THE HISTORICAL DEVELOPMENT OF THE STUDY OF

BROCA'S APHASIA
Yoke Lian Lau1,2

, Chek Kim Loi3

, Mohd Nor Azan bin Abdullah2

Correspondence: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS>

1Department of Applied Linguistics, Tsinghua University, 100084, Beijing, China

2Centre for the Promotion of Knowledge and Language Learning, 88400, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
3Centre for the Promotion of Knowledge and Language Learning, 87000 Labuan, Wilayah Persekutuan Labuan, Universiti Malaysia

Sabah, Malaysia

Article History:
Received: December 23 , 2020
Accepted: May 28, 2021
Published: July 1, 2021

ABSTRACT

Broca's aphasia is a type of aphasia named after the French surgeon Broca. Broca's aphasic patients
experienced difficulty in speaking, but they could understand both spoken and written language. There
were three essential patients in the historical development of the study of Broca's aphasia. Louis
Victor Leborgne (1809–1861) was also known as Monsieur Leborgne or 'Tan' as he could only utter
the syllable 'Tan' throughout his 21 years of illness. The second patient was called Lazare Lelong. His
language ability was slightly better than Leborgne. He could utter simple syllables, such as oui (yes),
non (no), and this (trois or three). The third patient was Gage, a railway company worker. Broca
studied similar cases in the following years and planned a brain function localization theory.
Keywords: Broca's aphasia, historical, Lelong, Leborgne, Phineas Gage

Cite this as:
Lau YK, Loi CK, Abdullah MNA.
The historical development of the
study of broca's aphasia. Malang
Neurology Journal; 2021.7: 125-
12.
http://dx.doi.org/10.21776/ub.mnj
.2021.007.02.8

Introduction
Broca's aphasia is a type of aphasia named after the French
surgeon Paul Broca. The primary manifestation is difficulty
in speaking, but the ability to understand spoken and
written language is relatively standard, also called
'expressive aphasia'.

1 Broca's area is at the motor cortex's
mouth in the frontal area of the brain. The lips and vocal
cords represent the front part of the site. When the central
part of the posterior part of the superior hemisphere of
motor language is damaged, this will also affect speech
pronunciation. Therefore, the neural pathways controlled by
language movement cannot operate normally, so Broca's
aphasia is also called 'motor aphasia/anandia'.
2,3,4,5,6,7
Some patients with Broca's aphasia have no sentence
rehearsal disorder. In other words, their retelling ability is
intact. Their oral comprehension is good, but there could be
severe dyspraxia, anomia, and writing defects 8,9,10,11,12
.
There is right hemiplegia in most patients, as the lesion is
mainly in the anterior or upper part of the dominant
hemisphere – mainly in the middle or anterior portion of the
inferior frontal region – it is also known as cortical motor
aphasia.
9,11,12
There are various titles for Broca's aphasia, such as
expressive aphasia, motor aphasia, cortical motor aphasia,
and 'coding' aphasia. Although the names are different, they
all emphasize the motor and expression disorder of Broca's
aphasia. When patients speak, it is often difficult for them
to find words, causing long pauses and communication to
slow down. Since the sentences produced contain simple
nouns, verbs, and adjectives, there is a lack of grammar and

appropriate ending changes. This type of language is also
known as telegraph language or agrammatism. The patient's
words will also lack normal language rhythm and tone,
which is extremely unnatural. In severe cases, patients can
only repeat one or two words when describing something
due to difficulty articulating. It is difficult for them to
communicate with others in a normal language.2.3.4.8,9,10,11,12
From Gall to Broca
The German anatomist and psychologist Franz Joseph Gall
(1758–1828) was the first to link brain function to specific
brain locations. He marked individual attributes based on
each skull's structure, such as advocacy, brutality, loyalty,
and so on. He believed that the head's design changed with
the development of human beings.

8,13,14 For Gall, the place
where the skull rises represented excellent human qualities,
whereas the place where there is a depression in the head
represented certain human defects. The study of skulls
became the standard for assessing a person's virtues,
leading to cortical positioning, which is notorious in the
medical profession.

8 As the first person specializing in the
brain positioning theory, Gall left some valuable ideas. For
example, he distinguished six different memories: verbal,
grammatical, the relation of numbers, locality, colors, and
tonal harmony. This later laid the foundation for
Bouillaud's theory of language lateralization.
2,14

French doctor Jean-Baptiste Bouillaud (1796–1875)
proposed in 1825 the idea that language function is in the
brain's front.

8,15,16 He believed that all the roots of language

pathology come from the frontal lobe of the brain. His son-
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MNJ (Malang Neurology Journal) Vol. 7, No. 2, July 2021

in-law and student Ernest Auburtin (1825–1893) also
strongly supported his theory. He claimed that although the
frontal lobe is damaged, and the lesion is beyond the frontal
lobe, it is impossible to directly prove that the frontal lobe
is damaged and language ability is lost. Broca himself was
also a supporter of the brain function orientation theory.
Bouillaud's idea inspired his focus on the frontal lobe of the
brain. Broca's subsequent success was the implementation
of Bouillaud's doctrine.
4,8,15,16

The debate between scholars engaged in brain function
localization and whole-brain theory became very intense in
the middle of the nineteenth century. At the Parisian
Anthropological Society meeting on 4 April 1861, scholars
from both schools of thought engaged in a discussion.
During the conference, embryologist Louis Pierre Gratiolet
(1815–1865) said that a larger brain shows higher
intelligence also fuelled controversy among scholars11,12,17
.
Auburtin's point of view at the meeting inspired Broca,
which later led to Broca inviting him to take part in a
consultation session involving a patient who experienced a
loss in language ability and paralysis symptoms on the right
side of the body.
8,15

Three Important Patients
There are three essential patients in the historical
development of the study of Broca's aphasia. The patient
called Louis Victor Leborgne (1809–1861) was also known
as Monsieur Leborgne or 'Tan' because he only uttered the
syllable 'tan' in his 21 years illness.

2,4,5,6,7,8,9,17,18,19,20 He was
born in a small village in France on 21 July 1809. His father
was a primary school teacher, and he had five brothers and
sisters. Leborgne's physical condition was poor, as he had
epilepsy from a young age. However, he worked until he
turned 30, as his language ability became a barrier.
Although he could not talk, his intelligence level was
normal as he could understand what other people said. The
only syllable he could utter was 'tan,' but he could also
respond to 'tan' in various tones and gestures.
5,6,14,18 His
family thought it was only a temporary condition and did
not take him to the hospital for treatment. Ten years later,
he became hemiplegic on the right side. Another four years
later, his hemiplegia gradually became severe. After seven
years, on 11 April 1861, he was transferred to the
department of Bicêtre Hospital surgery at which Broca was
working. He was placed under Broca's care.
2

Leborgne's case is defined as a significant example of
Broca's aphasia patient. Some latest research argues that
Leborgne might have other cognitive problems due to his
brain-injured involvement such a big portion4
. And his
situation becomes worse when sending to Broca's hand, as
his family sent him to the hospital when he was 30.
17,18,19,20

The relationship between severity and the family's decision-
making level to the departure interval when a patient has a

stroke can go to the emergency department as soon as
possible could be one reason the situation worsens.
21
Leborgne was 52 years old. Broca realized he was a case in
which Bouillaud's brain function localization theory could
be confirmed, so Auburtin was invited to participate in the
consultation. Six days later, Leborgne died. Broca dissected
his brain and found that there was a large lesion on the
inferior frontal lobe. The second frontal convolution of the

left cerebral hemisphere was damaged, and the injury was
most profound. This area was later named Broca's area, and
aphasia caused by damage to the x-domain of this area was
later named Broca's aphasia.

4,5,615,16,17,18,19,20

Broca believed that this case confirmed Bouillaud's view
that language functions were at the forefront of the brain.
Although he knew that a single case was not sufficiently
convincing, he published his findings at the Paris
Anthropology Conference on 18 April 1861.

2 His views
attracted little attention. Four months later, Broca submitted
a neurological, anatomical report on Leborgne and
published it in the Anthropological Society Journal. The
report officially proposed the existence of the loss of the
frontal lobe and language ability.
2

In the same year, Broca submitted the autopsy report of
another patient2

. Like Leborgne, this patient had lost his
language ability. After dissection, it was found that his
posterior inferior frontal lobe was damaged, and it closely
resembled Leborgne's brain damage. The second patient,
called Lazare Lelong, was an 84-year-old worker sent to the
hospital due to dementia. His language ability was slightly
better than Leborgne's as he could utter five simple
syllables, namely: oui (yes), non (no), tois (trois, or three),
toujours (always), and Lelo (when he tried to speak his
name).
2,4,20
Whenever he said 'tois,' somebody's language was
accompanied, especially the swinging of his fingers to
correct linguistic errors. For example, when asked how
many children he had, he replied with 'tois' but showed four
fingers. When asked if he had any daughters, he said 'tois'
but showed three fingers. Lelong died 12 years after he had
a fall. Broca dissected his brain and discovered that his
lesion was like Leborgne.4
In the next few years, Broca collected similar cases. He
published the anatomical report of the case. The more
accurate the brain function localization theory, the more he
realized the human left hemisphere was more likely to be
the functional language area than the right hemisphere. In
1863, Broca reported eight cases of language output
disorders. None of the patients in the eight cases could
speak, and their autopsy reports showed that damage to the
frontal lobe of the left hemisphere had led to the loss of
language ability. Another case involved damage to the
frontal lobe of the right hemisphere. In 1865, Broca
announced his research conclusion—'humans speak with
the left hemisphere' ('Nous parlons avec l'hemisphere
gauche' 13 [Herron, 2012, p. 19]).
2

The words 'tois' and 'trois' in French are pronounced
virtually the same but have different meanings, origins, and
spellings. As a native speaker, Broca could identify the
word 'tois' by the patient's gestures, 'trois,' and quickly
recognized that the patient was trying to say the number'
three.' However, it is difficult for non-native speakers to
identify 'tois' as 'trois,' especially when the patient showed
an incorrect number of fingers. In French, all three words
(tois/twa/no meaning, Toi /twa/ pronoun 'You' informal,
and Toit /twa/ roof) are pronounced similarly. However, it
does not mean that it is the number 'three.'4,18,19,

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MNJ (Malang Neurology Journal) Vol. 7, No. 2, July 2021

Table 1. Lazare Lelong speaks five simple syllables
Syllable Meaning Other
oui yes -
non no -

Tois /twa
(Trois/trwa)

No meaning
Three

Using gestures
and the patient's
words, Broca
could identify that
the word 'tois'
referred to the
number trois
(three).

toujours always
Lelo When he spoke his

name

-

Besides the study of Gall and his followers, an incident in
the United States further reinforced brain function
localization.
Phineas Gage (1823–1869) was originally a railway
company worker. On 13 September 1849, at 4:30 pm, he
and his workmates worked for the Rutland and Burlington
Railway Company. Gage placed blasting powder in a deep
hole and packing the powder with a tamping iron rod. The
steel rod weighed 13.25 pounds, was 3 feet 7 inches long,
and had a diameter of 1.25 inches. The rod was tapered at
one end. During the subsequent accident, the iron rod was
driven entirely through Gage's head, but miraculously he
survived. Nevertheless, he lost his language ability and
observed changes in his temperament.
14,15,22

The Intellectual Property Dispute in
The Left-Brain Control Language
Theory
In 1836, Marc Dax (1770–1837), a rural doctor from the
south of France, published more than 40 aphasic brain
damage reports of his discoveries at regional doctors'
conferences. Medical reports of aphasia often accompany
left brain injury cases. His reports pointed out that among
language disorder patients who gained aphasia due to brain
damage caused by accident and stroke, the number of
patients with paralysis on the right side of the body was far
more than that of the body's left side. The left hemisphere
of the brain controls the movement of the right side of the
body, and language output disorders accompany the
paralysis of the right side of the body. His findings were
reported 25 years earlier than Broca's.15,23,24,25,26
Marc Dax's son, Gustave Dax (1815–1893), submitted his
article to Academie de Medenine in Paris in 1863, but it
was rejected. He later offered the paper to another
publication named 'Gazette hebdomadaire de Medicine et
de chirurgie'. The report 'Lesions of the left half of the
encephalon coinciding with the forgetting of signs of
thought' (original title: Lesions de la moitie gauche de
L'encephale coincident avec l'oublie des signes de la
pensee) was published in 1865.
8,23,24,25,26

Four years after Broca presented his report, Gustave Dax
appealed to the Paris medical community, advocating that
left hemisphere dominance for language should rightfully
be his father's intellectual property. The attempt was
unsuccessful because his father's report was not published
in time, even though it was published two weeks earlier

than Broca's report in a small publication in 1865 3,7
.
Unfortunately, the journals were not considered
authoritative and representative. Cubelli and Montagna
(1994)3
thought Marc Dax's contribution was also
significant and that the relevant theory should be renamed
'The Theory of Dax–Broca'.
3

The Contributions and Disadvantages
of Broca's Theory
Broca is considered a pioneer and significant contributor's
well-deserved status in the neuro-basic study of language.
One of his main achievements was that he discovered that
the left hemisphere is the dominant hemisphere of language
and that the right hemisphere is the minor hemisphere7
. Of
course, this conclusion is only statistically significant as the
right hemisphere dominates some language functions.
Broca's contributions are discovering the inferior frontal
gyrus, also known as Broca's area, the language-generating
area. If a patient cannot pronounce words and speak, it is
probably due to the dysfunction of the inferior frontal
gyrus.
2
Broca's theory of 'humans speaking with the left
hemisphere' has dominated medical and scientific thinking
for decades. He believed that language barriers are
obstacles to performing everyday tasks such as speaking,
understanding, reading, and writing. While this approach
focuses on daily tasks based on language communication,
allowing researchers to explore how the brain is related to
language function also has drawbacks. For decades, it has
hindered the investigation of the organizational part of
physiological linguistic tasks that negatively impact
aphasia, neurolinguistics, and treatment methods8,28,29
.
Decades ago, to judge a Broca's patient was more quickly,
and the focused factors were more concentrated. However,
families play a crucial role in helping Broca's patients;
families due to the caregiver's lack of knowledge could be
caused to patients' delay to deliver to gets their consultant.
27

Conclusion
The development of Broca's aphasia, if tested today by
using the advanced method, might occur some debate, but
the contribution of Broca's to the aphasia field could not be
questioned. The effort of Gustave Dax to call for the
recognition of his father's discovery should be paying more
attention and giving credit; Gustave Dax should be
considered a person to fight for intellectual rights in this
field and not just a messenger boy.
Acknowledgment
This work was supported by The National Social Science
Fund of China (14BYY065).
Conflict of Interest
The authors declare that there is no conflict of interest. 

1.
Research Aim:
Understand the purpose of the study. What is the researcher trying to investigate?
What is Broca’s aphasia and how it was discovered and how they found out what it was  
2.
Hypothesis: 
Identify the hypothesis or predictions made by the researchers.


3.
Methodology




Participants: Note the sample size, demographics, and selection method.




Design: Understand whether the study is experimental, correlational, longitudinal, etc.




Procedures: Look at how the study was conducted, including any materials or tasks used.


4.
Results
Focus on the main findings. What data was collected, and what were the key outcomes?


5.
Conclusion: 
Analyze the interpretations made by the researchers. Do they support the hypothesis?


6. 
Limitations: 
Consider any weaknesses or limitations of the study, such as sample bias or methodological flaws.


7. 
Ethical Considerations
Pay attention to how the study addressed ethical issues, such as consent and confidentiality.


8. 
Application: 
Think about how the findings can be applied in real-world contexts or relate to psychological theories.


9. 
Critical Evaluation:
Reflect on the study's strengths and weaknesses. How does it contribute to existing knowledge in psychology?


10.
Additional comments/notes (if any)