The validity of Barlow's 1877 case of acquired childhood aphasia: case notes versus published reports

In 1877, Barlow described a ten-year-old boy with right hemiplegia and aphasia, quick recovery of language function, and subsequent left hemiplegia and aphasia, who was shown to have symmetrical left and right Broca's area lesions at autopsy. The report of this case motivated many writers in the second half of the nineteenth century to develop theories on localization, laterality, equipotentiality and development of specialization, recovery of function, and the role of the right hemisphere (see Finger et al., 2003, for review). This paper presents an analysis of the original archived case notes that have recently come to light. Examination reveals discrepancies in significant details of the history of the case and raises questions about the degree of impairment and recovery throughout his illness as reported in the published article. Consideration of these differences between the presentation of the case in the British Medical Journal publication and the documentation in the original patient records raises issues about the validity of this case as evidence for the many arguments it was to support that have persisted to the present.