On types of imbecility : (paper read before the Harveian Society) / by Fletcher Beach.

  • Beach, Fletcher, 1845-1929.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: On types of imbecility : (paper read before the Harveian Society) / by Fletcher Beach. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    in swallowing tlie milk drawn from the breast; whether the infant is capable of grasping one’s hand, any notice taken of passing objects, and what capability of following with the eyes, any notice of sound, any voice. The facial aspect should also be marked (that the patient is of low type can often be seen at a glance) ; the presence of strabismus or nystagmus should also be noted, as well as the distance between the eyes, these being too nearly approximated in microcephalic and too widely separated in hydrocephalic cases. The position (oblique or not) of the eyes should be noted, the former being found in the Mongolian variety. The integument about them should be examined for epi- canthic or semilunar folds of skin at the inner canthi; and the position of the ears, whether implanted far back or not should be observed. Later on we compare the child’s intellect with that of o‘her children of the same age; we observe whether the fontanelles ai'e closed; the shape of the palate—a highly arched, or, on the other hand, an elongated one being found in congenital imbecility; the grasping power of the hands— often little in imbeciles; the presence or absence of auto- matic movements, contractures, or spastic rigidity—these symptoms being found in cases of low type ; whether there is any flow of saliva from the mouth ; the state of the circula- tion—often feeble in imbeciles; the amount of development of the senses; the presence or absence of will; the presence or absence of epilepsy. To the classification of imbecility above given I shall adhere, and I now, without further preface, proceed to describe types of imbecility, endeavouring to impress my descriptions more fully upon you by means of photographs of cases. Simple Congenital Imbecility. By this term I mean that the patient was born an imbe- cile, without any obvious defect or abnormality of skull or limbs. This classification includes some cases of a very low, and others of a fairly high, type. I have with me illustrations of all. The first eight photographs which I hand round illustrate low-type imbeciles, and include two cases of Mon- golian imbecility, or furfuraceous cretins—the former name being given to them by Br. Langdon Down ; the lat ter, which I consider a bad one, by the late Dr. Seguin, of America. You will see at a glance that all eight cases are imbeciles of low type. Note the animal expression, thick lips, pug nose, and small forehead in some; the open mouth,large ears, and depressed look in others. Here is a description of a con-