Lecturer's Précis - Kussmaul
(1878)
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First published online 13:43 GMT 22nd March 2002,
Copyright Derek J. Smith (Chartered Engineer). This
version [2.1 - link to graphic] dated 09:00 BST 30th June 2018
Kussmaul's (1878)
Early Transcoding Diagram
Adolf Kussmaul (1822-1902) was a German physician who became interested in acquired language disorders in the period following the Broca (1861) publication. In his entry in Volume 14 of Von Ziemssen's "Cyclopaedia of the Practice of Medicine", he offered the following improvement on the Wernicke (1874) diagram. Students may detect visual similarities with the Wundt (1902) diagram, and concept similarities with the Freud (1891) diagram and modern transcoding models.
Kussmaul
(1878): Here is Kussmaul's early transcoding
model. The italicised letter codes (black) are Kussmaul's
original scheme for navigating the diagram; the full word captions (green)
are our own. We have omitted the flowlines serving the optical image centre
(top right). Kussmaul's own explanation is included
verbatim in the Appendix below. If this diagram fails to load automatically,
it may be accessed separately at |
Redrawn from a
coloured original in Kussmaul (1878:779). This version Copyright © 2002,
Derek J. Smith. |
References
Kussmaul, A. (1878). Disturbances of speech: An attempt in the
pathology of speech. In Von Ziemssen,
H. (Ed.), Cyclopaedia of the Practice of Medicine (Volume 14), London:
Sampson, Low.
Appendix - Kussmaul's
Original Caption
[To be read in conjunction with the black italicised single letter codes in the diagram.]
"The circle J
designates the ideational centre or centre of conceptions, in other words all
that portion of the cellular network of the cortex in which ideas are produced
as a result of impressions of the most varied description made on the senses
(object- and word-images).
B and B' are the sensory centres for
word-images, B for the acoustic (sound-images), B' for the optical
(text-images).
C and C' are the motor centres for the
coordination of the sound-movements into spoken-words (C), and of the
strokes produced in writing into written-words (C').
a is the acoustic nerve, o the optic. Each of
these nerves is seen to divide into two branches, one of which, however, is
indicated only by points for the sake of clearness - a b c b d is the
collective acoustic motor track for spoken speech, o p q p r the optic
motor track for written speech. The adjoining punctated
[sic] lines and circles are intended to indicate that still other tracks lead
from the nerves of sense through other image-centres to the centre for conceptions;
the acoustic nerve, e.g., also conveys melodies, and delivers musical ideas and
the sound attributes of object-images (song: the nightingale), the optic nerve
brings gesture-images and physiognomic attributes (grimaces: the monkey). For
the sake of clearness we leave out the tracks of the other nerves of sense,
e.g., the nerve of taste, and the motor centres of co-ordination for all other
voluntary expressions, except spoken and written words; the centre for
pantomime is also left out.
a b d is the track for the imitative speech of children or
parrots who repeat uncomprehended words; o p r
is the track for the copying of uncomprehended words;
c b d is the track for the utterance of the conceptions in spoken words;
q p r for the writing down of the thoughts. The track c x q forms
the connection between sound-images and text-images in the centre of
conceptions, and renders feasible the change of spoken-signs into written-signs
through the intervention of the thoughts.
b r and p
d are the tracks between the centre for spoken-images and the motor centre
for writing on the one side, and between the centre for written-images and the
motor centre for speech on the other side. A person
who writes down an uncomprehended word that he has heard,
uses the track a b r; one who reads aloud an uncomprehended
written word, uses the track o p d. In writing down dictated words that
are understood, the longer track a b c b r is employed; in reading aloud
written words that are understood, the track o p q p d.
Let us now examine
with the aid of the diagram the phenomena of deaf-mutism and of the different
dysphasic derangements.
The deaf-mute
can never use the tracks a b c b d and a b c b r; they remain
closed for him, because the acoustic entrance gate remains unopened. On the
other hand, he can arrive at C' and C through o; he can
thus learn to write and speak. He learns to transcribe without conceptive
comprehension of the text by the path o p r, with conceptive
comprehension by the path o p q p r. This, however, does not suffice to
unlock and drill the centre C. For this purpose he must erect for
himself an optical image -centre B'' for the sounds and words seen
coming from the mouth of the speaker, and construct paths from u to z,
and back through u to d. This centre B'' acts vicariously
for B [].
In complete
ataxic aphasia, C is no longer available, and hence the tracks b
d and p d are also unserviceable. Spontaneous speech, repetition of
words uttered by others, and the reading aloud of text, are impossible. The
track a b c, for the comprehension of words heard,
is preserved, as is also the track c b, by means of which the conception
brings the sound-image into recollection." (Kussmaul, 1878:780-782; italics original.)