Volume 2

Aphasia and kindred disorders of speech / by Henry Head.

  • Henry Head
Date:
1926
Catalogue details

Licence: In copyright

Credit: Aphasia and kindred disorders of speech / by Henry Head. Source: Wellcome Collection.

    14/476 page 8
    On the other hand, a severe case of acute aphasia, such as No. 20, may pass in the course of recovery through a stage in which the defects are confined to acts of verbalisation. On the other hand, exactly opposite changes may occur in patients who are suffering from progressive organic lesions of the brain. No. 26 (see p. 394) was a case of extremely severe aphasia of vascular origin in an un¬ usually intelligent man of sixty. Speech was reduced to meaningless sounds with “ Si, si ” used correctly for affirmation. He could repeat nothing. He understood what was said to him and chose familiar objects correctly, although he could not execute more complex oral commands. He read to himself with pleasure and selected common objects slowly but accurately when shown their names in print; but he failed to execute more difficult printed orders. He could write nothing spontaneously, except his name and the first nine numerals; yet he could copy correctly, provided he was not compelled to transcribe print into cursive script. The use of the alphabet was defective; even when given twenty-six block letters he failed to arrange them in order. Arithmetical exercises were impossible and he could neither name coins nor express the simplest relation between any two of them. Orientation was not affected. Games, except draughts, were difficult or impossible. He enjoyed music and could sing without words. Vision was unaffected and there were no abnormal physical signs in the nervous system. No. 21 (see p. 320) was a case of severe aphasia due to avascular lesion in an elderly man. When first examined by me four days after the onset of the stroke, he was speechless except for “yes” and “no” together with a few emotional expressions. He could not say or repeat his name. He understood much of what was said to him, provided it did not convey an order, and seemed to comprehend the meaning of simple words in print. Writing was profoundly affected. There was no disorder of motion or sensation and the reflexes were normal. Vision was unaffected. The arterial tension was grossly raised and the vessel wall thickened. He remained in fundamentally the same condition, and, eight and a half years after the seizure, I was able to make a complete examination with the following results. He was still speechless, except for “yes” and “no” and a few automatic expressions. He could not repeat anything said to him, even “yes” and “no.” He understood most of what he heard, choosing common objects and colours correctly to oral commands; yet he failed to execute more complex tasks, such as setting the clock and the hand, eye and ear tests. He could read nothing aloud and had difficulty in understanding what he read to himself; but he chose familiar objects to printed commands and on several occasions succeeded in selecting a printed card which bore words corresponding to the colour or to the simple pictures he had just seen. Thus, it is obvious that printed words conveyed some meaning to him, provided they did not imply a command. He could write nothing but his surname spontaneously, failed altogether to write to dictation and could not copy print in cursive script. He was unable to say, to repeat, to read or to write the alphabet. He succeeded in writing some of the letters to dictation and copied them with four errors only. He counted with extreme difficulty and failed to reach twenty. Simple problems in arithmetic puzzled him greatly, but he was able to indicate on his fingers with remark¬ able accuracy the relative value of two coins.
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