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Although communication is, in our days, thought to be one of the most important and most powerful processes active in human relationships, students of medicine and of education still have only a bowing acquaintance with the nature of speech and its
disorders. This book is therefore to be welcomed as an introduction to this very complex subject.
There are excellent chapters on the anatomy and physiology of speech, and on its neurological disorders such as aphasia, alexia, and agraphia, as well as chapters on kindred disorders such as apraxia and agnosia. It will, no doubt, be found useful by anyone trying to comprehend these topics, that the historical background to the problem of aphasia is given, and that the variegated and disjointed aspects of this disorder are brought into coherence by means of J. H. Jackson's theory of dissolution and the author's own concept of the “schema”. “Schema” is, according to Brain, “a physiological and not a psychological concept … without a corresponding state of consciousness.” It is difficult, therefore, to see how the factors involved in this assumption could be verified, i.e. how they could possibly be utilized in treatment. It is equally difficult to understand the meaning of the statement that aphasia “is a psychological disorder, but it presents itself to the clinician as a symptom of an anatomical lesion”. Such a statement can only confuse a therapist faced with an aphasic patient.
It is perhaps not surprising, therefore, that the chapters on treatment are extremely short and that there are no suggestions as to how the concepts of “schema”, “pattern”, and “dissolution” could guide the therapist. Brain regards die development of speech in infancy as the first source of information about the “psychophysiology” of speech. Yet the nature of babbling, its significance as a regressive symptom in stammering, and its crucial importance in the treatment of the latter, are not expounded. Although the references to the psychopathology o