354: NERVOUS SYSTEM. 



by A. Flint, H. B. Wilbur, E. C. Seguin, and others, in 

 this country. According to recent observers, the most fre- 

 quent lesion in aphasia is in the parts supplied by the left 

 middle cerebral artery, particularly the lobe of the insula, 

 or the island of Reil ; and it is a curious fact that this part is 

 found only in man and monkeys, being in the latter very 

 slightly developed. While we must agree with Dr. Ham- 

 mond in the statement that the organ of language cannot 

 be absolutely restricted to these parts, it is none the less 

 certain that they are most frequently the seat of lesion in 

 aphasia. 



As illustrating the loss of the faculty of speech without 

 any marked impairment of the intellectual faculties, we can 

 cite numerous cases recorded by Dr. Hammond. A woman 

 is described as presenting a countenance remarkably bright 

 and cheerful, her whole expression being exceedingly intelli- 

 gent. " She comprehends every word that is said to her, 

 and attends to all her household duties. Yet she is unable 

 to utter any words but ' no,' ' yes,' and ( dado.' " l Other 

 cases are given, in which the intellect seemed to be clear, but 

 in some, the faculty of speech was lost, and in others, both 

 the faculty of speech and of writing. One case reported by 

 Dr. Hammond is so striking that we give it in full : 



" The patient was a retired officer of the army, and con- 

 sulted me in the autumn of 1869 for paralysis, vertigo, and 

 slight difficulty of speaking, from which he had suffered for 

 some months. Several years previously he had been under 

 the care of my friend Dr. Metcalfe, for acute rheumatism, 

 with cardiac complications. The history of the case pointed 

 strongly to embolism, and, as the paralysis affected the right 

 side, I diagnosticated a previous attack of embolism of the 

 left middle cerebral artery. 



" The difficulty of speech was slight ; there were both 

 amnesic and ataxic aphasia. 



" Under the treatment employed he improved very much 

 1 Op. tit., p. 210. 



