``Is your head shaped, just as you are smart?``

Now and again, one may stumble into a situation, whereby in social circles, one may be obliged to enlighten otherwise enlightened members of the society, on a subject not talked about otherwise in social circles. One may not be able to escape. So it becomes an obligation. Going by the Teutonic saying, “there can never be foolish questions, only foolish answers.” The question arose on one such occasion, “Just how are we smart?”

One of the men who taught Albert Einstein, (1879-19540), in his early school years, was an illustrious Mathematics Teacher called, Dr. Joseph Degenhart. His pronouncement on the young Albert was that, “nothing would come out of this boy in life.” Dr, Degenhart had probably read in the newspaper, a publication, or he might have heard a verbal lecture, delivered by a man who was a prominent Doctor of medicine, whose name was Dr. Franz Joseph Gall, (1758-1828). Dr, Gall had established a new “Science” which had already moved beyond the metaphysics.

The new “medical science” soon became known as “Phrenelogy”, and it was all about looking at the form and size of a man's, or woman's head, and feeling its unevenness, or contours, and being able to tell how the individual would fare intellectually in life. The size of the head was to take a prominent position in this deliberation. Dr. Gall stumbled into fame to begin with in Austria, his country of origin. Anthropologically, Europeans would take a place, different from their non-European human counterparts, considering the size and shape of their head.

Dr. Gall had evolved this controversial theory, without passing through the then usual method of “seeking scientific” conviction, through experiments. He was soon to meet resistance, and scorn, or disdain from his colleagues. He then moved to Paris, but the controversy as “his brain child”, preceded him. Between 1805, and 1807, he toured Europe extensively, trying to paint a better picture of his new-found hypothesis, which if consolidated into something factual, could make him truly famous, and even at that time, “an added financial garment” was not without interest. Caricatures, plenty of which were printed everywhere, were more in the direction of charlatanry, than anything serious.

In the meantime though, experiments had begun to surface, especially in Paris in the physiological laboratories of Dr. Pierre Flourens, (1794-1867). He was able, through experiments on primate-brains, to establish that, if you took away brain substance from any part of the cortex, (direction of the surface), you would register diminution of function, the more material you removed. This came in support of Descartes ideas, (1596-1650), which stood in favor of dualism, as against materialism, the philosophical concept that, “mind and body function separately, without interchange.” In the meantime, Doctors in Paris were actively trying to establish such mental deficits affecting speech, writing, and reading, and the loci in the brain cortices, responsible for them. It was all an attempt to establish how correct, or otherwise, “Gallism” stood.

Then the “French Society of Anthropology” was founded in 1859, following Charles Darwin's (1809-1882) publication of the “Origin of Species”, in the same year.

With a collection of star Scientists, led by Paul Broca, (1824-1880), and under the topic designated “Craniology”, serious efforts were made to establish any possible correlation between brain volume, (in correlation with shape and size), vis-a-vis intelligence. Paul Broca, who was Anthropologist as well as a Surgeon, was convinced, that such a correlation “had to exist”. The case of the patient, “Mr. Tan” led Broca to coin the expression “aphemia”, which was later changed to be “motor aphasia”- a state of deficit in which the individual is (was) unable to say some words, even though the muscles of his tongue may not be paralyzed. Within a decade, Agraphia, (-inability to write, in the presence of ability to speak), Apraxia, (inability to carry out instructions, such as stretching out your tongue, or showing your teeth, without having lost ones understanding, had been delineated. Wernicke described sensory aphasia, which entails loss of comprehending what the individual is told. With the cluster of the above, all within a decade, they could celebrate the break-through, in the sense that, Broca was able to establish a link with an area of the brain, and its influence on the intellect of the affected individual. The area was found to be located in the left hemisphere, and “more to the frontal”, (anterior) part, in proximity to Wernicke's, and an area that bears his (Broca's) name till today. Readers will find the expression “dominant Hemisphere”, synonymous with the left hemisphere in 85% of world populations.

The patient “Mr. Tan” could say only the word “Tan”, who must have passed through the hands of the men in Paris, later to be designated as Psychiatrists, Neurologists, Neurosurgeons, Neurophysiologists, and were instrumental in mapping deep-seated areas in the brain, and their interconnections to surfaces, called cortex, (cortices), designated projection-fibers, or interconnection of surface areas on the same hemisphere, -association fibers, and from one half of the brain, (called hemisphere), to the other, through components of the corpus callosum. These would lead in further understanding how our brain works, or malfunctions, as disruptions in the anatomic pathways might occur. A lot of us have come across individuals, (children, many a times), but adults as well, with unusually large head, that might strike the observer instantly. We arrive in this world with a head circumference, which would range from 27.5cm, and 42.5 cm. The former is called in the Neuro-pediatrician's parlance, microcephalus, (small head), and the latter, macrocephalus, (big head).

On the average however, most children will arrive with a head circumference that lies around 37.5cm, (+, - 2.5cm). In other words, the above data would stand in relation with the weight of the baby, family characteristics, etc, might play a role. There is a standard linear along which the child's head, height, and other parameters would grow, which under normal, or “advanced circumstances”, the pediatrician would monitor, as he monitors the child's developmental milestones. Assuming all goes well, this child will grow into an adult, with a head-circumference that should lie between 56cm, and 62cm. “In Big-headed” individuals, (macro-cephalic) it could reach 65cm.

Some individuals might have a head-form, which may be broader than it may be long, (brachycephalus), or the other-way round and it is then called (dolicho-cephalus). There will be varieties, and the child will acquire normal intellectual yard-sticks, or miles-stones, not necessarily in relation to the head-size, or head-form. The manner and sequence, in which the sutures of the skull may fuse, will influence the shape, (normocephalus), or plagio-cephalus, and uneven head.

That needn't prove wrong, Franz-Joseph Gall's hypothesis. What should be of interest to a parent that might stumble on this article, or have a child that might fall in the realm, should be such matters as the Gynecological and Obstetric history. Seek the Expert's opinion, and the expert could be your Pediatrician, Neuro-pediatrician, Neurosurgeon, and in the absence of any of the aforementioned, any Physician “might bail you out.” A lot of inroads have been made in Medicine since the era of Gall and his contemporaries, or subsequent colleagues. Imaging: X-rays, as discovered by W. Konrad Roengtgen, (1845-1923), in 1896; Godfrey Hounsfield, (born1919), invented the CAT-Scanner, in 1972, and Paul Christian Lauterbur, (born, 1929), evolved the MRI in 1984. With these machines, the skull, (the bony cover of the brain, the contents, -brain, and its appendages), can be examined to the latest detail. Franz Joseph Gall's achievement may be seen in the light that, his provocation did lead the way to an intensive search in the direction of seeing ones head, and being able to deduce anything that might explain an abnormality in brain function. We do of course, know today, that intrinsic as well as extrinsic factors, that might influence how our brain may form, may function well, or malfunction. Examples are such factors as malformations of the brain that may lead to blockage of the fluid-circulation that would in turn lead to excessive growth of the head, even prior to delivery. Excessive pressure may develop in the cranium, with deleterious consequences. Infections such as bacterial meningitis or viral infections, (German measles), might lead to stunted brain function, with or without hydrocephus, (fluid collection, and excessive head-size-increase). A brain tumor would exhibit similar characteristics. Luckily, investigations that could be added to our naked eye, and or manual investigations, i.e. X-rays, CAT-Scan, or MRI could detect all pathologies, or abnormalities. Neurosurgical Technology makes it possible for situations to be corrected, as may be required, with good results, and prognosis. It has taken two centuries to reach where Neuroscience is since Franz Joseph Gall. The co-operation has been between us Medici, and men from the Technical World. We need to continue on the same path, and work even harder together.