18. Bardeen-Quoted by Thompson, Johns Hopkins Hospital Bulletin, Nov. 1900. 19. Thompson-Johns Hopkins Hospital Bulletin, Nov. 1900. 20. Hervieux-Traité des Maladies Puerpérales, Paris, 1870. 21. Mills-Ibid. 22. Dercum-Recorded in Discussion of Mills' Paper, University Medical Magazine, May 1893. 23. Sinkler-Recorded in Discussion of Mills' Paper, University Medical Magazine, May, 1893. 24. Aldrich-Ibid. 25. Winckel-A Text-Book of Obstetrics, Translated by J. Clinton Edgar, A. M., M. D., 1890. 26. Hünermann-Ibid. OTHER REFERENCES Bernhardt-Deut. med. Woch., 1894, p. 935. Lever-Guy's Hospital Reports, 1847: Disorders of the Nervous-System, Associated with Pregnancy and Parturition. Whitfield-Lancet, March 30, 1889; Peripheral Neuritis due to the Vomiting of Pregnancy. Ramskill-Obstet. Jour., Great Brit., 1880, vol. viii, p. 678. Jolly-Archiv. für Psychiatrie, Band xvi, Heft 3. Bianchi-Des Paralysies Traumatiques des Membres Inférieurs chez les Nouvelles Accouchées, Paris, 1867. Donath-Pest. med. chirurg. Presse, Dec. 16, 1900. Desnos Joffroy and Pinard-Bulletin de l'Académie Royale de Medecine, 1889, tome xxi, p. 44. Welch, J. C.-Medical News, October 19, 1895. Roberts Loyd-Lancet, 1880, vol. 1, p. 54. Adams-Lancet, 1880, vol. ii, p. 699. Vinay-Nouvelles Archives d'Obstétrique et de Gynécologie, 1895, p. 463. Stembo-Deutsche medicinische Wochenschrift, 1895, p. 461. Mader-Weiner klinische Wochenschrift, Band viii, Nos. 30 and 31, 1895. Leyden-Charité Annalen, 1862. Lloyd-Twentieth Century Practice of Med., vol. xi, 1897, pp. 303-327. Wichmann-Die Rückenmarksnerven u. ihre Segmentbezüge. Berlin, 1900. Verlag v. Otto Salle. Moebius-Ueber Neuritis puerperalis. Münchner med. Wochenschr., xxxiv, 1897, 9. Beiträge zur Lehr v. der Neuritis puerperalis. Münchner med. Woch, xxxvii, 1890, p, 14. Weitere Fälle von Neuritis puerperalis, Münchner med. Wochens., xxxix, 1892, p. 45. Collected in Neurologische Beiträge, iv Heft. Huber. W.-Zur Prophylaxe der Neuritis puerperalis, Monatsschr. Geburtshülfe u. Gynae., Bd. ix, 1899, Heft 4, p. 487. Bayle-Jour. de Méd. de Paris, Feb. 25, 1897. Six Cases of Right Hemiplegia with Aphasia By GEORGE A. COLLAMORE, M. D., Toledo These cases were all seen within one year and are noticeable from the fact that they were right hemiplegias, involving the leg, arm and speech centers, while no case occurred to my observation involving the left side. They were of varying degrees of severity and duration, none proving fatal. They all occurred in middle-aged or elderly men, all in active business life. Case I: Personal Case. I was called July 30, 1901, to see Mr L., aged about 58, a road contractor, who had been seized with paralysis when some miles from home. He was in doubt lest it might be heat prostration, but I found marked paralysis of the right leg and arm and a partial paralysis of the power of speech-motor aphasia. The leg and arm paralysis rapidly disappeared and the aphasia gradually improved, so that in a month's time he was practically well, except for the debility usually following such attacks. He never had much difficulty in writing, and his mental powers were apparently never impaired. He is now well, except that the paralyzed leg gets tired more easily than before. Case II: August 26, 1901, I saw Mr R. in Oak Harbor, in consultation with Dr Huyck. He was 53 years old, weighed 210 pounds, a tile manufacturer by profession and a hard-working man. He was seized August 21 with paralysis of the right arm and leg, and with aphasia. At this time, five days after the attack, he had very little use of the leg or arm, and speech was difficult, evidently from involvement of the speech centers-motor aphasia. His mental condition was normal. He was perfectly conscious of his condition and understood everything said. He recovered rather rapidly and is now, I understand, in good health. My notes at the time mention that he talks slowly but accurately. The tongue deviates to the right. Case III: In consultation with Dr Brigham, on October 31, 1901, I saw Mr. S. aged about 58, who had been seized about two weeks previously with right hemiplegia with aphasia. He had improved somewhat, but the arm and leg paralysis was almost complete. The aphasia was quite marked, much to the distress of the patient, who was quite aware of his disability, but unable to overcome it. This case has improved to the extent that he is now able to walk and attend to business very moderately, the usual debility still continuing. The right arm is still useless, no aphasia remaining. Case IV: Personal Case. Mr L. aged 77, a hard-working business-man, who smokes much, was seized on November 28, 1901, with ill-defined head symptoms, mainly vertigo and bad feeling in the head. I saw him soon; he was sitting in a chair, from which he suddenly slipped to the floor, apparently from inability to sit up. He walked upstairs with assistance and was put to bed, and found to have almost complete paralysis of the right leg and arm, and aphasia, without much mental disturbance. The paralysis continued for several weeks, then gradually disappeared, and is now all gone. The aphasia was of motor form, and for a time there was considerable mental incapacity, displayed mainly in loss of memory. Case V: Personal Case. Mr G. aged about 60, of previous good health, of sedentary occupation, and of good habits, was seized some time in the night of December 19-20, with complete paralysis of the right arm, and partial paralysis of the right leg, with motor aphasia. His mind was perfectly clear, and he was particularly distressed at this sudden and unexpected attack. Within 48 hours all symptoms of paralysis and aphasia had disappeared leaving only the usual debility and perhaps a certain slowness of mental action, which is now practically gone. This case is remarkable in that so severe a lesion should disappear so rapidly. Case VI: Personal Case. Mr W. about 51 years of age, a county official, was found lying on the floor at the court house, December 22, 1900. He was unconscious. He was taken to his home, where, with assistance, he was able to walk upstairs and go to bed. I saw him soon after, and found he had paralysis of the right arm and leg and a com plete inability to speak. In fact, he did not regain his power of speech until the third or fourth day after the attack. On January 4, 1901, I made the following note: Paralysis has disappeared, he can walk and use his arms as well as usual, except for some loss of strength. He can apparently understand everything said to him, but is unable to speak distinctly, though he talks fairly well. His peculiar form of aphasia is that he is unable to speak the name of any article shown, as key, or knife. He appears to know what they are, but cannot name them, the form of aphasia called anomia. He can write his name on being asked, but cannot write from dictation. He can write the word key, on being told, but not knife. Being asked to write knife, he wrote "seer." Seeing the word knife written, he recognized it as the name of the article, and copied it correctly. Now, being shown a pencil and asked to write it, he wrote "knife." To copy the written word "pencil," he wrote "pencel," twice the same way. Asked to touch his nose with his finger, he did not succeed. When told to shut his eyes, he did so after being told several times. Puts out tongue after being told several times. Cannot add or multiply, although he was an expert in mathematics, as in computing interest, etc. He was given the following example in multiplication with this result: He gradually recovered from his physical paralysis, and when I saw him several months ago, he was apparently well in body, but mentally had not made corresponding improvement, though he had no muscular aphasia, and had relearned the names of ordinary objects. His future is problematic, though it is doubtful if he ever recovers his former usefulness. I have very recently had an opportunity to examine this patient more critically, and according to Butler's series of question, have elicited the following result: Arm and leg paralysis absent; but the right leg gets tired more easily than before; bodily functions normal; weight apparently less than normal; is not doing business. and acknowledges inability to do so. The form of aphasia in this case is mixed. As he can hear spoken words and understand them, though slowly, I infer a slight degree of auditory aphasia is present. No visual aphasia (alexia). As he cannot repeat spoken words correctly, or read aloud correctly, he has motor aphasia (aphemia). As he cannot write to dictation, he has partial agraphia. As he commits errors in the use of words in speaking and writing, he has paraphasia and paragraphia. He has a certain amount of mind-blindness, inasmuch as he does not recognize all ordinary objects and their uses; he is entirely unable to speak the names of certain things, as match-box, knife, pencil, but now writes them correctly. He tried to give a description of washing out his stomach by Dr Greenfield, which was largely illustrated by gesture, writes "hose" and makes circle describing it— could not remember doctor's name-used to live over here (towards Monroe street), now on Adams street, he finally writes Dr Green, but is not sure of name. In expressing ideas he often failed to give the important word, as, he said he could (dance) as well as ever, the word "dance" being written. Also, he likes to play (cards), the word "cards" being written. Also, to go to the (minstrel), the word "minstrel" being written, and he could not then pronounce it. In analyzing this case, we find that he has not worddeafness or auditory aphasia. He has not alexia, wordblindness or visual aphasia. The only doubt is as to that of reading silently. He has motor aphasia or aphemia. He has partial |