A month in the country: The sesquicentenary of David Ferrier’s classical cerebral localisation researches of 1873

The British Medical Journal issue dated 26 April 1873 contained a ‘Preliminary Notice’ contributed by David Ferrier, M.D., entitled ‘Experimental researches in cerebral physiology and pathology’. ¹ A medical graduate of Edinburgh University in 1868, Ferrier’s current affiliations were listed as ‘Professor of Forensic Medicine in King’s College; Junior Physician to the West London Hospital’. However, the researches described had taken place far from the capital, in the West Yorkshire town of Wakefield, about 160 miles north of London. The paper began:

The opportunity kindly afforded me by Dr Crichton Browne [sic], of experimenting on over thirty guinea-pigs, rabbits, cats, and dogs, in the pathological laboratory of the West Riding Asylum, Wakefield, has enabled me to arrive at certain results and conclusions which seem worthy of a brief preliminary notice, pending the publication of details of method, experiments, and illustrations, in the West Riding Asylum Reports [sic].

This modest paper, listing twelve ‘important conclusions’ and taking up less than a column of print, summarised experimental findings which established the principle of cerebral localisation as physiological fact rather than, as previously, phrenological speculation. Ferrier (1843–1928) had undertaken the experiments to test the views of John Hughlings Jackson (1835–1911) on the pathology of epilepsy as a discharging lesion. James Crichton-Browne (1840–1938), the medical superintendent of the West Riding Pauper Lunatic Asylum in Wakefield (also an Edinburgh graduate, 1862), had established and equipped a pathological laboratory there in the year prior to Ferrier’s arrival.

The preliminary report of Ferrier’s findings was supplemented later in the year by the promised substantive paper, bearing the same title, which appeared in the West Riding Lunatic Asylum Medical Reports, ² the house journal of the West Riding Asylum, edited by Crichton-Browne. This second paper, which may have appeared in July, and certainly by September, mentioned experiments on pigeons and fowls, in addition to guinea-pigs, rabbits, cats and dogs. Furthermore, in a footnote (p. 89n2), Ferrier reported that ‘I have now (June 14) ascertained the position of all these centres in the brain of the monkey, and therefore, by implication, their situation in man. These experiments will soon be published.’ The monkey studies were undertaken in London with funding from the Royal Society. This extended experimental work – ‘I operated on nearly a hundred animals of all classes – fish, frogs, fowls, pigeons, rats, guinea pigs, rabbits, cats, dogs, jackalls [sic] and monkeys’ – was mentioned in a note published in Nature on 2 October 1873. ³ The monkey work was also referred to in a brief paper in the Journal of Anatomy and Physiology dated November 1873, ⁴ prior to the definitive publications in the house journals of the Royal Society in 1874–1875.^5–8

How had it come about that Ferrier journeyed to Wakefield to initiate these researches? According to Charles Scott Sherrington (1857–1952):

In March 1873, when he [Ferrier] was paying a visit to his friend . . . James Crichton-Browne . . . conversation turned upon the excitability under galvanism of part of the cerebral surface of the dog reported by . . . Fritsch and Hitzig. There followed, during the course of the spring and summer of 1873, in the laboratory recently founded at the Asylum . . . the memorable experiments with which Ferrier opened his detailed exploration by faradic stimulation of all parts of the central nervous system in representative types of vertebrate from the lowest to the highest. ⁹

This account was written for Ferrier’s obituary, hence more than 50 years after the events described. Some caution as to its accuracy may therefore be appropriate, even accepting that Ferrier and Sherrington were friends (Sherrington’s magnum opus The Integrated Action of the Nervous System of 1906 was dedicated to Ferrier). Likewise, Finn’s more recent account, ¹⁰ given without reference(s):

Late in 1872, when Crichton-Browne’s good friend and fellow Scotsman Ferrier visited Wakefield for the annual conversazione, the two talked about many things, and Fritsch and Hitzig’s results were chief among them. . . . Crichton-Browne . . . thus invited Ferrier back in March to conduct more electrical experiments in rooms of the asylum.

The annual meetings, termed conversazione, arranged by Crichton-Browne at the West Riding Asylum between 1871 and 1875, certainly attracted ‘men of science’ as well as local practitioners, but the five-line report of the meeting of 15 October 1872 published in the Lancet (1872; 2: 615) mentions no names other than that of the keynote speaker, Professor William Turner of Edinburgh, who lectured on the cerebral convolutions (he was also a co-founder and editor of the Journal of Anatomy and Physiology).

However, a contemporaneous record provides more information. In a letter to Charles Darwin (1809–1882) dated 16 April 1873, Crichton-Browne states:

Professor Ferrier of King’s College has just completed an experimental investigation in my pathological laboratory which cannot fail to interest you and which must have an incalculable bearing on your views. By exposing the brains of living animals, under chloroform, and stimulating the cerebral grey matter by an electric current from Du Bois Reymond’s [induction] coil he has discovered that every convolution of the brain is in direct relation with certain groups of muscles, and controls their actions. . . . Professor Ferrier’s researches which are to be published in the next volume of West Riding Asylum Medical Reports [sic] in July, will I believe constitute the most important advances yet made in cerebral physiology. ¹¹

Thus, if Ferrier arrived in Wakefield to begin his work in March 1873, it would seem that in little over a month he had made his key observations and was ready to go into print. The site of his experimental work now shifted back to London for the monkey experiments; contra Sherrington, it does not seem that Ferrier undertook any further experimental work at Wakefield in the summer of 1873, or indeed at any future date, although he did later avail himself of the Asylum’s written resources.

Awareness of, and response to, Ferrier’s researches was prompt. On 10 May 1873, just 2 weeks after the initial report, Hughlings Jackson responded in the British Medical Journal. ¹² Ferrier’s work was also mentioned and/or discussed in several addresses published in the British Medical Journal in 1873, some delivered at the 41st Annual Meeting of the British Medical Association held in London in early August of that year. For example, Harrington Tuke stated that ‘Dr Ferrier is at this moment engaged in a series of scientific experiments, bearing on the nature and treatment of insanity . . . at the West Riding Asylum’ (BMJ 1873; 2: 189; 16 August issue) and Burdon Sanderson discussed ‘the very extended and laborious experimental investigation of the motor functions of the brain, of which some of us have seen the results’ (BMJ 1873; 2: 197; 16 August issue).

For those not privy to those results, the opportunity was available to see a demonstration of the findings for themselves, since on 8 August (the same day as Burdon Sanderson’s address):

Dr FERRIER experimented upon a cat and a monkey. After removing the vault of the cranium and the dura mater, he faradised various portions of the convolutions in succession. In applying his electrodes to the several convolutions, Dr Ferrier predicted movements, for example, of the foot, the shoulder, the ear, the mouth, the eye, the head, etc.; and almost always the predicted movement occurred. . . . We believe that the researches of which Dr Ferrier gave examples are regarded by competent physiologists as of very great importance (BMJ 1873; 2: 241).

Ferrier had a further opportunity to disseminate his findings in September of 1873, at the Annual Meeting of the British Association for the Advancement of Science held in Bradford, West Yorkshire. His address, entitled ‘On the Localisation of the functions of the brain,’ was presented on 19 September and this formed the substance of his note published in Nature the following month. ³ According to the correspondent from the Lancet, this was ‘the most important communication made in the Section of Biology during the meeting. The large room was positively crammed during its delivery, which occupied nearly two hours’ (Lancet 1873; 2: 503).

At the West Riding Asylum conversazione of 25 November 1873, William Carpenter was the keynote speaker, his presentation entitled ‘On the physiological import of Dr Ferrier’s experimental investigations into the functions of the brain’. This was undoubtedly one of the two lectures alluded to in the British Medical Journal (1873; 2: 641; 29 November issue) as recently given by Carpenter on the functions of the brain, and Ferrier was listed as one of those present (Lancet 1873; 2: 788; 29 November issue). In the same issue of the Lancet reporting the West Riding Asylum conversazione, a note informed readers that:

Dr Ferrier has received a grant from the Royal Society for the purpose of enabling him to pursue his investigations upon the brains of monkeys, &c. The results of his experiments will in due time be embodied in a paper which he will read before the Society (Lancet 1873; 2: 788).

Although monkey studies had been in progress at least since June 1873, ² were publicly demonstrated in August, and adverted to in a presentation in September and a publication in October, ³ the substantive papers on this aspect of Ferrier’s work did not appear until 1874–1875,^5–8 followed in 1876 by the monograph The functions of the brain (second edition 1886). ¹³ By this time, the experimental techniques had been taken up by more investigators and in other countries, including Roberts Bartholow’s infamous experiment upon his patient Mary Rafferty, leading to some differences in interpretation of Ferrier’s results. ¹⁴

At the end of 1873, the BMJ published a report of ‘Ferrier’s experimental researches in cerebral physiology and pathology’ (1873; 2: 767–8; 27 December issue) based on his publications of that year. Also in December, the retiring President of the Royal Society, Sir George Airy, noted in his address reviewing the year ¹⁵ that ‘In Anatomy [sic], the most striking subject appears to be Professor Ferrier’s experimental discussion of the actions of different parts of the brain, explained at the late Meeting of the British Association’ (p. 9).

As noted by Sherrington, ⁹ one of the principal stimuli to Ferrier’s experimental studies, in addition to Huglings Jackson’s clinical inferences, was the work of Gustav Fritsch (1838–1927) and Eduard Hitzig (1838–1907) who in 1870 had reported localised centres for various movements in response to galvanic stimulation in the cortex of the dog. ¹⁶ Ferrier certainly mentioned their work in his 1873 papers (e.g. in the second conclusion of his BMJ paper ¹ ) but evidently felt he had gone beyond them, both in method (faradic rather than galvanic stimulation) and extent (species examined, centres identified). Hitzig, however, was vocal in his feelings about under (rather than lack of) acknowledgement, sentiments shared by the referees of Ferrier’s initial report to the Royal Society ¹⁷ and the author(s) of an editorial in Nature. ¹⁸ Young has suggested that thereafter Ferrier’s references to Fritsch and Hitzig were more generous, ¹⁷ although it cannot be doubted that Ferrier advanced the field far beyond their initial study.

Ferrier’s experiments had also excited wider public notice, not least within the anti-vivisection movement, eventually leading to the passage of the Cruelty to Animals Act 1876, under the terms of which Ferrier was later (1881) unsuccessfully prosecuted. However, it seems that Ferrier was alive to potential criticisms of his work from this source much earlier, since in the 1873 substantive paper ² he noted that the animals had to be experimented upon under the influence of chloroform or ether ‘not only from humane motives, but to exclude the complication of voluntary or reflex movements’ (p. 33) and also stated ‘once for all, that before and throughout all the following experiments, ether or chloroform was administered’ (p. 35).

From the outset, Ferrier was considering the implications of his findings not only for the physiology of motor function and the pathology of cerebral disease such as epileptic seizures but also for higher mental functions. In his first paper, conclusion number 1 stated: ‘The anterior portions of the cerebral hemisphere are the chief centres of voluntary motion and the active outward manifestation of intelligence’. ¹ In the second, substantive paper, he questioned whether ‘ideational centres’ were situated in the same regions as the corresponding motor centres, and in favour of this possibility cited the ‘now tolerably well established fact of loss of speech following destructive lesions of the lower frontal convolutions in the neighbourhood of the Island of Reil’. ² Aphasia was thus conceptualised as destruction of the centres of word memory: ‘The part of the brain which is the seat of the memory of words is that which governs the movements of the mouth and the tongue’. ³ Hence in Ferrier’s view ‘The pathology of aphasia is thus rendered comparatively simple’ because the patient is unable to ‘lay hold of the word which he wishes to express’. ⁴

More on the ramifications of Ferrier’s findings for ‘psychical manifestations’ (what we might now term cognitive and behavioural symptoms) was to follow. In a second West Riding Lunatic Asylum Medical Reports paper he attempted clinico-pathological correlation in five patients, based on their details as recorded in the West Riding Asylum casebooks, in order ‘to show the clinical bearings of experimental researches on the functions of the brain’. ¹⁹ These five patients had diagnoses of epileptic insanity, epileptic mania (both with defects of memory), dementia, aphasia and melancholia. Perhaps the clearest correlation was in the aphasic patient: loss of speech output for all but single syllable words beginning with ‘b’ yet preserved language comprehension, accompanied by right hemiplegia and dementia, in association with a destructive lesion of the left hemisphere. Perhaps the least clear correlation was in the melancholic: the ‘symptoms not altogether easy of explanation by the lesions of the brain discovered on post-mortem examination’. Ferrier’s conclusion was prescient: ‘though much yet requires to be done, especially in reference to the psychical function of the brain, there is every reason to believe that the union of physiological experimentation with pathological observation will ultimately succeed in unravelling even this obscure subject, and establishing mental physiology and pathology on a more tangible basis’. ¹⁹

As shown in the foregoing account, all Ferrier’s key observations were made and reported in 1873 and were already widely disseminated and commented upon by the end of that year. Hence, it is appropriate to commemorate, and celebrate, 2023 as the sesquicentenary of Ferrier’s pioneering work on cerebral localisation.