Essentials of Nervous Diseases And Insanity; Their Symptoms And Treatment. a Manual for Students And Practitioners

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" In 1885, Dr. B. Delavan reported (N. Y.
Medical Record) the case of a man having suft'ered an apoplecti- form seizure from which there was complete recovery. A year later he had an attack followed by marked hemiplegia, almost total inability to swallow, and a remarkable change in the quality of his voice ; articulation impaired. There was no aphasia.
A number of similar cases have been reported in the last ten years. It is not unfrequently observed in cases of cerebral 124 NERVOUS DISEASES AN
...D INSANITY.
hemorrhage or embolism that there is a difficulty iu speech, thick, indistinct (not aphasic), or it may be associated with aphasia and difficulty of swallowing, which may be of tempo- rary duration. The study of these cases, clinically and patholog- ically, is of importance. In 1881, in a note on the tendon reflex in general paralysis of the insane (Archives of Medicine), I intimated that there was an anatomical lesion which gave rise to the association of disturbances of speech (the alaxic paralytic form) and increased tendon reflex, and that it was in these cases apoplectiform seizures were most common.


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