Some of the characteristics of idiocy / by G.E. Shuttleworth.

  • Shuttleworth, G. E. (George Edward), 1842-1928.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Some of the characteristics 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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    emotion during gestation. Idiots of this type are for the most part very imitative, they have a good ear for tune and time, and are capable of a fair degree of scholastic educa- tion. But their temperament is sluggish, and their vital powers feeble, and soon after puberty, if not before, they may be expected to die of some phthisical degeneration. The following are the measurements taken from the head of an imbecile of this type,: thirteen years of age:—Circumference 19j in. = 49*5 c. Transverse, 13 in. = 33 04 Callipers, 5| in. = 14*5 c. Longitudinal, 12 in. = 305 c. Callipers, 6^ in. = 16-5 c.i Contours are exhibited in Fig. 2. In cretinoid idiots, the large irregularly-expanded head, the distant orbits, and the depressed root of nose, co-exist with general heaviness, dulness of eyes, and wide and coarse nose and mouth, and a corresponding stupidity and slowness of comprehension A special and peculiar class of these cretinoid idiots has been described by Curling Hilton Fagge, and others under the name of sporadic cretinism, and in these there is a more pronounced dwarfishness of body with a curious bagginess of skin, as if th bony skeleton were made on a smaller scale than that of the integument. The menta stature as well as the bodily is dwarfed, and there is a remarkable deliberateness abon all their actions, and in their speech, which in many cases is moderately well developed The physical resemblance to each other borne by idiots of this type is very striking. I have not had an opportunity of examining post-mortem any example of th latter type; but Dr. Beach and others have described the existence of fatty tumour above the clavicle and the absence of thyroid enlargement as characteristic of the cases. I have indeed only had one autopsy of a cretinous patient, a lad twent years of age, 4 ft. 7^ in. high, who had enlarged thyroid, and presented the ordin characters of cretinism, though born in Northamptonshire, in a district whei cretinism is not endemic. In this case the sutures were all closed, nothing remarkab was noticed about the spheno-basilar bone—[the head measured 20£ in. (515 c.) circumference, 13| in. (35 c.) transversely, and 13^ in. (34-3 c.) antero-posteriorly] though a horizontal position of the basilar process—i.e., an absence of the occipitc basilar angle—has been noted by Lombroso, Fodere, Ackermann and Niepce as one the characteristics of cretinism. In the other variety alluded to (that somewhat co fusingly called sporadic cretinism) a remarkable steepness of the clivus has beennotio by Virchow and other observers. The cranial characteristics of hydrocephaly consist of a general obovate appearance the crown looked at from above, the contour from back to front and side to side beu more or less globular, and the greatest circumference being found at the temples, wfil there is sometimes a perceptible bulging. The back of the head is somewhat flatten< Imbeciles of this type, if not suffering from active disease, usually improve very co siderably under training, and at last approach very nearly the standard of ordina intelligence. This is exemplified in one of the cases whose head contours are exi bited, a lad of twenty-one, who, with the exception of a certain amount of childS curiosity and moral imbecility, may be described as cured.* Resembling the hydrocephalic cases in size, though not in form of head, those comparatively rare cases of hypertrophy of brain, which, when complicated w« encephalitis, usually issue in a form of idiocy tending to pass into a variety of man Dr. Fletcher Beach, who lias paid much attention to the subject of hypertrop idiocy, gives the following as the points of cranial distinction between hypertrop and hydrocephalus:— In hypertrophy of the brain the head does not attain so large a size as in chro hydrocephalus. The head of my first case measured 23 inches in circumference, t ol the second 22 inches. I have three cases of chronic hydrocephalus now in asylum, and their heads measure 23^, 25£ and 25| inches respectively. * Head measurements: Hydrocephalic Imbecile (B. M., cet. twelve).—Circumference, in. = 59 5 c. Transverse, 15£ in. - 39 5 c. Callipers, 4| in. = 12 4 c. Longitudii 14J in. = 37-5 c. Callipers, 7| in. = 19 4 c. Contours are exhibited in Fig. 3.