A woman at the age of twenty suddenly became unconscious and remained so for three hours; on recovery of consciousness 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 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, 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.