An example of this was communicated by Darwin to Romanes. One of his children who was just beginning to speak, called a duck a "quack." By an appreciation of the resemblance of qualities it next extended the term "quack" to denote all birds and insects on the one hand, and all fluid objects on the other. Lastly, by a still more delicate appreciation of resemblance the child called all coins "quack" because on the back of a French sou it had seen the representation of an eagle (Romanes' "Mental Evolution in Man," p. 183). Later on, children who have been educated acquire a knowledge of [!-- pagenumber --]the application of visual symbols, and how to represent them by drawing and writing, and associate them with persons and objects.
3. There is more definiteness of impression and readiness of recall for auditory than for articulatory motor sense feelings.
4. After the acquirement of speech by the child, auditory feelings are still necessary for articulate speech processes; for if it were not so, how could we explain the fact that a child up to the fifth or sixth year in full possession of speech will become dumb if it loses the sense of hearing from middle-ear disease, unless it be educated later by lip language.
5. Cases have been recorded of bilateral lesion of the auditory centre of the brain producing loss of hearing and loss of speech, the motor centres being unaffected. This is called Wernicke's sensory aphasia. The following case occurring in my own practice is probably the most complete instance recorded.
CASE OF DEAFNESS ARISING FROM DESTRUCTION OF THE AUDITORY CENTRES IN THE BRAIN CAUSING LOSS OF SPEECH
A woman at the age of twenty suddenly became unconscious and remained so for three hours; on recovery of consciousness [!-- pagenumber --]it was found she could not speak; this condition remained for a fortnight; speech gradually returned, although it was impaired for a month or more. She married, but soon after marriage she suddenly lost her hearing completely, remaining permanently stone deaf; and although she could understand anything of a simple character when written, and was able imperfectly to copy sentences, she was unable to speak. Once, however, under great emotional excitement, while I was examining her by written questions, she uttered, "Is that." But she was never heard to speak again during the subsequent five years that she lived. The utterance of those two words, however, showed that the loss of speech was not due to a defect of the physiological mechanism of the vocal instrument of speech, nor to the motor centres in the brain that preside over its movements in the production of articulate speech. She recognised pictures and expressed satisfaction or dissatisfaction when correct or incorrect names were written beneath the pictures; moreover, in many ways, by gestures, facial expression, and curious noises of a high-pitched, musical, whining character, showed that she was not markedly deficient in intelligence. Although [!-- pagenumber --]in an asylum and partially paralysed, she was not really insane in the proper sense, but incapable of taking care of herself. When other patients were getting into mischief this patient would give a warning to the attendants by the utterance of inarticulate sounds, showing that she was able to comprehend what was taking place around and reason thereon, indicating thereby that although stone deaf and dumb, it was probable that she possessed the power of silent thought. I observed that during emotional excitement the pitch of the sounds she uttered increased markedly with the increase of excitement. After having been discharged from Claybury Asylum she was sent to Colney Hatch Asylum. Upon one of my visits to that institution I learnt that she had been admitted, and upon my entering the ward, although more than a year had elapsed since I last saw her, she immediately and from afar recognised me; and by facial expression, gesture, and the utterance of inarticulate sounds showed her great pleasure and satisfaction in seeing one who had taken a great interest in her case. This poor woman must have felt some satisfaction in knowing that someone had interpreted her mental condition, [!-- pagenumber --]for of course, her husband and friends did not understand why she could not speak. I may mention that the first attack of loss of speech was attributed to hysteria.
This woman died of tuberculosis seven years after the second attack, and examination of the brain post-mortem revealed the cause of the deafness. There was destruction of the centre of hearing in both hemispheres (vide [fig. 17]), caused by blocking of an artery supplying in each hemisphere that particular region with blood. The cause of the blocking of the two arteries was discovered, for little warty vegetations were found on the mitral valve of the left side of the heart. I interpreted the two attacks thus: one of these warty vegetations had become detached, and escaping into the arterial circulation, entered the left carotid artery and eventually stuck in the posterior branch of the middle cerebral artery, causing a temporary loss of word memory, consequently a disturbance of the whole speech zone of the left hemisphere. This would account for the deafness to spoken language and loss of speech for a fortnight, with impairment for more than a month, following the first attack. But both ears are represented in each half of [!-- pagenumber --]the brain; that is to say, sound vibrations entering either ear, although they produce vibrations only in one auditory nerve, nevertheless proceed subsequently to both auditory centres. The path most open, however, for transmission is to the opposite hemisphere; thus the right hemisphere receives most vibrations from the left ear and vice versa. Consequently the auditory centre in the right hemisphere was able very soon to take on the function of associating verbal sounds with the sense of movement of articulate speech and recovery took place. But, when by a second attack the corresponding vessel of the opposite half of the brain was blocked the terminal avenues, and the central stations for the reception of the particular modes of motion associated with sound vibration of all kinds were destroyed in toto; and the patient became stone deaf. It would have been extremely interesting to have seen whether, having lost that portion of the brain which constitutes the primary incitation of speech, this patient could have been taught lip language.
There is no doubt that persons who become deaf from destruction of the peripheral sense organ late in life do not lose the power of speech, and children who are [!-- pagenumber --]stone deaf from ear disease and dumb in consequence can be trained to learn to speak by watching and imitating the movements of articulation. Helen Keller indeed, although blind, was able to learn to speak by the education of the tactile motor sense. By placing the hand on the vocal instrument she appreciated by the tactile motor sense the movements associated with phonation and articulation. The tactile motor sense by education replaced in her the auditory and visual senses. The following physiological experiment throws light on this subject. A dog that had been deprived of sight by removal of the eyes when it was a puppy found its way about as well as a normal dog; but an animal made blind by removal of the occipital lobes of the brain was quite stupid and had great difficulty in finding its way about. Helen Keller's brain, as shown by her accomplishments in later life, was a remarkable one; not long after birth she became deaf and blind, consequently there was practically only one avenue of intelligence left open for the education of that brain, viz. the tactile kinæsthetic. But the tactile motor sense is the active sense that waits upon and contributes to every other sense. The [!-- pagenumber --]hand is the instrument of the mind and the agent of the will; consequently the tactile motor sense is intimately associated in its structural representation in the brain with every other sense. This avenue being open in Helen Keller, was used by her teacher to the greatest possible advantage, and all the innate potentialities of a brain naturally endowed with remarkable intellectual powers were fully developed, and those cortical structures which normally serve as the terminal stations (vide [fig. 16]) for the reception and analysis of light and sound vibrations were utilised to the full by Helen Keller by means of association tracts connecting them with the tactile motor central stations. The brain acts as a whole in even the simplest mental processes by virtue of the fact that the so-called functional centres in the brain are not isolated fields of consciousness, but are inextricably associated one with another by association fibres.