CEREBRAL LOCALIZATION 229 



and present it to the physician." A patient of de 

 Buck's, asked to lift her right ann, crossed it over 

 her body, put it in her left axilla, and after making 

 various other vigorous but futile efforts, said plain- 

 tively, " Je comprends bien ce que vous voulez, 

 mais je ne parviens pas a le faire " : this just expresses 

 the condition. 



In some of the cases, there is imperfect recognition 

 of objects or of their uses (agnosia), but these are 

 compHcated and cannot be described here. 



It is an important fact that apraxia of the left 

 arm is common in right hemiplegics, whereas apraxia 

 of the right arm rarely occurs in left hemiplegics ; 

 moreover, in the cases where there are apraxia of the 

 left side and hemiplegia of the right, there is evidence 

 that the lesion is cortical, not in the internal capsule. 

 Thus Liepmann examined eighty-three hemiplegic 

 patients, with these results : — 



Forty-two had left hemiplegia ; they could nearly 

 all obey directions with the right arm. 



Forty-one had right hemiplegia ; of these 20 had 

 apraxia of the left arm, and 14 in this group also 

 had aphasia (therefore the lesion was cortical) ; 21 

 had no apraxia, and of these only 4 had aphasia (in 

 most of the other 17 cases the lesion was probably in 

 the internal capsule). 



Of course, as left-handed persons form one- 

 twentieth of the community, it is possible to find a 

 few cases of left hemiplegia with right apraxia. 



There is good ground, then, for believing that the 

 centres which consciously initiate voluntary move- 

 ments for both sides of the body are Hmited to the 



