The surgical treatment of idiocy / by G.E. Shuttleworth.

  • Shuttleworth, G. E. (George Edward), 1842-1928.
Date:
[1896]
Catalogue details

Licence: Public Domain Mark

Credit: The surgical treatment of idiocy / by G.E. Shuttleworth. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    to repair the breaches made by the surgeon. He maintains that this method of treating idiocy is of little, if any, value, any apparent good results being due to increased care and attention bestowed on the child while under active observa- tion and treatment, and not to the operation itself. So far as my own experience goes, I am quite in accord with Bourneville in the view that medico-pedagogic, rather than surgical methods, offer the best chance for the amelioration of the mentally deficient child. Personally I am acquainted with the progress of three crauiectomised patients. The after-history of two is given on page 62 by my successor at the Royal Albert Asylum, Dr. Telford-Smith. I need, consequently, only now refer to them to say that one (N. L.), who underwent a series of operations by Prof. Victor Horsley, in 1891, and again in 1894, has un- fortunately not fulfilled the favourable anticipations origi- nally formed. With regard to a third case, the child of a medical man, craniectomised (at four stages) in 1891, the father reported as follows:—“I cannot say that he has been in any way benefited by the operation. The small amount of muscular strength he had prior to that time was diminished by the operation, and he has not yet, after three years, regained it. There has been some degree of mental improvement, but probably not more than would have come had there been no operation.” It is only fair, however, to add that I should not be justified in asserting that the above cases are to be taken as average samples of the re- sults obtained from craniectomy, and I am indebted to Mr. Victor Horsley for access to his notes of other cases which certainly show a more favourable result. The improved methods of operating which experience has suggested, especially the cautious removal of small portions of bone only at one sitting, have much reduced the mortality of the operation, which was at first considerable. Dr. Allen Starr, in his admirable work on Brain Surgery, devotes a chapter to the consideration of “ Trephining for Imbecility due to Microcephalus ; ” and he divides the latter into three clinical types. The first group contains cases of hemiplegia, with or without athetosis ; the second, cases of mental defects of various grades ; and the third, certain cases of sensory defects. This is no doubt an excellent division of cases appropriate for operative interference, but it seems to me that the hemiplegic cases do not necessarily fall into the category of microcephalus. My own view is