ON THE FUNCTIONS OF THE CEREBRUM 333 



Further, and this is the most important part of the doctrine, 

 Marie urges that in true aphasia intellectual impairment is 

 invariably present. " C'est qu'il y a chez les aphasiques 

 quelque chose de bien plus important et de bien plus grave 

 que la perte du sens des mots; il y a une diminution Ms 

 marquSe dans la capacity intellectuelle en general." He considers 

 that the notion of intellectual impairment should dominate the 

 doctrine of aphasia. 



He affirms that in all cases of the aphasias both of Broca and 

 of Wernicke there is a greater or lesser amount of difficulty in 

 the understanding of spoken language, and that evidence of definite 

 diminution of the intellectual powers can invariably be obtained 

 if the patients are properly studied. For this purpose he gives 

 his subjects complicated instructions. Instead, for example, of 

 telling the patient to cough, spit, put out his tongue, or shut his 

 eyes, he gives certain instructions of which the following two are 

 very commonly employed. " Of three pieces of paper of unequal 

 size which are placed on this table, you will give me the largest, 

 you will crumple up the medium one and throw it on the ground, 

 as to the least you will put it in your pocket." ..." You will 

 stand up, you will go and tap three times on the window with your 

 finger, then you will return before this table, you will walk round 

 your chair, and you will sit down." He points out that, on 

 superficial observation, aphasics may appear to possess normal 

 intelligence, but that careful investigation readily enables their 

 defective mental powers to be determined. He gives, as an 

 illustration, a description of the blunders made by an aphasic who, 

 prior to the onset of his infirmity, had been a really good cook, 

 when he was provided with the necessary ingredients and instructed 

 to prepare an " ceuf sur le plat " or fried egg. His account of the 

 incident is as follows : 



" Un de mes malades, atteint depuis des annees d'une aphasie 

 d'intensite moyenne qui ne I'empe'che d'ailleurs pas de se meler a 

 la vie commune, est un cuisinier, un bon cuisinier qui, sans aucun 

 doute, savait bien son metier. Je lui demandai un jour de me 

 faire un ' ceuf sur le plat.' Nous nous rendimes done tous a la 

 cuisine, avec la surveillante qui devait remplir les fonctions 

 d'expert. La, devant le fourneau, on remit au malade les in- 

 gredients necessaires : un plat, un ceuf, du beurre, du poivre et du 

 sel et on 1'engagea a exercer ses talents. Get homme hesite un 



