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A Bit About Phrenology

by Roy Selby
Originally Published in the Spring 1993 AANS Bulletin

Franz Joseph Gall
Franz Joseph Gall

Phrenology Drawing

One may wonder why a long discredited pseudoscience would retain any interest for today's neurosurgeons and neuroscientists in general. Its history helps us to understand better the developments of concepts of the localization of cerebral functions, primarily those of the 19th century. The concept of cerebral localization is directly traceable to the concepts of a German physician, Franz Josef Gall. After required to leave Vienna, he and his colleague and former student, Johan Caspar Spurzheim, settled in Paris.

Gall was an excellent anatomist. However, he developed a theory that one could discern the relative strengths, weaknesses, proclivities, and abilities of an individual's behavior from measurement of the contours of one's head. He believed these were indicative of underlying cerebral contours, which in turn possessed those particular attributes.

Physiognomy has a very long history in medicine, the arts, and literature, but Gall focused his attention upon the detailed configuration of the human head. He slowly increased the number of areas he attributed to specific localizations of cerebral functions which he thought were indicative of the underlying attributes of the human personality. Gall used the term, "cranioscopy" but his younger colleague, Spurzheim, coined the word "phrenology" as he went abroad to evangelize and elaborate upon Gall's concepts.

A pre-eminent Parisian physiologist, Flourens (who was a follower of the general ideas of René Descartes) challenged and attempted to refute the claims of phrenology. Flourens had only primitive tools to conduct his experiments upon the brain. Gall had asserted that "amativeness" is apparent by the degree of prominence of the occipital bone, and reasoned that matinees must be localized within the cerebellar hemispheres. Flouren's research noted no sexual behavior changes following removal of the corresponding structures from experimental animals. He concluded that there was essentially no localization of brain functions, in keeping with the traditions of Descartes, and published a small volume vehemently attacking phrenology.

The public argument was rather heated. Some physicians were skeptical and some were convinced by Flourens; other, usually younger doctors, felt that there might be merit to at least some of Gall's and Spurzheim's ideas. In Great Britain, Spurzheim met with similar reaction, but gained a rather wide following among many educated people. A phrenology movement arose there - not the least important leader being George Combe, a lawyer, who published several influential works on the subject.

Spurzheim came to Boston to lecture on phrenology - the first such lecture of his intended American tour. He was, in general, well received though a few prominent Boston physicians has reservations about the scientific validity of phrenology. Unfortunately, he became quite ill, possibly from typhoid, and died shortly after his arrival. His funeral was well attended. There services were held at Park Street Church, where his casket was placed in its crypt because the Mount auburn cemetery was not yet completed. First, however, his heart, brain, and skull were removed. Unfortunately, his heart and brain have been lost, but the skull is on display at the Warren Museum of Harvard Medical School. Although there is a grave for Spurzheim at Mount Auburn, there is no record that his remains were ever moved there.

Both Spurzheim and his ideas took root in the United States. Phrenology became rather widely accepted and practiced, once again with varying degrees of acceptance by doctors. Following the U.S. Civil War, the school of phrenology received further and enthusiastic support and usage by two rather remarkable families - the Fowls and the Wells - and by a good many other phrenology disciples and practitioners in other cities and states.

Head analyses were relatively inexpensive. Following each analysis, the summary of findings would be inscribed, often in a small book, which explained the principles of phrenology and the particular qualities of an individual associated with prominence or lack of it of the many areas of the head. The person's strengths, relative weaknesses, and other attributes were noted, sometimes with advice for correction or improvement. It was not uncommon for young couples to present themselves prior to marriage to learn if they were compatible. Perhaps, some people were helped psychologically by the analysis.

Clara Barton attributed her successful career to the phrenological analysis made of her when she was quite young, shy, and uncertain about herself. For a time, Walt Whitman worked for the Fowlers in New York. Slowly, enthusiasm waned for phrenology as increasing skepticism and loss of acceptance by physicians and other occurred, and by the 1920s it was largely denounced as medical quackery.

Phrenology might otherwise be a sociological curiosity except that it stirred the thoughts of a few doctors, primarily in France, that some localization of cerebral functions might exist. The most notable initial observation was that of Paul Broca in 1861, which led to the work of Wernicke in Germany and the general formulation of ideas about the localization of language functions. Ferrier and Jackson in Great Britain and Fitsch and von Hitzig in Germany discovered the primary visual cortex and the sensorimotor cortex.

This pseudoscience contributed to the initial discoveries and concepts of cerebral localization. The latter eventually reached rather extreme parcellation of both cortical functions and anatomy, which have undergone significant modifications in understanding. Yet the development of the initial ideas of localization allowed the preoperative diagnosis of the location of the first successful operation for brain tumor, thus making possible important contributions to clinical neurologic exams.

Suggested Reading: Greenblatt, SH: Phrenology in the Science and Culture of the 19th Century. Neurosurgery, 37:790-805, 1995.

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