CONTENTS.

PART I.

Bibliography. Hippocrates; Sauvages. Description of the dis-

position and arrangement of the cerebral convolutions.

Writers of the French School-Bouillaud; Andral; Drs. M.

and G. Dax; Professor Broca, his ne plus ultra of pathologi-

cal topography, summary of his two primitive and typical

cases; Jules Falret; Trousseau. The celebrated discussion

at the Academy of Medicine of Paris; case of M. Velpeau's

barber; divers observations from the French press.

statistics of tumours of the brain, opposed to the localisation

of speech in the anterior lobes

Ladame's

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1

PART II.

-

Pibliography continued. Schroeder van der Kolk. German

writers — Romberg; Bergmann; Hasbach; Nasse; Von

Benedikt and Braunwart. English, Scotch, Irish, and

American contributions to the literature of Aphasia

PART III.

Author's own clinical experience-Volumetric Analysis of the
urine in cerebral disease. Aphasia of the ataxic form, occurr-
ing as the earliest indication of disease; curious chain of
morbid symptoms, eventually merging into general paralysis.
Question of the testamentary capacity of aphasics-M. Legrand
du Saulle. Three cases of aphasia in which the autopsy re-
vealed a healthy condition of the frontal convolutions. Im-
portance of examining the condition of the bones of the skull,
in the autopsies of patients who during life had exhibited
symptoms of impaired speech. Loss of Speech with Para-
plegia; Spinal Symptoms. Ataxic Aphasia as a Climacteric

23

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symptom. Case of Aphasia with left hemiplegia; fibrinous

deposits in the Spleen. Coincidence of left heiniplegia with

aphasia more common than generally supposed

PART IV.

Definition of Aphasia. What is Speech? There are several

kinds of language. The elementary form of language is

gesture. The conditions necessary for the development of

articulate language. Classification. The discussion on aphasia

at the British Association Meeting of 1868. Varieties, or

principal forms of impairment of speech met with by the

clinical observer-Defect limited to a particular language-

Vocabulary limited to a single phrase. Cases of Heterophasia.

Loss of Speech may be the sole morbid symptom; is commonly

associated with agraphia, or loss of the power of writing.

Language of signs, and of pantomimic expression generally

unaffected. Remarkable echo case; a human parrot. The

language of physiognomy. The interjectional expressions of

aphasics. Spasmodic mutism

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91

PART V.

Etiology of Aphasia-May be congenital; the loquelar defect in

Idiots; the deaf and dumb. Traumatic aphasia. Loss of

Speech from tumours of the encephalon; a remote symptom

of endo-pericarditis; a symptom of disease of the spinal cord ;

a nervous symptom; a complication of epilepsy, of neuralgia,

and of hysteria. The result of reflex action, of worms, of

atmospheric changes, and of the administration of certain

drugs. Septicemia. Loss of Speech from the bite of ven-

omous snakes.

Diagnosis-Importance of the volumetric analysis of the urine;

the Sphygmograph; the results of Thermometric observation.

Professor Broca's method of taking the temperature of the

brain. Prognosis. Treatment. Re-education of the nervous

centres.

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PART VI.

Summary of the whole question-Crude notions of the functions

of the brain possessed by the ancients. Gall; the value of his

researches; the cerebral localisation of our divers faculties

strikes no blow at the great principle of the moral unity of

man. The different theories as to the seat of speech con-
sidered, and weighed by the evidence contained in the pre-
ceding pages. Location of speech in the Olivary Bodies; in
the Anterior Lobes; in the third left Frontal Convolution.

Minute Anatomy of the Brain; comparative weight of the two

hemispheres. Structure of the cerebral convolutions.

Physiology-Ligature of the common carotid, its effect upon
speech. Aphasia with left-hemiplegia in left-handed people;
a left-handed family. Why is the human race right-handed?
Gratiolet's theory of the early development of the frontal
convolutions of the left hemisphere denied by Carl Vogt.

Comparative Anatomy-Is language the exclusive prerogative

of Man? Max Müller on Speech. Why Man speaks and the

Ape does not. M. Bouillaud's experiments on the brain of

animals. Affinities and differences between the brain of Man

and that of animals. The Hippocampus minor. Anthrop-

ology-Gratiolet's three divisions of the human species. Is

there a cerebral centre for speech at all? What do we under-

stand by the expression-Faculty of Speech? Dr. Richard-

son's experiments of freezing the cerebrum of animals. Action

of Chloroform on nerve tissue. There may be changes in

nerve tissue not patent to our present means of investigation.

Each brain cell a minute voltaic battery. Chemistry of the

Brain-Conclusion.

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14:

APHASIA,

OR

Loss of Speech,

AND

THE LOCALISATION OF THE FACULTY OF ARTICULATE LANGuage.

PART I.

APHASIA is the term which has recently been given. to the loss of the faculty of articulate language, the organs of phonation and of articulation, as well as the intelligence, being unimpaired. The pathology of this affection is at the present time the subject of much discussion in the scientific world; the French Academy devoted several of their séances during the year 1865 to its special elucidation, and the Medical Journals of France and of our own country have lately contained a good deal of original matter bearing upon this obscure feature in cerebral pathology.

In a short paper published in the "Lancet" for May 20, 1865, I drew attention to the existing state of our knowledge of the pathology of aphasia; since that period I have had occasion to make researches among various British and foreign authors, and having

B