THE ASSOCIATION CENTERS OF FLECHSIG 669 



all sense of his actual relations to the world, imagining himself possessed of 

 great wealth, or the recipient of high honors; sometimes he confuses per- 

 ceptions of external objects with the inner consciousness of his own person, 

 or vice versa, his consciousness of himself with impressions of the outer world, 

 so that he either forgets that he exists or takes no notice of his surroundings. 

 There need be no confusion of ideas in the strict sense of the term. He may 

 speak rationally and in a perfectly orderly way about various subjects within 

 his mental grasp, but he is unable to distinguish between the true and the 

 false, the imaginary and the real, the possible and the impossible ; and along 

 with this defect of the logical sense there goes a loss of the ethical and esthetic 

 judgments, so that he does things which are utterly irreconcilable with his 

 former character. The patient thus loses his composure, and this to a greater 

 degree the more he is actuated by strong feeling or is under the influence of 

 passion. When once he becomes angered, a fit of rage comes over him like an 

 avalanche. A stage is finally reached where all self-control is lost and he is 

 ruled in everything merely by the logic of madness. Whatever is uppermost 

 in his mind he does without regard to his surroundings or to good taste. At 

 last imbecility sets in and the personality is lost entirely. 



C. THE POSTERIOR ASSOCIATION CENTER 



Goltz observed the following effects of removing the occipital lobes from 

 dogs. The tactile sense was undisturbed, the animal was not merely able to 

 move all the muscles of his body voluntarily, but could perform all kinds of 

 movements with almost as much facility as a normal animal. He had no trouble 

 in eating and could hold a bone between the paws, etc. 



If the animal were vicious before the operation, removal of the occipital 

 lobes made him docile. Nothing then served to excite him ; he was always calm 

 and deliberate. But his perceptive faculties suffered considerable diminution 

 and his intelligence sank to a low level. 



In man lesions within the posterior association center have been observed 

 to produce alexia (cf. page 663), and a more or less distinctive loss of the 

 power to interpret visual impressions of other kinds. All such disorders, 

 whatever their extent, are included under the term " mind blindness " given 

 by H. Munk. 



Typical mind blindness in man is characterized by v. Monakow in the fol- 

 lowing manner: The person affected has impressions and sensations of light but 

 can no longer recognize the objects of his surroundings. This is not because 

 his memory pictures of the objects are gone, but because the associations neces- 

 sary for understanding them are no longer possible, that is, the memory pic- 

 tures cannot be called up by the retinal stimulus, although they may be aroused 

 by another sense, or quite spontaneously. Among other things a person can tell 

 one color from another but cannot find the right names for the colors. He 

 cannot tell just the quality of the color of the sky, or of leaves, or of blood, etc. 



While the memory for many different forms of visual impressions may be 

 just as good as ever, it appears as a rule to be considerably impaired for recent 

 impressions. Such patients are unable to describe the forms of objects pre- 

 sented to them just a moment before, while they have a perfectly clear picture 

 of objects with which they are familiar, such as a knife or a watch, and can 



