Literaty Notices. xiii 



paresthesia was present in seven out of nine. Attention is always im 

 paired and curiosity is diminished. Sensory aura is frequent. Indiffer- 

 ence in affections and suspicion are frequent. The intellectual pow- 

 ers are characterized as sluggish rather than perverted. Volition 

 especially is impaired and loss of inhibition is evidenced, but typical 

 dementia is not reached. In those cases where thyroid treatment was 

 resorted to the cure was affected though the fact was brought out that 

 the effects of the long-standing malady may long remain latent even 

 after all apparent signs have disappeared. Caution is necessary in 

 the use of the remedy. 



The cortex of a myxcedematous patient was examined. Since 

 the person was sixty years old it remains doubtful whether the slight 

 thickening of the pia, increase in spider cells, pigmentary degenera- 

 tion of cortical cells, increased fibrilation of the neuroglia, increase 

 of nuclei in the walls of the vessels, and other points reported are 

 not results of senile change. 



The article closes with the hypothesis that the neuroglia of the 

 cortex becomes to a slight degree water-logged [sic] by mucin, which 

 causes lowered anabolism and katabolism of the cells, whose reactive- 

 ness is thereby impaired. 



A Complicated Case of Aphasia. 1 



Patient, 66 years old, slightly demented, after apoplectic stroke 

 acquired complete right hemiplegia speech disturbance, hemianopsia. 

 After five months dementia well-marked, temperature sense and sense 

 of position and muscular sense absent on the right side. Later the 

 power to distinguish colors was lost and the right knee reflex was 

 greatly exaggerated. Autopsy revealed a softening of the central 

 convolution and part of insula (i cm. long) and similar amount of the 

 operculum and temporal lobes. The supra-marginal and both the ad- 

 jacent parietal convolutions were involved. The entire orbital aspect 

 of the frontal lobes markedly atrophied. Blood vessels at the base 

 atheromatous. 



Sections showed atrophy of the cortex especially marked over the 

 superior temporal convolution. A small focus of softening was found 

 in the cerebellar vermis. Diffuse atrophy of the callosum, total de- 

 generation of the left internal capsule, partial degeneration of the left 

 optic tract, almost complete cellular obliteration in the external genic- 

 ulate body and a degeneration of the right lateral pyramid complete the 



^leuler. Archiv f. Psychiatrie u. Nervenk., XXV, 1893. 



