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.
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.
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