Word-blindness (Alexia).—The patient sees written or printed letters and words and may be able to distinguish one from another, but they no longer have any meaning for him. Word-blindness is rarely total, however, a few words or let ters being usually understood, nor is the disorder often found existing alone. In nearly every case there co-exists either word-deafness or motor aphasia or some other complication of speech.
Word-blindness is often found in con- • nection with right lateral hemianopsia, or concentric diminution of the field of vision. The patient can no longer read. but can write; as he cannot read what he has written the letters and lines are sometimes uneven and resemble those written with the eyes shut. In the right hemianopsia found in this connection the written lines always begin on the left side of the page. The visual memory of numbers may be preserved or may also be lost (emeitas numerals). ness can, therefore, be divided into two categories: in the one, the sense of the letter itself is lost (eceeitas literals); as a consequence, persons who generally read slowly, and spell out each word, suffer the total loss of the power of read ing. In the other, the accompanying hemianopsia prevents the general phys iognomy of a word being rapidly taken in by the patient (ca?citas verballs).
Subco•tical Word-blindness. — In sub cortical alexia the patient can read or copy, but he does not understand what he does until the movement of his hand awakens in his mind the sense of word hearing and of motor articulation through the muscular sense.
In pure verbal blindness the meaning of the words may be lost, but, by follow ing with the eye the form of the letters, the patient finally may spell out the word.
Four cases of word-blindness. The first occurred in a man 34 years of age. In this case the condition developed after an attack of left hemiplegia with paralysis of the left side of the face, from which he had been recovering grad ually. The second case occurred in a man 57 years of age. The condition came on very suddenly during active exercises. It was ushered in by slight frontal headache and some mental con fusion. The third case occurred in a man GO years of age. The onset in this case was also abrupt. The fourth ease occurred in a woman 34 years of age. In this case the onset was marked by unconsciousness, which remained for several days. Then consciousness was restored, paralysis in the right arm and right leg developed, and site was com pletely aphasic. J. Hinshelwood (Lan cet. Feb. 8, 1902).