CHAP. XXIX.] SPEECH AND THOUGHT. 655 



of comprehending signs, and an inability to Will and 

 execute even the simplest motor acts. 



M. C , set. 24, had suffered much mental distress owing to the 

 recent death of one of her children. On October 3rd she had a fit 

 for the first time, whilst in the street, but was able to walk home, 

 and during the two days which intervened before her admission 

 into University College Hospital she had twelve other epileptiform 

 attacks. 



Soon after her admission, she had another series of convulsions, 

 affecting both sides of the body, though principally the right. 

 During the intervals between the separate attacks, it was found 

 that her face was partially paralysed on the right side, the right 

 arm was completely paralysed, and the leg to a less extent. She had 

 six series of these convulsive attacks in the three days following 

 her admission, and during this time remained in a dull, lethargic 

 state. On October 13th she gradually began to regain a certain 

 amount of intelligence in look and manner. 



On the 19th, her attention could be at once arrested ; she made 

 decided efforts to speak after questions, and was able to say ' yes ' 

 and 'no' indistinctly, though not appropriately. When told to 

 show her tongue she merely opened her mouth, not attempting to 

 protrude the organ. Was able to swallow without difficulty, and 

 took food eagerly. On the 26th, seemed still more intelligent. 

 Did not protrude the tongue when told, but opened her mouth 

 and took hold of the tip with her fingers, with the view of bringing 

 it forwards. Although unable to move it by an unaided volitional 

 stimulus, on a sweet lozenge being applied to her lips she imme- 

 diately put out her tongue ivith great readiness, and whilst eating 

 it laughed and seemed much pleased. On the 28th, looked much 

 brighter, and took notice of what passed around her. Made signs 

 when she wished to attract the attention of the nurse. When asked 

 if she had pain in the head, she nodded assent; but did not move 

 her hand when told to place it upon the painful part, or else 

 moved it in quite a different direction. Paralysis of limbs and 

 face continued much the same. 



About ten days afterwards I examined her again carefully. She had 

 continued to improve in the meantime, and could now say 'Nurse' 

 distinctly, in addition to ' Yes ' and ' No.' She could not repeat 

 the simplest vowel sounds, neither could she read single words in 

 large print, either aloud or to herself, so as to comprehend them. 



