Page:EB1911 - Volume 02.djvu/176

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164
APHELION—APHIDES
  

majority of people when they speak do so by recalling the auditory memories of words stored up in the auditory speech centre. Amnesia verbalis is employed to designate failure to call up in the memory the images of words which are needed for purposes of vocal expression or silent thought.

Visual Aphasia or Alexia.—The visual speech centre, which is located in the left angular gyrus, is connected with the two centres for vision which are situated one in either occipital lobe. Destruction of the visual speech centre produces visual aphasia or alexia. Word blindness, sometimes used as the equivalent of visual aphasia, is, like word deafness, a misleading term. The individual is not blind, he sees the words and letters perfectly, but they appear to him as unintelligible cyphers. When the visual speech centre is destroyed, the memories of the visual images of words are obliterated and interference with writing, a consequence of amnesia verbalis, results. On the other hand, when the lesion is situated deeply in the occipital lobe, and does not implicate the cortex, but merely cuts off the connexions of the angular gyrus with both visual centres, agraphia is not produced, for the visual word centre and its connexion with the graphic centre are still intact (pure, or sub-cortical word blindness).

Motor Vocal Aphasia or Aphemia.—The centre for motor vocal speech is situated in the posterior part of the third left frontal convolution and extends on to the foot of the left ascending frontal convolution (Broca’s convolution). Complete destruction of this region produces loss of speech, although it often happens that a few words, such as “yes” and “no,” and, it may be, emotional exclamations such as “Oh! dear!” and the like are retained. The utterance of unintelligible sounds is still possible, however, and there is neither defective voice production (aphonia) nor paralysis of the mechanism of articulation. The individual can recall the auditory and visual images of the words which he wishes to use, but his memory for the complicated, co-ordinated movements which he acquired in the process of learning to speak, and which are necessary for vocal expression, has been blotted out. In the great majority of cases of motor vocal aphasia there is associated agraphia, a circumstance which is perhaps to be accounted for by the proximity of the graphic centre. When the lesion is situated below the cortex of Broca’s convolution but destroys the fibres which pass from it towards the internal capsule, agraphia is not produced (sub-cortical or pure motor vocal aphasia). Destruction of the auditory speech centre is, as we have seen, commonly accompanied by more or less interference with vocal speech, a consequence of amnesia verbalis.

Agraphia.—Discussion still rages as to the presence of a special writing centre. Those who favour the separate existence of a graphic centre locate it in the second left frontal convolution. It may be that the want of unanimity as to the graphic centre is to be explained by an anatomical relationship so close between the graphic centre and that for the fine movement of the hand that a lesion in this situation which produces agraphia must at the same time cause a paralysis of the hand. Destruction of the visual speech centre by obliterating the visual memories of words (amnesia verbalis) produces agraphia. Further, several instances are on record in which agraphia has followed destruction of the commissure between the visual speech centre and the graphic centre. As already mentioned, agraphia is very often associated with motor vocal aphasia.

A number of aphasic defects are met with in addition to those already mentioned. Thus paraphasia is a condition in which the patient makes use of words other than those he intends. He may mix up his words so that his conversation is quite unintelligible. In the most pronounced forms he gabbles away, employing unrecognizable sounds in place of words (jargon and gibberish aphasia). Paragraphia is a similar defect which occurs in writing. Both paraphasia and paragraphia may be produced by partial lesions of the sensory speech centres or of the commissures which connect these with the motor centres. Object blindness (syn. mind-blindness) refers to an inability to recognize an object or its uses by the aid of sight alone. The probable explanation would seem to be that the ordinary centre for vision has been isolated from the other sensory centres with which it is connected. Not uncommonly there is associated visual aphasia. Optic aphasia was introduced to designate a somewhat similar state in which, although the uses of an object are recognized, the patient cannot name it at sight, yet, if it is of such a nature that it appeals directly to one of the other senses, he may at once be able to name it. Tactile aphasia, is a rare defect in which there exists an inability to recognize an object by touch alone although the qualities which, under normal circumstances, suffice for its detection can be accurately described. Amusia, or loss of the musical faculty, may occur in association with or independent of aphasia. There is reason for believing that special receptive and emissive centres exist for the musical sense exactly analogous to those for speech.

The speech centres are all supplied by the left middle cerebral artery. When this artery is blocked close to its origin by an embolus or thrombus, total aphasia results. It may be, however, that only one of the smaller branches of the artery is obstructed, and, according to the region of the brain to which this branch is distributed, one or more of the speech centres may be destroyed. Occlusion of the left posterior cerebral artery causes extensive softening of the occipital lobe and produces pure word blindness. Further, a tumour, abscess, haemorrhage or meningitis may be so situated as to damage or destroy the individual speech centres or their connecting commissures. The amount of recovery to be expected in any given case depends upon the nature, situation and extent of the lesion, and upon the age of the patient. Even after complete destruction of the speech centres, perfect recovery may take place, for the centres in the right hemisphere of the brain are capable of education. This is only possible in young individuals. In the great majority of instances the nature of the lesion is such as to render futile all treatment directed towards its removal. In suitable cases, however, the education of the right side of the brain may be very greatly assisted by an intelligent application of scientific methods.

Bibliography.—Broca, Bulletin de la Société anatomique (1861); Wernicke, Der Aphasische Symptomen-complex (Breslau, 1874); Kussmaul, Ziemssen’s Cyclopaedia, vol. xiv. p. 759; Wyllie, The Disorders of Speech (1895); Elder, Aphasia and the Cerebral Speech Mechanism (1897); Collins, The Faculty of Speech (1897); Bastian, Aphasia and other Speech Defects (1898); Byrom Bramwell, “Will-making and Aphasia,” British Medical Journal (1897); “The Morison Lectures on Aphasia,” The Lancet (1906). See also the works of Charcot, Hughlings Jackson, Dejerine, Lichtheim, Pitres, Grasset, Ross, Broadbent, Mills, Bateman, Mirallié, Exner, Marie and others.  (J. B. T.) 


APHELION (from Gr. ἀπό, from, and ἥλιος, sun), in astronomy, that point of the orbit of a planet at which it is most distant from the sun. Apogee, Apocentre, Aposaturnium, &c. are terms applied to those points of the orbit of a body moving around a centre of force—as the Earth, Saturn, &c.—at which it is farthest from the central body.

APHEMIA (from Gr. , without, and φήμη, speech), in pathology, the loss of the power of speech (see Aphasia).

APHIDES (pl. of Aphis), minute insects, also known as “plant-lice,” “blight,” and “green-fly,” belonging to the homopterous division of the order Hemiptera, with long antennae and legs, two-jointed, two-clawed tarsi, and usually a pair of abdominal tubes through which a waxy secretion is exuded. These tubes were formerly supposed to secrete the sweet substance known as “honey-dew” so much sought after by ants; but this is now known to come from the alimentary canal. Both winged and wingless forms of both sexes occur, and the wings when present are normal in number, that is to say two pairs. Apart from their importance from the economic standpoint, Aphides are chiefly remarkable for the phenomena connected with the propagation of the species. The following brief summary of what takes place in the plant-louse of the rose (Aphis rosae), may be regarded as typical of the family, though exceptions occur in other species: Eggs produced in the autumn by fertilized females remain on the plant through the winter and hatching in the spring give rise to female individuals which may be winged or wingless. From these females are born