232 CEREBRAL LOCALIZATION 



The majority even of the nineteen cases allowed 

 by these writers they consider to be inconclusive 

 for various reasons. 



Two cases of Burckhart's are of sufficient surgical 

 interest to be worth quoting. In the first, he removed 

 5 grams of grey matter from the foot of the first and 

 second left temporal gyri, but no word-deafness 

 resulted. Eight months later he resected the cap 

 and foot of the left third frontal gyrus (Broca's 

 convolution), but no aphasia followed. In the second 

 case he resected, in several operations, the left 

 supramarginal, temporal, and third frontal gyri, 

 but he failed to induce any speech defect. The 

 patients were demented, with verbal delusions and 

 logorrhoea. 



Marie maintains further that all patients with 

 aphasia are mentally deficient ; thus, the cook can 

 no longer compound an omelette, and the pianist 

 can no longer play the piano. He locates all the 

 speech functions diffusely in the left temporo- 

 parietal region, maintaining that this is merely a 

 region of intelUgence specialized for language, and 

 not a storehouse of sensory images ; a mild lesion 

 destroys the function last acquired, viz., reading, 

 and a severer lesion produces loss of voluntary 

 speech and of recognition of spoken language as well. 

 What Marie calls " anarthria " — a word previously 

 used in another sense — meaning loss of the power to 

 utter speech, although the individual can say the 

 words over to himself, is due to a lesion in " the 

 quadrilateral," bounded in front and behind by the 

 anterior and posterior limiting sulci of the island of 



