Observations on some of the more important diseases of childhood / [Charles West].

  • West, Charles, 1816-1898
Date:
[1843]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on some of the more important diseases of childhood / [Charles West]. Source: Wellcome Collection.

    18/28 (page 14)
    Is at the present moment under my care, in whom all the indications of cerebral tubercle exist, and in whom the motor power of one side of the body is very considerably impaired. In both of these instances, as well as in many others which might be adduced, the paralysis is only a secondary incident, merely a symptom betokening the ad¬ vances of a grave and incurable malady; and to enter upon their examination would be foreign to the present purpose. It may perhaps be convenient to arrange these cases in three classes; of which— The first will include those instances in which the paralysis was congenital. The second, those in which it accom¬ panied or followed convulsions, or other symptoms of cerebral disorder. The third, those in which the para¬ lysis occurred without any indication of cerebral disease. 1st. Cases of congenital paralysis. Rebecca Swan, aged eight years, 19, Regent Street, Poplar, one of ten chil¬ dren, of whom nine are still living. One died at the age of two months, but all the others are said to be strong and healthy. Her father is healthy, but not robust. Her mother is in the last stage of consumption; and this disease is hereditary on her mother’s side. Rebecca was a delicate child from birth, and her relatives assert that from her very earliest infancy she has had imperfect use of her right side. She is of a spare habit, and rather sickly appearance ; but her manner is cheerful, and her intellect does not seem at all defective. The palsied condition of her right side is very obvious: she limps in her walk, treads always on her toes, with her heel raised very considerably above the ground, and turns her foot inwards at every step she takes. She can use her right arm, though but imperfectly; the fingers of the right hand are constantly flexed and drawn into the palm; and though by a great effort she can extend them, yet the moment her attention is withdrawn they return to their former flexed po¬ sition. Sensation is as perfect in the right limbs as in the left; but their wasted condition and smaller size, as compared with the left extremities, show that nutrition has been but very imperfectly carried on. The left arm measures, from the acromion to the end of the radius, 14^ inches; right, 13 inches. The girth of the left arm at the mid¬ dle of the humerus, 5f inches; right, 5 inches. From the left trochanter to the heel, 24 inches ; right, 22f inches. The right leg and thigh measured considerably less in circumference than the left; but I have not preserved an account of their exact dimensions. A similar case, but one in which the deformity was still more marked, came under my notice some months since at the Finsbury Dispensary. The patient in this instance was a girl aged eighteen years, in whom not only were the left extremities much shorter and smaller than the right, but the left half of the face also was very much smaller than the right. The parent of the girl stated that the inequality in size of the twro halves of the body had existed from earliest infancy, and had not suc¬ ceeded to a fit or any other indication of acute cerebral disease. The left side was weak, and motion imperfect, but sensation seemed to be unimpaired. The patient in this case was rather deficient in intellectual endowments. 2d. Cases in which the paralysis accompanies or follows convulsions or other symptoms of cerebral disorder. The cases included in this class are of more frequent occurrence, and of greater practical importance, than the former, since they often excite great solicitude; though they for the most part eventually do well. The morbid phenomena are very frequently con¬ nected with disturbance in the process of dentition; and it will be seen that, in the former of the two following cases, they occurred during the period of teething. In this instance, however, there were but few indications of dis¬ order of that process ; nor did the fluc¬ tuations in the child’s condition, nor its ultimate recovery, appear to be in any way influenced by the eruption of teeth. Walter Scott Taylor, aged fourteen months, living at 39, Great Hunter Street, Old Kent Road, was the delicate child of parents who had lost two children in what they called a decline. In the first week of January 1840 he had a mild attack of measles, from which he recovered without any un¬ favourable symptom; but his parents placed him under medical care on