This is a disease interfering with speech. Where symptoms of aphasia begin to manifest, it points to a lesion of the nervous system, especially a chronic derangement of the brain located at the lower part of the fissure of Rolando. Patients beginning to show signs of this derangement will have difficulty in making themselves understood. They will say words that have entirely different meanings from the words which they have in mind or wish to use. The derangement may spread to and affect the speech centers, the facial centers, and also the auditory centers. Aphasia is rarely simple. It will not exist very long before other symptoms develop. It is almost impossible to, draw the line between the various derangements of this part of the brain. There is a great deal written on this particular disease; but, inasmuch as no patients are ever benefited, but all of them travel slowly but surely to the grave, a minute history and description of the disease is worthless to anyone except those who desire the novelty of knowing all about it. Many family physicians will find it necessary to be thoroughly informed on the subject, in case patients suffering from this disease have large legacies to leave and the families are divided against themselves.

Where the disease occurs in youth, the probabilities are that, if proper care is given, the patients will get well. Aphasia may start up in very young children, who will be very slow to have command of language until they are ten, or even fourteen or fifteen, years of age. Youth is a wonderful restorative. Where men begin to show symptoms of aphasia after forty to fifty years of age, it is only a question of a few years when paralysis will develop. The patient then will remain speechless, though capable of understanding everything, and he may even attempt education. A stay in the progress of the disease may take place, and the patient remain in a semi-invalid state for several years.

Misplacing words is very common and very annoying to those who are afflicted in this way. The fact of the matter is that imperfect speech or misplacing words will not continue many years without being accompanied by impairment of the power of expression, and certainly reasoning will be affected more or less.

Hope may be given to parents of children troubled in this way; but in the case of those past middle life physicians should be very guarded about promises of betterment. Of course, the prospects of betterment in such cases will depend largely upon the past life. If the individual has gone the pace, he certainly will not be brought back to anywhere near the normal. The rule is that when this disease develops it means that the subject has been excessive in indulging himself sensually. In children the cause may be convulsions. By feeding children in such a way as to produce gastro-intestinal irritation--especially in children of a decidedly nervous temperment--they may be forced into epileptic seizures that will cause more or less paralysis of different parts of the body. Special brain centers are sometimes involved; and, if organic change has taken place, a cure is impossible.