The disorders of speech.

  • Wyllie, John, 1914-
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: The disorders of speech. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    walking, washing the hands, and buttoning the dress. Lastly, in the third stage, the mind is sunken deep in dementia; the speech totally inarticulate; and the hody paralysed, not only in its powers of voluntary movement, but also even partly in its reflexes, so that feeding must be carefully performed, lest the patient should choke, owing to paralysis of the reflex for deglutition. Utter ruin of both mind and body could not be more terribly exhibited. Mercifully, in a great number of cases, before this stage is reached, life is cut short by one of the congestive or epileptiform attacks that tend to occur in the course of the disease, with increasing frequency from the first stage onwards. In this typical course, the disease proceeds, as it were, from above downwards—first mind is affected and then motion ; and the mind displays the typical exaltation that has been referred to. But there are many cases in which the typical course is not strictly adhered to. In the first place, there is a group of cases that never display the typical exaltation with delusions of grandeur. In these the mental failure sets in with simple loss of memory and mental power, and often with depression of spirits. But these cases present the same speech peculiarities, and run ultimately the same course, as cases that have the delusions of grandeur. In a third group, the motor symptoms may appear before the mental, and keep in advance of them almost throughout. When I was making my notes of cases at the Asylum, one poor man in this condition was pointed out to me. His motor functions were deeply involved and his speech much affected, but his mind re- mained comparatively clear, and he seemed to realize his own sad condition in a manner that is rare among general paralytics. It is well known that the victims of this disease are generally men in the prime of life, and often previously of fine physique. Hard living and dissipation, especially if associated with hard work, physical or mental, are usually regarded as its most potent causes; the influence of heredity being by no means so marked as it is in the case of other forms of insanity. Before proceeding to attempt a more detailed analysis of the defects of speech in General Paralysis that can be detected by the ear, let us, in the first place, take note of an associated symptom that is perceptible to the eye : I mean the presence of abnormal movements in the lips and features, and in the tongue.