Respiration  is  not  afi'ected.  Respiration  becomes  impaired,  from  paral-

ysis of  the  muscles  necessary  to  that  act.
The  patient  often  cannot  cough  or  breathe
deeply.
Voice.
The  voice  is  normal.  Phonation  becomes  impossible  when  the

larynx  is  paralyzed.
Atrophic  Changes.
No  atrophic   changes  in   muscles   occur  As  the  disease  tends  to  extend  into  the

throughout  the  disease.  spinal  cord  and  involve  the  cells  of  its  gray

matter,  symptoms  of  muscular  atrophy  de-
velop.
HYPEK^MIA   OF   THE   BRAIN   AND   ITS    COVERINGS.  239

Motor  Paralysis.
The  rir/ht  side  of  the  body  is  usually  ren-  Motor   paralysis   is  not  developed  as  a

dered  hemiplegic,  when  the  aphasia  is  of  result  of  the  spinal  changes.  The  patient
the  motor  variety.  This  is  especially  true  becomes  unable  to  walk,  however,  as  a
if  an  embolus  exists  as  its  cause.  result  of  general  debility  and  the  atrophy

of  the  muscles.
Memory.
The  memory  may  be  impaired,  in  the  am-  The  memory  of  words  is  intact,  but  the

nesic  variety,  in  respect  to  words,  figures,       ability  to  use  the  tongue  and  lips  interferes
foreign  tongues,  familiar  objects  and  their       with  articulate  speech.
uses,  gestures,  etc.
Dementia.
Dementia  seldom,  if  ever,  occurs.  In  exceptional  cases,  dementia  develops

late  in  the  disease.
Symptoms  in  Common.
Both  may  be  associated  with  impairment  of  the  normal  use  of  the  tongue.
Both  may  be  associated  with  delects  of  speech.
Prognosis  and  Treatment. — The  duration,  course,  and  severity  of
the  abnormal  conditions  described  under  the  general  head  of  aphasia
depend  to  a  great  extent  upon  the  exciting  cause  and  its  exact  seat.  In
the  first  section  of  this  work,  the  localization  of  the  lesion  and  the  com-
plications most  frequently  encountered  in  connection  with  aphasia  have
been  quite  fully  discussed.     To  these  pages  the  reader  is  referred.
