Lost words: narratives of language and the brain, 1825–1926

Histories of aphasia are torn between telling simple stories of discovery about the brain and stories of seemingly endless complexity about language and human uniqueness. In this book, Stephen Jacyna goes beyond this with a different way of reading medical texts, to make "a new genre of writing dealing with the relations between language and the human brain" (p. 3) itself into the historical subject. This genre is the place where many varieties of aphasia come into existence, along with a distribution of power and influence between patient and doctor, between science and medicine, between doctor and doctor, and between the values associated with mind and with matter. Many of his texts will in part be familiar to historians of neurology or physiological psychology, but he interrogates them as forms of writing in a way that is entirely new. The result is a highly reflective, historically meticulous study at two levels: an account of key sources in the formation of aphasia studies, and a model of the "linguistic turn" for medical historiography. It is an excellent book, crafted with respect to language in both content and form, which should be a standard reference point in the history of neurology and neuroscience. The book is not a systematic history of aphasia; indeed, it rather severely dictates what it will and will not discuss. First and foremost, it provides what literary scholars call "a close reading" of "classic" texts, as well as some not so classic, to show how much more they contain than empirical representations of nature. Thus it examines narrative form, voice, metaphor, visual imagery and so on-providing a commentary on the technology of verbal and visual expression during the process of a speciality creating itself. Successive chapters examine Jean-Baptiste Bouillaud's and Jacques Lordat's creation of the aphasiological case history; the reshaping of this literature as a "physiological understanding of language" (p. 54)-the context of Paul Broca's work; the consolidation of a materialist discourse-the period of the localizers and "diagram makers"; John Hughlings Jackson's contrasted focus on the "psychological" speechless man; Henry Head's renewal of Jackson's programme and scathing dismissal of the diagram makers; and the dissonant voices of Pierre Marie, Sigmund Freud and Henri Bergson. The account of Head's enrolment of his patients, educated officers, into his medical science, is especially rich. The penultimate chapter turns to what, before 1900, was a much smaller body of writing, the possibilities aphasiacs provided for therapy rather than science. Another theme runs through the book. Alongside the examination of the particulars of language, it discusses the way in which the literature of aphasia articulates the nineteenth-century debate over naturalism-the explanation of existence in natural-scientific terms. Jacyna richly explores the representation of the speaking man as man and the speechless man as nature. Yet, quite where the argument will go, without drawing in such topics as the history of linguistic theory implicit in accounts of aphasia, or the theological