296 NATURE STUDIES. 



Some physiologists assert that defective speech, the 

 next symptom which we have to deal with, has been 

 the first symptom noticed in cases of cerebral disorder. 

 Dr. Forbes Winslow says: "The first evidence of 

 approaching apoplexy and paralysis is occasionally 

 a sudden loss of speech." This may have been the 

 first symptom noticed, but we question very much 

 whether it has ever been the first symptom which has 

 existed. 



We ought to distinguish, perhaps here, between 

 defective speech and defective power of expression 

 (by words indicated otherwise than by actual articula- 

 tion). In fact, an important distinction exists even 

 between the loss of the power of articulation and the 

 affection of the vocal organs indicative of cerebral 

 disease. Here, however, we consider generally the 

 impairment of the power of linguistic expression 

 which usually precedes serious mental trouble, and is 

 often enough noticed where rest only or change of 

 diet is necessary as a remedy. Usually, however, this 

 symptom is serious. Indeed, one writer on the sub- 

 ject of cerebral disease remarks that it is a most 

 unusual circumstance for the symptom to exist with- 

 out being followed by acute cerebral mischief. Possibly 

 the remark refers only to the absolute loss, whether 

 for a short or long period, of the power of expressing 

 ideas by language, spoken or written. That the power 

 of expression may be effected, and even for a time 

 affected seriously, while nevertheless there is no 

 serious cerebral mischief, is within the experience cf 



