Evening star. [volume] (Washington, D.C.) 1854-1972, 1891-02-28
PHASES OF A QUEER DISEASE.
Grotesque Effects Produced In Patients
Afflicted With Aph,sia.

VI ianBuase OF its EXPRESSION, independent OF
paralysis Of the tongue. 1t ia commonly de-
scribed as Of two varieties-the sensory or ann
nesic form, in which the memory Of words or
| symbols is more or less efaced, and the motor
or ataxic form, in which the memory is per-
feet, but the subject cannot properly pro-
nounce words from inability to perfectly
coordinate the muscles concerned in articula-
| ton. In tho amnesic variety the most famil-
lar objects are commonly misnamed and q
great peculiarly 10 that the subject 10 often
aware that the error bso been committed, but
! Is not able to correct it.
Some patients forget only names: others for
get numbers. In certain reported cases the
| names of things only in dead or foreign Ian
guagcs were retained in others the reverse had
oeen observed the patient losing all knowledge
OF acquired tongues. The sound Of words often
VIII not be recognized when the letters which
form them will. and the reverse Of this con-
dition is not infrequently met with in aphasic
patients.
In the ata1ic variety Of aphasia the patient
can usually write what cannot be spoken, thus
proving that the memory of words seen or
heard ia not effaced but rather the ability to SO
coordinate the muscles of speech as to properly
pronounce the words Several cases have been
| found where the amnesic form gave place to the
ataxic.
An explanation Of the general causes Of this
technical terms. which would be Incompetent
slble to the lay mind. 1t is sufficient TO say
| that Investigators have concluded that aphasia
is consequent upon LESSONS Of those certain
areas Of the brain wherein are conferred the
power for the normal exercise Of the functions
affected. The different phases or varieties of
the disease indicate the parts affected. The
most interesting facts in connection with the
cortical cells of the brain have been demon
| strnted during the investigation Of aphasia.
Drnf har anfr tod rhar
tieman could read by tracing the lines with his
finger when lesion of the brain had deprived
him OF his ability to recognize written
printed characters by sight. He could write
with ease, but could read what he had written
only by retracing the lines. Paraphrasia is
the substitution of wrong words or symbols in
conversation or writing. The remarkable fact
IL that the patient is conscious of his error.
but cannot correct it. Nouns are more fire.
quently lost than verbs. Patients of this sort
often exercise great ingenuity in avoiding
during conversation or writing the words they
fail to properly recall. By means of oddly
constructed sentences they often hide this de-
feet in speech from strangers. In true
motor aphasia patients cannot articulate
correctly. fact OF which they are painfully
conscious. and they often remain mute rather
than subject themselves to ridicule or criti-
clsm. The ludlcrous part Of this phase of the
disease Is that In case certain words or phrases
are retained or regained after the attach these
automatic way BY the patient in reply to any
question asked. These phrases words are, of
course, in the majority of cases absurdly irrele-
want to the question asked. DIR. Ranney in his
work already quoted, cites a case reported by
Hammond where patient would reply ''hell to
pay under all circumstances Another pa
tents unvaryiug reply was, Il want protec-
lion" and a third would say nothing but ''um-
brella, umbrella"
That condition in which from cerebral dis
"a oil thxa q =,
suddenly or gradually lost is called agraphia
The explanation of this condition rests in the
fact that the patient has lost certain memories
which previously enabled him to make the neces-
sary finger movements for placing upon paper
results obtained by his mental processes This
is certainly to the lay mind most remarkable
condition Of affairs. 1t well illustrates the di-
rectiOn of the muscles from the brain. for the
directing force being absent the muscles cannot
act
An agraphia patient cannot write from dicta-
ton or copy from a printed slip, though he is
not paral wed or affected with writer's cramp,
and though he can perform all other move
ments of the fingers not connected with the
writing of letters or figures with his accus-
toned deiicacy. The memory alone is at fault.
In some instances delicate finger movements
required in the mechanical trades or the use of
musical instruments have been known to be
suddenly taken away by q similar loss of motor
memories. Such cases are not included under
the term agraphia.
sword deafness and WORD blindness are
forms of sensory aphasa due TO LESSONS of diff
| ferent portions Of the brain. The word deaf
ness results from q lesion Of the first temporal
convolution. Patients suffering from it cannot
be made to understand spoken language, be-
cause their cen ters of hearing have been i'm
paired. 1t must be understood, however that
they are not deaf to sound. They can hear a
word spoken, but cannot tell what il means,
because they cannot appreciate the value of
tnfx fla b..
telligi3le to them as an unknown foreign Ian
Suage. This condition prevents the patient
from speaking correctly because of his inabil-
ity to recall the proper sound of many words
previously employed by him. His efforts to
read aloud will result in his utterance of q most
ludicrous iergon of unintelligible sounds. The
patient, however, will proceed solemnly with
his reading, not being aware that his utterances
are unnatural or inexpensive OF the ideas he
| wishes to convey. The following case is quoted
from the books:
One such person was asked to read aloud the
sentence: "You may receive a report from
other sources of supposed attack on a
British consul general. The affair is, however,
unworthy OF consideration" The patient
proceeded to read seriously and steadily as
directed, and As nearly as could be taken this
is what he said:
80 sur wisjee coy vehement apripsy fro
freny tenement WY seconce cos foz no So
phias the freckled pothy conollied. This at
ldlT en- Oh CONT on curly OF consequences.
This patient could not write to dictation,
though he could sign his name we'll and COPY
| accurately. As he made each letter. however
| he would attempt to name it aloud, but always
pronounced some other letter.
Word blindness is due to lesion of the visual
centers in the occipital lobes. 1t is accom-
panied by Q loss Of memory of the meaning of
printed or written symbols. Patients afflicted
with it can recognize familiar faces but thew
cannot read correctly. They cannot properly
read given selection. They can often write
from dictation, but cannot read what they
have written. Unless word deafness" is also
present their conversational powers are not
impaired. One patient, whose case is cited by
DIR. Ranney, when asked to read, would make
the most elaborate preparations putting on
his spectacles and taking some time adjust
ing himself comfortably. Then he would read
aloud, saying things that had not the remOtest
connection with anything in the print before
him. He was asked to read the following note:
DEAR SIR: 1 shall be much obliged if you will
let me know whether or not you consider it
likely that A. B. will recover.
He looked at it very carefully and then SLOWLY.
deliberately and without much hesitation he
read
DEAR Sra: You are requested to bring this
| note with you to the infr:nary.''
Then he said: That is what ] make of it. I
don't know whether it is right or not"
This same patient often tried to read news
paper aloud and his wife said that he read q
| lot OF stuff all made out Of his own head On
one occasion she took the paper and read it to
him. He was quiet for time and then asked:
| "Is that what it says in that paper?" Being
| assured that his wife had read correctly, be
| said: well, then, must be an IDIOT