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The Human Nature Review Human Nature Review  2003 Volume 3: 135-138 ( 13 March )
URL of this document http://human-nature.com/nibbs/03/jacyna.html

Essay Review

On Discourse, Freedom and the History of Aphasiological Research


André LeBlanc*

Review of Lost Words: Narratives of Language and the Brain, 1825-1926
by L. S. Jacyna. Princeton: Princeton University Press, 2000.
x + 241 pp. 18 halftones. ISBN: 0-691-00413-7.

In historical events great men--so called--are but the labels that serve to give a name to an event, and like labels, they have the least possible connection with the event itself. Every action of theirs, that seems to them an act of their own free-will, is in an historical sense not free at all, but in bondage to the whole course of previous history, and predestined from all eternity. (Leo Tolstoy) 1 

One of the most innovative aspects of L. S. Jacyna’s study of aphasiological research between 1825 and 1926 is his strategy of treating texts by different authors as if a single author had written them. Among other advantages, this strategy allows him to reveal the hidden assumptions of one text using the explicit assumptions of another. By comparing Herbert Spencer’s writings with those of the British neurologist John Hughlings Jackson, for example, Jacyna is able to show that just as Spencer believed that the female brain was less evolved than its male counterpart, so did Jackson characterise the aphasic’s brain as feminine because it suffered from a deficiency in the human capacity for language, the crown jewel of evolutionary traits.

I shall use the same strategy in introducing my essay review of Jacyna’s book. Compare, for instance, the above quote by Tolstoy to the following one by Jacyna: 

My emphasis is on the texts themselves rather than on their authors. I maintain that in important respects the signification of these documents cannot be referred to the motives or impulses of the individuals producing them. […] Thus, although I discuss Paul Broca’s early contribution to the literature at some length, that discussion is not about ‘Broca’ as such: that is a name conventionally assigned the authorship of a collection of texts some of which are relevant to this study (p. 4; my italics). 

While both Tolstoy and Jacyna assert that names like Napoleon and Broca are nothing more than historical labels, Tolstoy states plainly what Jacyna leaves implied: that we are the slaves of a deterministic universe. Jacyna is more explicit later, however, when, writing about ‘the great engine that Paul Broca had set in motion’, he adds in a footnote that ‘it would be perhaps more apt to say that the primed engine set Broca in motion’ (p. 203). For both Tolstoy and Jacyna the message is the same: we are mere cogs in the great engine of history.

Readers of Jacyna may be surprised to see him described as a determinist since he is rather against the whole notion of scientific reductionism. In reference to the widespread belief among neuroscientists that science will someday succeed in reducing the mind to inanimate matter, for example, the last paragraph of his book begins as follows: ‘The enormity of the claims made for the modern brain are a justification for seeking to write its history. The theme of this book has been to reveal something of the contingencies attending the creation of the brain by means of literary and other forms of representation’ (p. 238). The idea of revealing contingencies in the history of science, moreover, is not one that we typically equate with determinism. The theme of Jacyna’s book, therefore, is that the history of aphasia did not develop in a logically inevitable way, but that it followed a path that was often contingent upon literary and cultural factors. This theme is likewise reflected in the book’s overall structure: chapter one describes the emergence, in early nineteenth-century France, of the reductionistic discourse that has continued to characterise the way neurologists write and think about aphasia to this day; chapters two and three analyse the development and consolidation of this discourse; and chapters four through seven present alternative discourses that appeared in France, England and Germany around the turn of the twentieth-century, especially in the work of Hughlings Jackson, Henry Head, Sigmund Freud, Pierre Marie, Henri Bergson and Kurt Goldstein. In general, the received discourse was reductionistic, research-oriented and excluded the patient’s point of view, while the alternative discourses were holistic, therapy-oriented and included the patient’s point of view. Hence, the title of the book, Lost Words, refers both to the condition of aphasia and to the excluded voices of those who suffered from it.

Like Tolstoy, however, Jacyna is not a determinist at heart, and he clearly wants to use history in part to undermine the reigning reductionism of contemporary neuroscience. As I see it, he does this in basically two ways. The first, as mentioned above, is by tracing the origins of aphasiological research and by contending that it could have taken a more humanistic course. Why aphasia? Why not have focused on the history of neurology in general? Because, as Jacyna so well describes in his second chapter, the study of aphasia was a crucial stage in the grand movement of reductionism. ‘[T]he discovery of an organic seat for language’, Jacyna writes in the book’s conclusion, ‘posed a challenge for the assumption that the capacity of speech placed man above animals and mind above matter’ (p. 232). The second way in which he seeks to undermine reductionism is by demonstrating how the work of several nineteenth-century neurologists was structured by metaphors and assumptions of which they were not aware. And since many of these metaphors and assumptions were erroneous, as in Jackson’s case above, this suggests that today’s neuroscientists could be equally misguided in their reductionistic claims.

So far so good, but Jacyna does not stop there. Like other authors who are influenced by Nietzsche, Michel Foucault, and recent theories in literary criticism and the sociology of science, Jacyna’s book is marked by the implicit assumption that we cannot escape from the discourses through which we organise and express our ideas. If this is the case, there is, therefore, a sense in which we are determined by whatever discourse we happen to adopt since our representations of the world are always shaped and conditioned by it. As Jacyna explains, ‘every author must write in a language of which he or she is not fully the master; discourse exists as a datum which conditions and exceeds all efforts at individual expression’ (p. 5). While agreeing that discourse powerfully conditions human thought and action, I shall challenge the view that it is somehow beyond our grasp and control. In a close reading of Jacyna on Jackson’s work, I hope to show that Jacyna’s impressive analysis is itself evidence of a source of knowledge that transcends both discourse and culture.

As indicated in my introduction, Jacyna has shown us that Jackson’s understanding of the human brain was shaped by his implicit belief in the evolutionary superiority of the male over the female brain. Jacyna’s analysis is all the more remarkable in that the British neurologist Henry Head claimed that Jackson’s genius rested in his ability to investigate facts independently of any preconceived ideas. ‘[Jackson] never deduced his observations from his hypothesis’, Head wrote in 1915, ‘but any hypothesis he enunciated sprang, as it were, ready made from some clinical fact.… He stood like an observer on a bridge formulating the extent of the flood from the matter carried down by the stream’ (p. 126). Yet, ‘[i]f Jackson was not standing on some structure derived from hypothesis’, Jacyna asks, ‘of what was his bridge composed’ (p. 132)? His answer, of course, is that it was composed of the same general discourse Jackson shared with Spencer and his other contemporaries. For Jacyna, there is no discourse-free vantage point from which to examine the so-called facts of nature because any vantage point we choose is itself within a discourse and necessarily structured by it. 2

But it seems to me that Jackson also demonstrated the existence of facts that stood outside the discourse Jacyna so ably deconstructs, and that these facts ironically provide us with clues for understanding the psychological mechanism by which discourse shapes and conditions our thoughts and actions. Consider, for example, these famous passages by Jackson, which I cite from Jacyna’s book: 

When I hear a certain creaking noise, I ‘see’, in spite of myself, a certain room. I should have so suffered any time in the last twenty years, and may for the next twenty. Here a simple sensation rouses a perception…. In short, the sensation first acts upon me as it finds me, unawares. I am suddenly its victim, for it brings the room before me in spite of me. On the other hand, it was possible for the ‘I’ to ‘will’ to dwell on the perception which has been obtruded on me, and for this there would, I presume, be required a voluntary revival of the perception (p. 131). 

There have long been permanent modifications of my brain which make it possible for another person at any time to compel me to have in my consciousness, at least momentarily, unless I am strongly preoccupied, some kind of notion of horse. He excites certain changes in the ‘grooves’ of those permanent modifications of my brain which are always with me, part of me (p. 130). 

Is it not reasonable to suppose that the grooves through which Jackson is compelled to produce the notion of a horse are the same species of grooves, acquired through the habits and customs of late nineteenth-century English life, that compelled him to characterise aphasia as a feminine malady? And what are we to make of the ‘I’ that becomes aware of these culturally worn grooves and that exercises a certain measure of control over them? Is it not through the agency of his own ‘I’ that Jacyna was able to reveal implicit assumptions in Jackson’s texts? In other words, the bridge upon which we may momentarily stand to watch a discourse from above is composed of our innate intelligence--the same intelligence with which we may describe, judge and choose a particular discourse.

And even if it were true that we could not escape from the discourses that so condition and define us, it could not be absolutely true since we could at the very least condition and define ourselves by choosing our own discourses. Jacyna seems to deny the possibility of making any real choice between discourses, however. Even with respect to his brilliant comparative analysis in chapter one, in which he asserts that ‘[m]edical discourse about language and its loss could, in short, have taken a different form’, he is paradoxically unwilling to concede that one discourse could be inherently better than another. Referring to the first-hand accounts of aphasia that were displaced by the impersonal case histories of modern aphasiology, he writes: ‘It would, however, be a mistake to imagine that these narratives constitute a more natural or authentic account of the condition; they do provide a contrasting set of representations that help demonstrate the partiality and contingency of a ruling discourse. “Experience”, whether of work, illness, or any other mode of life, is never raw’ (p. 6). Yet, this view is contradicted by the double meaning of the book’s title--why speak of Lost Words if there can be no meaningful choice between whether a discourse is to be lost or gained?

This is not to say that we are always aware of how discourses govern our lives, nor even that we would always make the right choices in selecting from among different discourses. Like Nietzsche, Foucault and others, Jacyna succeeds brilliantly in showing the powerful influence of discourse on activities that seem the most immune to extra-scientific forces. But in assuming that this influence is absolute, he fails to highlight the full significance of his work for personal and societal transformation. Historians and philosophers need not of course use the past to shape the future, but they should at least acknowledge the possibility, lest they substitute one form of determinism for another.

* André LeBlanc, Ph.D., Post-doctoral Fellow, Department of the History of Science, Harvard University, Science Center 235, One Oxford Street, Cambridge, MA 02138, USA.


This paper was written with the support of Associated Medical Services, Inc., through a Hannah Institute for the History of Medicine Program Post-doctoral Fellowship.


1. War and Peace, translated by Constance Garnett, (London: Heinemann, 1971), 657.

2. Two chapters later, Jacyna makes a similar remark concerning a passage in Jacques Derrida’s Of Grammatology, which reads: ‘the writer writes in a language and in a logic whose proper system, laws, and life his discourse by definition cannot dominate absolutely. He uses them only be letting himself, after a fashion and up to a point, be governed by the system’ (p. 171). Jacyna admonishes Derrida, however, for begging ‘the question of after what fashion and to which point the writer “lets” himself be used’ (p. 171). Of Grammatology, translated by G. C. Spivak, (Baltimore: Johns Hopkins Press, 1974), 158.

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LeBlanc, A. (2003). On Discourse, Freedom and the History of Aphasiological Research. Human Nature Review. 3: 135-138.

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