Illustrations of Exceptional Symptoms and Examples of Rare Forms of Disease
Authors: J. Hutchinson
Journal: BMJ (1887)

I E. B., aged 7. Father had syphilis before marriage and communi- cated it to mother; mother very nervous; eldest sister of mother.has suffered from epileptic fits; paternal grandfather of patient imbecile; maternal grandfather very nervous; maternal grand-aunt insane.This case is a good illustration of several causes acting together to produce the imbecility, for we have insanity, imbecility, epilepsy, and great nervousness in the parents' relations.The' child' is stated to have been quite right at birth, and to have gone to school, where she made good progress, until two years before admission.The immediate cause of the imbecility is said to have been a fright, but it was noticed' that she was becoming nervous a year before.On admission she was bright-looking, with good features, but was very vicious and bad tempered.She would scream at the top of her voice and then stop suddenly and pull out her hair.Lately she has become quiet, very helpless, and more imbecile.E. P., aged 6. Mother consumptive, excitable, nervous, and has fits occasionally; cousin of mother insane; uncle and brother of father epileptic.OIne brother of the patient was born with convul- sions.The history of the case was that the child had always been bright, but for the last twelve months she had become " dangerous."She had paroxysms of rage without apparent'cause, during which she would tear out her hair, and bite her own and her mother's fingers.On admission she was bright and intelligent looking, and good tem- pered in disposition.Her mental capacity was fair, her powers of observation, imitation, and attention being good.She improved very much during her residence in the asylum, was quiet, well-behaved, and answered questions intelligently.She was taken out by her friends, after being in the asylum five months.The immediate cause of'the overthrow of the child's mental equilibrium is not apparent thp excitability from which she is said to have suffered had 'disap- peared when she was admitted, and practically her mental condition was fairly sound when she was discharged, although she had been in the asylum a very short time.D. A. P., aged 8. Father "touched in his mind ;" paternal grand- father and grandmother died in an asylum; paternal great-grand- mother committed suicide; maternal aunt subject to fits.The heredi- tary predisposition is here seen extending through three generations on the father's side, while epilepsy is present on the mother's side.The mother had a good deal of worry during pregnancy.The child did not speak till a short time before admission.There was evidently a good deal of excitability and destructiveness present, for she never could be left with babies ; she would dress and undress them, and smack them, and if she had a doll, the mother says, she would "limb" it.The hereditary neurosis was evidently well-marked in this family, for the eldest child was excitable, and the second dull; this was the third child.On admission, she was a well-nourished dark complexioned, good-tempered child, with a pleasing expression, subject to fits occasionally.She has made a little progress sincs her residence in the asylum.T. J., aged 7. Father suffered from numbness in the left arm, and had a few fits before his death from heart-disease ; paternal aunt died of fits; uncle and aunt of father died of paralysis, as also did mother's grandmother and aunt.Bath sides. of the family, but especially the father's side, were affected.The child was bright and cheerful until 2 years of age, when he was taken with a fit while teething.After this fit he used to have them every four months, and they continued up to the time of admission.He was then a bright-looking boy, of a restless disposition, and always in mischief ; mental capacity fair.Under treatment he has considerably improved, and has made good progress in school and in the tailor's shop.In 1881, it was noted that he had had no fit for two years.In 1883 he had another fit, and he has had one since.J. W. A., aged 13.Father intemperate and sulky; aunt epileptic, and has an imbecile child ; grandfather and grandmother died of apo- plexy.The mother had a fright when six months pregnant.The case is a congenital one, and is interesting, sbowing as it does the strong influence of neurosis in the family: first, from the fact that there are two other imbecile children besides this one ; and, secondly, in that the aunt, who is epileptic, has also an imbecile child.The boy was of a cheerful disposition, with small mental capacity.He was