The Goltz-Ferrier debates and the triumph of cerebral localizationalist theory

Objective: To analyze the significance of the Goltz-Ferrier debates held at the International Medical Congress of 1881 for the development of ideas on cerebral localization. Background: Cerebral localization was the subject o f vigorous debate throughout the 19th century. At the Congress of 1881, Dav id Ferrier, a leading proponent of cerebral localization, and Friedrich Leo pold Goltz, an equally prominent anti-localizationist, had the opportunity to present their experimental research before 3,000 of the world's leading medical figures. Methods: The authors reviewed and translated the presentat ions by Goltz and Ferrier at the Congress and supporting publications in co ntemporary medical journals. Results: In his presentation to the Physiology Section, Goltz criticized localizationists for their widely divergent conc lusions about the exact anatomic sites of cortical centers and for their fa ilure to adequately explain functional restitution after cortical ablations . He noted that localizationist theories could, like an apple, "look very t empting and still have a worm inside." He described his own studies on mass ive decerebrations in dogs and noted that despite complete destruction of t he cortices of both hemispheres these animals failed to exhibit motor weakn ess or deficits in primary sensation. Ferrier noted that Goltz's results we re irreconcilable with his own experiments in monkeys, in which circumscrib ed lesions produced clear and reproducible functional deficits. Both invest igators exhibited animals with cortical ablations. Ferrier's presentation o f a hemiplegic monkey prompted Charcot's famous utterance, "C'est un malade !" ["It's a patient!"]. A distinguished committee examined the brains of th e animals, and confirmed that Ferrier had indeed succeeded in producing a c ircumscribed lesion in the frontoparietal cortex, whereas the cortical abla tions in Goltz's dogs were much less widespread than anticipated. Conclusio ns: Ferrier's dramatic demonstration of the effects produced by localized l esions in macaques triumphed over Goltz's unitary view of brain function, p roviding a major impetus for the subsequent successful development of neuro logic surgery.