The hope that a study of aphasia might show a way to a better understanding of the nature of insanity is not new. Even at a time when far less was known about aphasia than is known to-day such a hope was not without easily conceivable grounds. It will now hardly be maintained that the perverted speech of a lunatic is always to be regarded as a just presentation of perverted thought. Not only is the thought disordered, but often also the speech itself. The symptom of perseveration, for instance, does not always represent morbid prevalence of an idea; it may express a disorder which lies rather within the sphere of speech. This is well illustrated in a case of eclamptic insanity reported by Heilbronner. Of pictures representing birds of various kinds, the patient designated many in succession as “swan,” even when identification was correct; she called a stork a swan, and at the same time alluded to the stork fable. In this instance it is not the idea that clings, but the word, as in the recurring utterances of an aphasic. In many forms of mental disease we meet with symptoms of amnesic aphasia, loss of nouns, inability to name objects seen. In certain forms of incoherence we can recognise an element of paraphasia. Thus we can often obtain a clearer conception of the speech disorder of a lunatic by regarding it from the aphasic standpoint.
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