Mutism and aphasia : a clinical lecture / by Hermann Gutzmann ; authorized translation by Max R. Dinkelspiel.

  • Hermann Gutzmann
Date:
1902
Catalogue details

Licence: In copyright

Credit: Mutism and aphasia : a clinical lecture / by Hermann Gutzmann ; authorized translation by Max R. Dinkelspiel. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The little patient I show you here is ten years of age. She was brought to us when she was about eight years of age and at that time was completely mute. Even now she speaks but little, as you will soon be able to convince yourselves. But little pro- gress has been made during this time as far as her development of speech is concerned. At the same time you see that her upper lip is considerably shor- tened by large strands of cicatricial tissue. This condition presents the characteristic picture of a bilateral congenital hairlip which has been subjected to early operation. When the child opens her mouth we find that there is a plainly visible scar in the raphe of the palate. This is a congenital cleft palate. The new soft palate, which has formed since the operation by Dr. James Julius Wolff, is suffi- ciently long and movable. Only between the upper row of teeth and the upper lip there is still the small communication between the oral and nasal cavities, but which, as can be easily demonstrated physiologi- cally, is not of particular importance as far as speech is concerned. As you can easily convince yourselves, the child understands everything that you say to it. Commands, even those of a complica- ted nature, she carries out correctly, her expression is intelligent, and she shows that she is able to fol- low, with attention, conversations that are held be- tween adults, as soon as such subjects are dis- cussed which one of her age is able to comprehend. The child is particularly small for her age. In gene- ral,her bodily movements are below normal. She only learned to walk in her fourth year and even now, as you see for yourselves, she is clumsy and weak upon her feet. When walking, she places her feet upon the floor with difficulty and at one time she fell quite often. She is just as clumsy with her hands. Nevertheless, she is self-reliant but cannot hold the pencil correctly when writing, so that she encoun- ters the greatest difficulty in performing her writing exercises and at her present age can hardly write at all. In those letters which extend from right to left,
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