INFRACORTICAL MOTOR APHASIA.—A pure motor aphasia without word-blind ness or word-deafness is likely to be of infraeortical origin. Cases, however, have been reported in which an infra cortical lesion has caused aphasia, word blindness, and word-deafness.
Etiology. — The various varieties of aphasia occur almost always as a mani festation of cerebral lesion. The most common factor is softening; next in frequency are cerebral tumors and, es pecially, syphilitic lesions (Fournier), cerebral hemorrhage, traumatisms, and in en ingo-en c ephalitis.
Aphasia may present itself during enteric fever, small-pox, and puerperal fever. Transient aphasia — following epileptic or hysterical convulsions, mi graine, or concussion of the brain—has been occasionally observed, and certain degrees of the affection may be tempo rarily present and even recurrent in states of profound anemia of the cen brunt Case of mixed aphasia with right hemi plegia due to meningo-encephalitis from cysticercus, affecting principally the an terior extremity of the sphenoidal lobe. Bitot (Jour. de Med. de Bordeaux, Dec. 15, '89).
Two cases dependent upon tubercular meningitis. Picot (Gaz. bleb. des Sci. MCl. de Bordeaux, Mar. 16, Apr. 13, 27, May 11, '90).
Case of mixed motor and sensory aphasia consequent on influenza. Re covery after several weeks. T. D. Poole (Edinburgh Med. Jour., Aug., '90).
Case of motor aphasia with graphia and dyslexia in conjunction with attacks of petit mt. Eye-strain. Improvement from properly adjusted glasses. Much leek (Univ. Med. Mag., June, '91).
Case with right facial paralysis and right Jacksonian epilepsy due to injury over base of right parietal. Recovery in few weeks. Symptoms supposed to be due to contusion of left centres, from counter-stroke. Ransohoff (Cincinnati Lancet-Clinic, Apr. 16, '92).
Case in girl, aged 10, due to embolism. Suckling (Brit. Med. Jour., May 21, '92).
Four cases occurring during puerperal period, sixteen from literature; some times hysterical; in others, urwmic. In nearly one-half of the eases aphasia is associated with right hemiplegia and due to embolism or thrombosis. Having oc
curred in ene pregnancy, it is liable to occur in the next, and usually appears about one week after delivery. Cowe (Archives c:e Taco]. et de Gyn., vol. xx, No. 7, '94).
Several cases of ataxic aphasia during pneumonia. In every ease there was pa resis and weakness of the right face and right arm. Cause supposed to be pneu mococcus toxins. Chantemesse (Med. Record, Feb. 3, '95).
Case occurring as result of wound in left side of skull 9 centimetres from hori zontal circumference, passing by superior border of auditory meatus and supra orbital margins, 7 centimetres from sagittal suture perpendicularly, 1 centimetres in front of left auditory canal. Spherical fragment separated and pressed down 1 centimetre into the wound. As soon as removed, speech be came normal. Dorrenberg (Berliner klin. Woch., No. 1S, '93).
Case of a woman, aged 20 years, who was infected, after her marriage, with gonorrhma, and who was attacked with severe convulsive movements in the right side of the face and tongue and in the right forearm. The following morning there were present right herniplegia and complete motor aphasia. Sensitiveness was preserved. The hemiplegia persisted and typical contracture occurring, but the paralysis of the facial and pharyngeal muscles improved. The aphasia im proved slowly. After six months it was found that understanding of words was completely restored, that both writing and print could be read, only some mutilation of words remained after a cer tain time. Repetition of words was per fect. The left band could be used to write grammatically with good orthog raphy. Since the patient suffered from salpingitis due to gonorrhma, the troubles described are undoubtedly due to a thrombosis. L. Bruns (Schmidt's Jahr bucher, B. 250, p. 236, '96).
In polyglottic patients suffering from aphasia the disturbances in speech do not always affect to the same degree all the languages spoken by the patients.