English: Case A. — W. M. Male ; superficial excitable idiot ; aged io}4
years when photograph was taken. Height 3 feet 11^ inches,
weight 44 pounds. Head, microbrachycephalic.
Head Measurements.
Inches,
Circumference 15^
Naso-occipital arc 105^
Binauricular arc loYs
Antero-posterior diameter 5J^
Greatest transverse diameter 3J^
Binauricular diameter 314
Facial length loj^
Cephalic index yy
A mute, with dark hair and gray eyes. Teeth fair ; alveolar
arches wider than usual, and palate almost flat. Sight, hearing,
taste, and smell apparently normal. Helpless, with marked sialor-
rhoea, he is unable to walk or to care for himself ; spends most of the
day in the rocking-chair. Is insensitive to pain, extremely nervous,
restless, and noisy, never quiet when awake, with pronounced im-
perative movements that follow a regular cycle thus : First, throws
up head and places left thumb in mouth with fingers resting on left
cheek while he rocks to and fro ; bending low, he straightens and
turns to right, at the same time placing right hand at nape of neck ;
next throws left arm to right shoulder ; crosses wrists, strikes right
side of face under ear with right hand and strikes hands together ; then wrings hands with imperative movements of fingers, and places
right index finger in left palm ; places left index finger to lips, thumb
in mouth ; waves both hands, and crosses feet. This he does con-
stantly when awake, with brief intervals between cycles, during
which, more quickly than the eye can follow, he pulls and picks at
clothing. Organs and functions of body normal, except for occa-
sional attacks of gastro-intestinal disturbance.
Under treatment for 7 years, learned only to feed himself with a
spoon, and became more cleanly in habits, indicating his wants by a
peculiar vv'ailing cry.
Second child ; born at full term ; labor ordinary ; nourished by
mother. Father, a laborer, 26 years, and mother 24, at time of W.'s
birth. Two sisters living, both healthy. Parents of " Pennsylvania
Dutch " stock. No cause for W.'s condition assigned. Died in
twelfth year, of intussusception.
At the necropsy the body weighed 45.64 pounds and measured 3
feet 11^ inches. Calvarium thin, measuring at cut portions but
one eighth of an inch. Brain not especially edematous, and only
a moderate amount of cerebro-spinal fluid escaped. Dura adherent
to pia over vifhole cerebral hemispheres, and in some places to the
calvarium, so that the latter was removed with great difficulty.
Brain weighed 20.64 ounces.
The cerebral hemispheres were of equal size — each hemisphere
measuring antero-posteriorly 5 inches — and did not cover the cere-
bellum, about one inch of each cerebellar lobe being left exposed.
The fissure of Rolando on each side was nearly perpendicular. The
cerebral convolutions were very imperfectly developed, especially in
each parietal lobe. The cerebellum measured transversely 4.14
inches, and was much better developed, proportionately, than the
cerebrum. The occipital lobes were separated from one another,
and the left superior vermis was exposed. The cranial nerves were
normal, and the pons was well developed. The spinal cord was
about as large as is usual in a child of the same size.