Abstract

The first number for the year is not remarkable for any paper of striking value. Readers of the Journal will be chiefly attracted by the long and clearly written resumé of Dr. Hughlings Jackson's recent studies “On Affections of Speech from Disease of the Brain,” which is contributed by Mr. James Sully. He remarks on the great value of Dr. Jackson's attempts to classify the different forms of aphasia under the three main heads or stages of—(1) Defect of Speech, in which the patient has a full vocabulary, but confuses words; (2) Loss of Speech, in which the patient is practically speechless, and his pantomimic power is impaired as well; and (3) Loss of Language, in which, besides being speechless, he has altogether lost the power of pantomime, and even his faculty of emotional language is deeply involved in the wreck. All these states or stages again are, properly speaking, to be distinguished altogether from affections of speech in the way of loss of articulation (owing to paralysis of the tongue, &c.), or loss of vocalisation (owing to disease of the larynx); whereas the three degrees or stages of aphasia proper are due to a deep-seated and severe disorganisation of the brain. The main interest of the theory lies in the ingenious and carefully-argued analysis of the symptoms, by which Dr. Jackson arrives at the theory that as the process of destruction goes on, the superior “layers” or strata of speech fail first—those namely which involve the ordinary power of adapting sounds to the circumstances of the moment as they arise; after them fail the “more highly organized utterances” those, namely, which have in any way become automatic, such as “come on,” “wo! wo!” and even “yes” and “no,” which stand on the border-line between emotional and intellectual language; next fails the power of adapting other than vocal signs to convey an intended meaning, which is called, rather clumsily, “pantomimic propositionising;” and last of all dies out the power of uttering sounds or making signs expressive merely of emotion—a power which, of course, is not true speech at all.

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