Copy 1

Lectures on the diseases of infancy and childhood / By Charles West.

  • West, Charles, 1816-1898.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the diseases of infancy and childhood / By Charles West. Source: Wellcome Collection.

    165/552 (page 137)
    Cases might be related in illustration of all these varieties in the form of infantile paralysis, in its onset and its duration; but time will not allow me to do more than refer you to this table, which embodies the most important points in the history of twenty cases of paralysis in infants or children.—[See pp. 138-9. ] If we leave out of the question the two cases in which the paralysis seemed to be congenital, we shall find that, in thirteen out of eighteen instances, it occurred between eight months and three years of age,—or, in other words, during that time when the process of dentition is going on most actively. In many of these cases, indeed, it was not preceded by any of the local signs of difficult dentition; but still it is quite apparent that the changes that are going on in the constitution during that im- portant period of development powerfully predispose to the affection. There were but two instances in which there seemed to be any reason for regarding the paralysis as connected with permanent disease of the brain ; and in eight out of the eighteen cases no indication of cerebral disturbance occurred before the paralysis, or came on afterwards. In the two cases in which the disorder was congenital, both extremities of one side were palsied, and in one of them the power over the same side of the face was likewise impaired. In seven of the other eighteen cases the leg only was affected, and in two of these the power over both legs was lost ; in five both the leg and arm were palsied, while in six instances facial para- lysis existed. In four of these six cases the paralysis of the portio dura was not associated with impaired power over any of the limbs; once it was combined with palsy of the leg, and once with a general impairment of the power of walking. One point which it behoves us to bear in mind in connection with these cases is, that though cerebral symptoms, or any other form of disturbance of the general health that may have preceded the paralysis, generally subside in a short time, there is still very great danger of the paralysis continuing in such a degree as to cause much disfigurement, or to interfere greatly with the usefulness of the limb. In only six of the eighteen cases did a cure of the palsy take place: in two of these cases the portio dura alone was affected ; in two others the paralysis of both leg and arm was incomplete, and was associated with a state of general debility ; and in one the loss of power over one leg had come on after the child had been sitting for some hours on a stone door-step. In four of these cases treatment was commenced within two or three days after the occurrence of the paralysis, and continued unin- terruptedly until the patient’s recovery. In one the treatment was begun after the lapse of nearly three weeks; and in another, though begun immediately, it was discontinued for some weeks. In four instances partial improvement took place, and there seems reason for anticipating that in one (No. 20) this improvement will go on to complete recovery. In Nos. 7 and 17 the improvement was but slight; in both these cases, however, there was more serious cerebral disease than in any others. The