APHASIA IN A CONGENITAL DEAF-MUTE

Abstract

As long ago as 1878, in considering the nature of language in general and the disorder of aphasia in particular, Hughlings Jackson commented, "No doubt by disease of some part of his brain the deaf-mute might lose his natural system of signs, which are of some speech value to him, but he could not lose speech, having never had it, " while still later, concerning the same question, Macdonald Critchley (1939) says: "The question then arises as to whether or not such a physiological shunting is associated with an anatomical substratum vulnerable to the usual morbid processes. In other words whether focal cerebral lesions, particularly of the left hemis-phere, could damage or destroy the manual sign-language of, for example, the deaf-mute." The rare occurrence of aphasia from acquired cerebral disease in a deaf-mute has stimulated a few important observations, but a review of the world's literature seems to reveal only three studies, one by Grasset (1896), which, however, is not exactly pertinent to the problem now under con-sideration because the patient could post-traumatically still execute finger spelling with the non-dominant hand. As Critchley (1939) rightly observes in reviewing the study, "Such an inconsistency suggests a differ-ent type of speech-affection than in my case, and is obviously to be regarded as an example of apraxia"; another by Macdonald Critchley (1938); and the most recent case study by Tureen, Smolik, and Tritt (1951). None of these, however, is sufficiently complete to meet the criteria required to answer the question originally raised by Hughlings Jackson—that the case be congenitally deaf and dumb and that all language functions be impaired including both finger spelling and basic sign language. An analogous contribution, however, appropriate to the discussion, is the publication by Gloning et ah (1955) of a case study of aphasia in a blind person who was unable to read Braille following cerebral injury. Our interest has been attracted by the unique opportunity of studying such a case in a con-genitally deaf-mute woman of 21 who developed an intra-partum stroke with right hemiplegia and dysphasia. by guest on M