A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Science
A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Medicine -- Practice
APHASIA, or loss of the faculty of language, is so important a symptom
as to deserve elaborate consideration in a separate article of this
volume; and to it the reader is referred. Suffice it here to state
that aphasia may be classified into three forms: (1) Sensory aphasia,
in which there is primary disorder of the psycho-sensory (perceptive
or centripetal) part of the complex central mechanism for speech; (2)
Motor aphasia (including ataxic aphasia), in which the primary lesion
affects the motor (expressive or centrifugal) parts of the mechanism;
(3) Amnesic aphasia, in which loss of memory (effacement of residua)
of words and signs is the prime condition.
II. Sensory Symptoms.
HYPERÆSTHESIA is a condition of exalted excitability in the various
parts of the sensory apparatus: terminal nervous organs, nerve-trunks,
central gray matter. We may admit such a state as existing {32}
independently of consciousness, as where a lesion cuts off
communication between the perceptive cerebral centres and the
periphery, but in practice we consider only conscious hyperæsthesia.
In this state the subject may be able to perceive (feel) slighter
impacts than would affect a normal individual, or he receives an
exaggerated, usually unpleasant, impression from ordinary excitations.
It may also be said that hyperæsthesia exists as a purely subjective
state, psycho-sensory hyperæsthesia, without external mechanical
excitations.
(_a_) Hyperæsthesia of common tactile sensibility in the skin and
mucous membranes is frequent. The least touch is felt with unpleasant
acuteness and causes unusual reactions of a reflex order; frequently,
but not necessarily always, a sensation of pain is produced at the
same time. It has been claimed that in certain cases the points of the
æsthesiometer could be perceived (distinguished as two points) at
smaller distances than the average normal, but I have never been able
to demonstrate this to my satisfaction. The simplest form of tactile
hyperæsthesia is met with in persons of a highly nervous organization,
in those under the influence of strong emotions, in the hypnotic
state, and while intoxicated. The common pathological conditions in
which increased sensibility is found are meningitis (cerebral and
spinal), hydrophobia, tetanus, neuritis, dermatitis, hysteria, and
spinal irritation; also in connection with inflammations and
traumatisms.
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