SENSORY APHASTA.—Auditory Apha sia.—This variety is more rarely met with than motor aphasia. Both the re ception and production of audible speech are deficient, the leading symptoms be ing, on the receptive side, word-deafness and, on the productive side, word-am nesia and articulative amnesia.
Speech and separate words are dis tinctly heard by the subject, but no meaning is attached to them. Sounds, however,—such as that of an engine whistle, an alarm-clock, the hour,—are heard and recognized. Right hemiplegia and a certain amount of word-blindness are frequently present. Certain cases of auditory aphasia hear as if spoken to in a foreign tongue, but they cannot under stand what is said, although they en deavor to do so. Other patients under stand neither what is said to them nor what they themselves say, but can repeat words after another. They repeat like parrots (echolalia) what is said; but, if the centre of articulate voice is still par tially connected with the sensory centres of audition and the latter are normal, the repetition of the word may suddenly give rise, in their mind, to the idea conveyed by the word. Instead of articulate speech the phenomena may show themselves in connection with music or numbers. In subcortical word-deafness the patient hears, but does not understand. He can, however, repeat at once whatever he hears, and write it down. While writing or speaking he may understand the words used, but not after the mechanical act is accomplished.
Case of woman, aged 72 years, who had been deaf since childhood, and re mained so until within six weeks of an apoplectic attack. Hearing during this period of six weeks had returned and remained. After the apoplexy she was found to be absolutely word-deaf. There were also motor aphasia and agraphia, with word-blindness. Shaw (Brit. Med. Jour., Feb. 27, '92).
[This ease presents several features of interest, among which may be noticed the return of hearing six weeks before the last stroke, to disappear again on its supervention; the remarkable picking out by the lesions of the several cortical areas, which by various observers have been associated with the faculty of lan guage corresponding with the clinical phenomena recorded,—the second frontal convolution with the agraphia, the third frontal with the aphasia, the angular gyrus with the word-blindness, the tern poro-sphenoidal with the word-deafness and general deafness,—and the apparent recognition by the patient of the total failure to make herself understood, this last feature being somewhat noteworthy in view of the extensive nature of the cortical lesion. L. C. GRAY and W. B.
PRITCHARD, Assoc. Eds., Annual, '93.] Medico-legal conclusions drawn from a consideration of aphasia: 1. Organic diseases of the brain may render a patient incapable of making a will, and that some form of aphasia may be produced also as one of the symptoms of the organic disease.
2. Some forms of aphasia may render a patient incapable of will-making.
3. Auditory aphasia, if at all well marked, incapacitates a patient from wil 1-making.
4. Some other forms of aphasia, such as pictorial word-blindness, pictorial Mo tor aphasia, and graphic aphasia, may render a patient incapable of making a will, not necessarily from being mentally incapable, but from the difficulty of carrying out the legal formalities.
5. These difficulties in carrying out the legal formalities necessarily vary accord ing to the law of the particular country.
0. Simple uncomplicated cases of infra pictorial auditory, infra pictorial visual. and infrapictorial motor aphasia are capable of valid will-making. William Elder (Brit. Med. Jour., Sept. 3, '9S).
Case in which the patient, during the year preceding death, had numerous at tacks of transient sensory aphasia. In the intervals there was no paraphasia, the language being correct, but he did not understand what was said to him. At autopsy general atrophy of the brain, with reduction of the size of the superior temporal convolutions. espe cially marked on the left side; also of the opereulum and of the inferior fron tal convolution. The case demonstrates that word-deafness is essentially of cor tical origin. O. Veraguth (Deutsche Zeits. f. Nervenheilk., B. xvii, H. 2 and 4, 1901).