CHAP. XXIX.] SPEECH AND THOUGHT, 633 



did not squeeze my hand on repeated requests, but went on shak- 

 ing it and smiling ; put out his tongue repeatedly when told to close 

 his eyes, but instantly imitated the act after Dr. Felce. It was 

 doubtful how far lie recognized the state of his speech ; he went on 

 chattering as if he tliouylit lie was understood, but he also made 

 signs .... He remained in much the same state till his death, 

 about Christmas ; once startling some friends in conversation at 

 his bedside by exclaiming ' Exactly ' at a very appropriate moment, 

 but not otherwise regaining speech." 



In this case, whilst the damage to the left Visual Word- 

 Centre was probably even greater than that recorded by 

 Dr. Banks, the left Auditory Word-Centre seems to have 

 been equally damaged, as was shown by the patient being 

 unable to articulate distinct words, combined with his 

 seeming inability to understand spoken language.* In 

 another case, recorded by Dr. Broadbent, there was the 

 same inability to understand what was said, although this 

 patient was accustomed to speak not in mere inarticulate 

 gibberish, but in distinct though irrelevant words. f Here, 

 however, it is said that after the fit by which the lady's ill- 

 ness was initiated, " her naturally cheerful expression was 

 exchanged for a dull stolid look, and she took no notice 

 of anything." There was evidently a condition of par- 

 tial dementia ; but in a case very briefly recorded by 

 Trousseau, in which there was a similar irrelevant use 

 of words whose meaning was not realized by the 

 speaker, the patient is said to have been in other respects 



* As the right Hemisphere was open for the reception of auditory 

 impressions, it seems strange that Speech should not have been 

 comprehended better in this case. Correct and incorrect auditory 

 impressions, simultaneously impinging on the two sides of the 

 Brain, might, however, produce so much mental confusion as to 

 prevent the correct impression being realised. 



f A similar inability to understand what was said by himself 

 occurred in a patient, whose case is referred to by Winslow (" Ob- 

 scure Diseases of the Brain," 3rd. Ed., p. 328). 



