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J R Soc Med. 2006 March; 99(3): 105.
PMCID: PMC1383749

The long shadow of cerebral localization

I am distinctly puzzled by Saad Shafqat's article on cerebral localization (December 2005 JRSM1). The foundations of cerebral localization are generally accepted to have been laid by Paul Broca2 and, more significantly, by Gustav Fritsch and Eduard Hitzig3 and David Ferrier.4

Dr Shafqat goes on to say `The problem, unfortunately, is that lesion localization became an end in itself'. Oh? Within 5 years William Macewen was operating on abscesses of the brain that he had successfully located. He was soon followed by the likes of Victor Horsley, Charles Harrison Frazier and Harvey Cushing, all active before the end of the first decade of the 20th century. Besides abscesses, tumours and epilepsy were tackled by a handful of men with pretty satisfactory results considering the state of surgery at the time.5

Before computerized tomography and magnetic resonance scanning appeared on the scene, Walter Dandy had devised pneumoventriculography and Egas Moniz had introduced arterial encephalography.


1. Shafqat S. The long shadow of cerebral localization. J R Soc Med 2005;98: 549. [PMC free article] [PubMed]
2. Broca P. Remarques sur le siege de la faculté du language articulé, suivie d'une observation d'aphémie (perte de la parole). Bull Soc Anatom Paris 1861;36: 330-57
3. Macewen W. Cases illustrative of cerebral surgery. Lancet 1885;i: 934-6
4. Fritsch G, Hertzig E. Ueber die elecktrische Erregbarkeit des Grosshirns. Archr Anatom Physiol 1870;37: 300-32
5. Richardson R. The Story of Surgery, with Commentaries. Shrewsbury: Quiller Press, 2004. (see Chapters 14, 15 for references.)

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