On April, 18th, 1861, during a seating of the Société d’Anthropologie de Paris, Pierre Paul Broca (1824–1880) presented the case of his most famous patient Mr Tan.
M. Broca, à l’occasion du procès-verbal, présente le cerveau d’un homme de cinquante et un ans qui est mort dans son service a l’hôpital de Bicêtre, et qui avait perdu depuis vingt et un ans l’usage de la parole. La piece devant être déposée dans le musée Dupuytren, et l’observation complète devant être publiée dans le Bulletin de la Société anatomique, nous nous bornerons à donner ici un court résumé de ce fait, qui est tout à fait semblable à quelques-uns de ceux dont M. Auburtin a parlé dans la dernière séance.
Lorsque le malade fut admis à Bicêtre, il y a vingt et un ans, il avait perdu, depuis peu de temps, l’usage de la parole; il ne pouvait plus prononcer qu’une seule syllabe, qu’il répétait ordinairement deux fois de suite; quelle que fût la question qu’on lui adressât, il répondait toujours tan, tan, en y joignant des gestes expressifs très-variés. C’est pourquoi, dans tout l’hospice, il n’était connu que sous le nom de Tan.Broca, 1861, p. 235-236.
You can read the announcement (Broca, 1861) and the more extensive paper (Broca, 1861, start reading from section II, p. 343) online at Classics in the History of Psychology. Broca wasn’t the first to suggest a relation between a brain lesion and language; for a very detailed account, see Lorch, 2011. Ernest Aubertin (1825 – 1893) for example, who was mentioned in the first paragraph by Broca, has described a similar case -in the presence of Broca who was the secretary of the meeting- just the week before (April 4th). By some extraordinary lucky coincidence, Mr Tan was transferred to Broca’s ward on April, 12th, where he was examined by Broca and died soon after (April 17th). From the superficial autopsy, Broca made his famous conclusion “la lésion du lobe frontal a été la cause de la perte de la parole”, the same conclusion as the one of Aubertin the week before. You can read Aubertin’s report online at Google Books.
Figure 1: Brain of Mr. Leborgne alias Tan. From Dronkers et al., 2007, p. 1436.
Original at Musée Dupuytren, Paris
According to Broca, the lesion was at the third frontal convolution (and perhaps at the second). For unknown reasons, Broca however didn’t want to dissect the brain. His description of the lesion was thus based on superficial observation (see figure 1). The extent of the underlying damage was not visible to Broca, although he was aware of it. Dronkers et al. (2007) used high resolution magnetic resonance imaging to locate the region and found several inconsistencies between the area originally identified by Broca and what is now called Broca’s area (Brodmann areas 44 and 45). You can compare both regions from figure 2.
Figure 2: Broca area then and now.
Left panel: from Aubertin, p. 27. (colorization by me)
Right panel: area 44 en 45 from Brodmann.
Broca also didn’t reveal much details about his patient’s personal history or social background. In the second publication (Broca, 1861b) he mentioned the name of the patient (Mr. Leborgne) and his previous occupation (formier; a craftsman who produced forms for shoemakers).Thanks to the investigative work of Domansky (2013), we now know that Louis Victor Leborgne was born on July 21, 1809, in Moret (currently known as Moret-sur-Loing). Leborgne worked until the age of 30 when the loss of speech occurred. Two or three months later, he was admitted to the Bicêtre hospital, where he died 21 years later.
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