of the white substance in the immediate neighbourhood of the third frontal convolution of the left anterior lobe, great stress being laid on the fact that the convolution itself was in nowise affected.*

Professor Béhier, in a clinical lecture recently delivered at the Hôtel Dieu, mentioned the case of a woman who was admitted into one of his wards with right hemiplegia, the result of cerebral hæmorrhage; and in whom, one of the first symptoms following the effusion was aphasia, which assumed in her case a very exceptional form. This woman was born in Italy, and had resided both in Spain and France; of the three languages she had thus acquired, she had completely forgotten the Italian and Spanish, and had only retained a most limited use of French, in which language she only repeated as an echo the words pronounced in her presence, without, however, attaching any meaning to them.

In reference to the question of localisation, M. Béhier stated, that after analysing the cases observed during the last few years, as well as those recorded by Abercrombie, Rochoux, Lallemand, and Andral, he had collected 122 observations opposed to the theories of M. M. Bouillaud, Dax, and Broca; in 82 instances, lesion of the anterior lobes had been observed without aphasia, and in 34 cases, aphasia coincided with disease in other parts of the brain.†

The next three cases I have to mention are instances of the lesion of the third frontal convolution without aphasia; but as the lesion was on the right side, they * Gazette des Hôpitaux, May 16, 1867. Ibid., March 20th, 1869.

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may be adduced as negative proofs of the truth of M. Broca's theory.

M. Fernet has recorded a case of left hemiplegia without aphasia in a female aged 36, and at whose autopsy, the entire frontal lobe of the right hemisphere was found broken down by softening. In the 'Gazette Hebdomadaire' for July, 1863, M. Parrot relates a case of complete atrophy of the island of Reil and of the third frontal convolution on the right side, with preservation of the intelligence and of the faculty of articulate language. M. Charcot has recorded the case of a woman, 77 years of age, who had left hemiplegia without embarrassment of speech, or loss of the memory of words, and at whose autopsy there was found yellow softening of the surface of the right frontal lobe, the second and third frontal convolutions being completely destroyed, and there being no lesion of the central parts of the brain.

I need scarcely remark that cases like the three just mentioned, of lesion on the right side without aphasia are quite as valuable in a statistical point of view, and tend as much to settle the quæstio vexata, as cases where the converse condition exists, viz., lesion on the left side with aphasia.

I now arrive at a class of cases which have a directly opposite pathological signification to those above mentioned, the six following observations being all calculated to invalidate the recent theories as to the seat of articulate language.

M. Peter relates the case of a man who fractured his skull by a fall from a horse. After recovery from the initial stupor there succeeded a remarkable loquacity,

although after death it was found that the two frontal lobes of the brain were reduced to a pulp (réduits en bouillie).

In Trousseau's 'Clinique Médicale,' the following case is recorded:-In the year 1825, two officers quartered at Tours quarrelled, and satisfied their honour by a duel, as a result of which one of them received. a ball which entered at one temple and made its exit at the other. The patient survived six months without any sign of paralysis or of lesion of articulation, nor was there the least hesitation in the expression of his thoughts till the supervention of inflammation of the central substance which occurred shortly before his death, when it was ascertained that the ball had traversed the two frontal lobes at their centre.

M. Charcot, who has collected a number of observations more or less corroborative of M. Broca's assertions, has however recorded the case of a woman, aged 47, who from a fit of apoplexy suddenly became hemiplegic on the right side and aphasic. Her intelligence was unaffected, and memory reported as good, but her articulate language was reduced to the monosyllable "Ta," which she was in the habit of repeating several times over ("Ta, ta, ta, ta "), very rapidly and very distinctly, every time she tried to answer any question or to communicate her own ideas; the tongue was perfectly free, and could be moved in every direction. After death it was found that softening had destroyed the first and second convolutions of the temporosphenoidal lobe, the island of Reil, the extra-ventricular nucleus of the corpus striatum, and the intra-ventricular nucleus in its posterior half, the optic thalamas being intact; the frontal convolutions presented no alteration

either in volume, colour, or consistence, the examination being conducted with the greatest care, and even in the presence of M. Broca, who frankly admitted this case to be at variance with his hypothesis.*

A woman, aged 73, was admitted into the Salpêtrière under M. Vulpian, her only symptom being loss of the power of speech, there was no paralysis of limbs, and M. Vulpian looked upon this patient as a type of aphasia. After a few days she became hemiplegic on the right side, and died of pneumonia five weeks after admission. At the autopsy softening was observed to a considerable extent in the posterior half of the supraventricular white matter of the left hemisphere, there being not the slightest indication of any lesion of the frontal or other convolutions; there was, however, obstruction of the left middle cerebral artery, caused partly by atheromatous thickening of the walls and partly by a fibrinous deposit evidently of a recent date, the result rather of a thrombosis than of an embolism.

A man, aged 42, was admitted into the Hôtel Dieu, under the care of M. Trousseau, on 25th March, 1865. The sister of the ward, deeming him to be in extreme danger, began to exhort him to think about his last moments, when she received for an answer, "N'y a pas de danger." Soon afterwards the dresser arrived, and to his first question the patient replied, "N'y a pas de danger." Second question, same answer. It was evident that the man was aphasic, and the discovery that there was paralysis of the right side of the body confirmed the diagnosis. There was marked rigidity of the right upper extremity, the forearm being Broca, op. cit., p. 6.

strongly flexed upon the arm; the tongue was protruded straight, and was freely moveable; the right half of the face was paralysed, but the orbicularis palpebrarum was unaffected. Some weeks after admission he seems to have forgotten his old formula, for to every question he answered, "Tout de même." Tout de même." Death occurred after hospital, when the

four months' residence in the necropsy gave the following results. Almost the entire left hemisphere was converted into a vast cavity, having the appearance of a true cyst, the walls of which were formed above by a very thin layer of cerebral matter flattened and even softened, and which was adherent to the much-thickened pia mater; in front and behind, all the remaining cerebral substance was yellowish and much softened. The orbital convolutions, the island of Reil, and the first and second frontal convolutions were in a perfectly normal condition; the third frontal convolution was pronounced healthy in that portion (the posterior third or half) which bordered the fissure of Sylvius and the furrow of Rolando, but it was evidently softened and almost destroyed in its upper part, where it was included in the general softening of the hemisphere, which also involved the corpus striatum and the thalamus opticus; the middle cerebral artery was not obliterated. This examination was made in the presence of Professors Trousseau and Guillot, and whilst showing the care with which this subject is being investigated by the French faculty, it possesses an additional interest from the fact that when the autopsy was completely finished and the brain mutilated by the successive slices that had been made, M. Broca arrived, and declared that the postero-external part of the third frontal convolution was yellow and softened, and that