APHASIA. 105 



APHASIA. 



By aphasia is meant loss or impairment of the faculty of language. It is quite 

 a different thing from an affection of the voice. It is a brain disease, and there is 

 nothing wrong with the throat, or larynx. Sometimes there is a loss only of the 

 f acuity of articulate language, but more frequently there is likewise an inability to 

 express the thoughts by writing or by gestures. There is loss, not only of the 

 memory of words, but also of those acts by which these words are articulated. 



This curious condition is a form of paralysis, and is not unfrequently the result 

 of a " stroke." It is very generally associated with some other form of paralysis, 

 and more especially with loss of power in the right arm and leg. The faculty of 

 language is supposed to be situated exclusively in the left half of the brain, and it is 

 well known that injury or disease of one side of the brain results in paralysis of the 

 opposite side of the body. This readily accounts for the frequent association of 

 aphasia with paralysis of the right side, for they would both be caused by some 

 affection of the left half of the brain. 



A patient who is suffering from aphasia, or who, as we say, is aphasic, may 

 present several different manifestations of his complaint. He may be altogether 

 wordless, or may utter inarticulate sounds, or mere unmeaning gabble. He may 

 use to express all his wishes only one or two familiar words, such as " yes " or " no," 

 or perhaps both of them. For example a young lady who became aphasic could for 

 a long time say nothing but " oh, no," " papa," and " Bob." The case, too, is related 

 of a young man, twenty-five years of age, who was attacked with aphasia and 

 paralysis of the right side. In time some power of moving the right leg, and then 

 the right arm returned, but he could articulate only two words, "no" and 

 "mamma." "What is your name?" "Mamma;" "What is your age?" 

 " Mamma, no." He was unable to say anything else, but yet was perfectly aware 

 that his reply was incorrect. Sometimes all the aphasic patient can do is to utter 

 some word or sound that has no intelligible meaning. Sometimes he has an almost 

 unlimited flow of words, and yet may be unable to use them to express his desires 

 or wishes. The mother-in-law of a medical man had an attack of aphasia. When- 

 ever a visitor entered her room she rose from her chair with an amiable look, and, 

 pointing to a seat, exclaimed, " Pig animal, stupid fool." She did not in the least 

 understand the meaning of these insulting expressions, and her son-in-law had to 

 explain her wishes. 



The patient often substitutes one word for another in a manner which would be 

 intensely amusing were it not for the knowledge that it is the result of brain disease. 

 Sometimes he uses instead of the right word some other that somewhat resembles it 

 in sound; thus, for example, he may say "pamphlet" for "camphor," "dispersion" 

 for " dispensary," and so on. Sometimes he substitutes some word which has aia 

 obvious connection or association with that he wishes to express, as " breakfast " for 

 " supper," or " toast " for " hot." He may invert the whole of a word, and say " mug " 

 for " gum," for example ; or may roughly invert certain syllables, like the man who 

 always said "gippin" for "pigeon." It has been remarked that, curiously enough, 

 it is only individual words that are misplaced, or mispronounced, and that the 



