varied functions of the cerebral cortex. He dedicated his book The Functions of the Brain (1876) to Hughlings Jackson.
- Pearce JMS. The Neurology of Aretaeus: Radix Pedis Neurologia. Eur Neurol 2013.
- Gall F. J. (1807). Craniologie ou dicouvertes nouvelles cancernant le cerveau le crane et les organes. Paris; Necelle and (1813). Dictionnaire des Sciences Medicales, Paris, Vol. 4, p. 447.
- Sanders FH, Fisahn, C, Iwanaga, J. et al. Johann Gaspar Spurzheim (1775–1832) and his contributions to our understanding of neuroanatomy. Childs Nerv Syst 33, 877–879 (2017).
- Critchley M. Neurology’s Debt to F. J. Gall (1758-1828). British Medical Journal 1965;2:775-81.
- Gall FJ, Spurzheim JG. Anatomie et physiologie du systéme nerveux en général et du cerveau en particulier. Atlas. Paris: F. Schoell; 1810.
- Pearce JMS. Marie-Jean-Pierre Flourens (1794–1867) and Cortical Localization. Eur Neurol 2008;728:
- Rollin H. Magic and mountebanks in the development of psychiatric thought. J. Royal Society of Medicine 1992;85: 381-385.
- Pearce JMS. Richard Bright and His Neurological Studies. Eur Neurol 2009;61:250-254.
- Phillips CG. Cortical Localization and ‘Sensorimotor Processes’ at the ‘Middle Level’ in Primates. Proc Roy Soc Med 1973;66:987-1002.
- Jackson JH. Observations on the localization of movements. In: Jackson JH. In: Taylor J, ed. Selected writings of JH Jackson, 2 volumes. 1931. Reprinted: London: Staples Press 1873/1958. pp. 77–89.
- Pearce JMS. Convolutions and asymmetries of the brain. J Neurol Neurosurg Psychiatry. 1999;66(1):56-75.
- Pearce JMS. Sir David Ferrier MD, FRS. J Neurol Neurosurg Psychiatry. 2003;74(6):787.
JMS PEARCE, MD, FRCP, is emeritus consultant neurologist in the Department of Neurology at the Hull Royal Infirmary, England.