Assessing Kurt Goldstein's lasting influence in the neuropsychology of language versus his use of aphasic symptoms as diagnostic insights into brain injuries

Abstract

In the history of the neurological relationship between human behavior and brain function in Europe and North America, various perspectives on brain localization and holistic functioning have been addressed. One of the founding figures of modern neuropsychology, Professor Hans-Lukas Teuber (1916-1977) of the Massachusetts Institute of Technology, reminded the scholarly community of its negligence of preceding traditions in day-to-day research endeavors. Teuber particularly emphasized that during the development of the aphasiology field (1950s-1960s) even major figures, such as the German-American neurologist Kurt Goldstein (1878-1965), had been neglected in the scientific community's collective memory. This happened despite Goldstein's contributions to cortical blindness, vicarious brain functioning, and neurorehabilitation. The outcome of the debates regarding the neurology of language had to be incompletely relearned in later decades. Neuropsychological concerns regarding the relationship between cortical localizationism and functional holism have made recourse to Goldstein's work necessary for reviving historical answers for current conundrums. It is therefore opportune to review Goldstein's work in the light of the history of aphasiology. Contemporary scholarship has once more drawn research attention to the works of Goldstein along with Norman Geschwind (1926-1984) and his pupils. It has also resurrected the underlying research of Carl Wernicke (1848-1905). This review article explores deep and lasting questions regarding the positioning of Goldstein's holism among the contemporary holistic perspectives. It does so by firstly discussing Wernicke's traditional model of distributed localizationism. Secondly, it describes Goldstein's previous work in the German brain sciences. Thirdly, it examines his aphasiological contributions on both sides of the Atlantic. Fourthly, it addresses the advancement of a dynamic localizational perspective by Geschwind and his pupils. This article intends to render a historical analysis fruitful for those exploring modern-day problems in the neurology of aphasia and clinical speech neuropsychology.

Keywords: Carl Wernicke; Kurt Goldstein; Norman Geschwind; aphasiology; history of neurology; holism and localizationism.

Figure 1

(A) Wernicke (1874), Der Aphasische Symptomenkomplex. Eine psychologische Studie auf anatomischer Basis, 19. Sketch © Public Domain. (B) Wernicke (1893), Gesammelte Aufsaetze und kritische Referate zur Pathologie des Nervensystems. Berlin, Germany: Fischer, 100. Sketch © Public Domain.

Figure 2

Tachistoscopic vision defect experiment at Goldstein’s and Gelb’s Institute for Research into the Effects of Brain Lesions: Goldstein and Gelb (1918), Psychologische Analysen hirnpathologischer Faelle auf Grund von Untersuchungen Hirnverletzter, fig. 48, p. 141. Photograph © Public Domain.

Figure 3

Map drawing of the Villa Sommerhoff with adjacent functional buildings of the rehabilitation unit: Goldstein (1919), Die Behandlung, Fuersorge und Begutachtung der Hirnverletzten. Zugleich ein Beitrag zur Verwendung psychologischer Methoden in der Klinik, 3. Map © Public Domain.

Figure 4

Schemata of head and brain injuries for clinical-diagnostic purposes: Goldstein (1916), Schemata zum Einzeichnen von Kopf-und Gehirnverletzungen, Cover. Sketch © Public Domain.

Figure 5

Roeder (1950), Erkrankungen des Nervensystems, 78. Sketch © Public Domain.