CHAP. XXIX.] SPEECH AND THOUGHT. 643 



order. He cannot name any coins, but seems to have some idea of 

 their relative value. He indicated on his fingers that sixpence was 

 worth six pennies not being able from sight to utter its name. 



On April 16, the patient had two slight fits, which, judging from 

 the symptoms, were apparently due to some further slight damage 

 to the left side of the brain. After neither of these fits did his 

 speech seem to be worse. The second, however* was followed by an 

 aggravation of the right-sided paralysis, though there was no further 

 impairment of sensibility. Three days afterwards this increase of 

 paralysis had passed off, and the patient was again able to walk 

 about the ward. 



Two weeks afterwards, it was noted that his speech was as bad as 

 ever; he could name any numeral written down and pointed out to 

 Mm, and he could also correctly add small columns of three or four 

 figures; but he altogether failed to name individual letters of the 

 alphabet, however plain or large the}' might be. He could recognize 

 common objects, such as a dog, a fowl, or a tree, in an engraving, 

 and point out any one of them when asked to do so. But he could 

 not volunteer the name even of the most familiar object to which 

 he pointed. 



May 8. Asked successively to name large, separate, printed 

 capitals 0, K, and G from sight, on each occasion he said ' P,' and 

 on D being pointed to, he called it ' M ' though he repeated the 

 name of each of these letters without a moment's hesitation after 

 hearing it pronounced. Although there is this inability to name let- 

 ters from sight, thepatient now seemsto understand simple sentences 

 written or printed; thus, when the sentence " Have you a wife ? " 

 was written on a slate, it seemed perfectly evident that he under- 

 stood the writing. His condition, however, in this respect seems to 

 vary from time to time. In the sentences, the meaning of which he 

 comprehends, he is still quite unable to pronounce the individual 

 words from sight, though after hearing them uttered he can articulate 

 them at once, more or less distinctly. 



Two days after, he was observed reading something in the news- 

 paper, and on being asked if he understood it (the report of a case 

 of poisoning in a police-court), he at once said he did, and unmis- 

 takeably indicated by his gestures that this was true. With his 

 left hand he could write his own name after a copy, but not 

 easily without, and sometimes not at all A less familiar word 

 he did not even attempt to write from the sound, even when it 

 had been distinctly heard and comprehended. 



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