Page:Popular Science Monthly Volume 25.djvu/186

176, which is an emotional manifestation, must be distinguished from pantomime, which is part of intellectual language, (b.) The frequent persistence of "Yes" and "No," in the case of patients who are otherwise entirely speechless, is a fact of extreme significance. We see that the patient has lost all speech, with the exception of the two most automatic of all verbal utterances. "Yes" and "No" are evidently-most general, for they assent to or dissent from any statement. In consequence of being frequently used, the correlative nervous arrangements are of necessity highly organized, and, as a further consequence, they are deeply automatic, (c.) A more important, though not more significant, illustration is that the patient who can not get out a word in speech nevertheless understands all that we say to him. Plainly this shows loss of a most voluntary service of words, with persistence of a more automatic service of words. We find illustrations in small corners, (d.) There are three degrees of the utterance "No" by aphasics. A patient may use it emotionally only—a most automatic service; another patient may also be able to reply correctly with it—a less automatic but still very automatic service. (Here there is some real speech.) There is a still higher use of it, which some aphasics have not got. A patient who can reply "No" to a question may be unable to say "No" when told to do so. You ask the aphasic, "Is your name Jones?" he replies, "No." You tell him to say "No," he tries and fails. You ask, "Are you a hundred years old?" He replies, "No." You tell him to say "No." He can not. While not asserting that the inability to say "No" when told is a failure in language, it is asserted that such inability with retention of power to use the word in reply illustrates dissolution, (e.) A patient who is speechless may be unable to put out his tongue when told to do so; that he knows what is wanted is sometimes shown by his putting his finger in his mouth to help out the organ. That the tongue is not paralyzed in the ordinary sense is easily proved. The patient swallows well, which he could not do if his tongue were as much paralyzed as "it pretends to be." Besides, on other occasions he puts out his tongue, for example, to catch a stray crumb. Here is a reduction to a more automatic condition; there is no movement of the tongue more voluntary than that of putting it out when told.

[The lecturer then remarked on swearing and on the utterance of other and innocent ejaculations by aphasics, remarking that some of these utterances had elaborate propositional structure but no propositional value. The patients could not repeat, say, what under excitement they uttered glibly and well. He spoke next of the frequent retention of some recurring utterance by aphasics, such as "Come on to me." These were not, from the mouth of the aphasic, of any propositional value, were not speech. He had no explanation to offer of these, but stated the hypothesis that they were the words the patient was uttering, or was about to utter, at the time he was taken ill.]