Text Appearing Before Image: ars, oldest in family of four children. Others normal.Mother not in good health during gestation. Labor lasted twelve hours. Noforceps. Child was always irritable, but had no convulsions until four months ofage, when first tooth appeared. There were frequent recurrences of spasms, two tofour daily. Has never walked, stood alone, nor been able to support her head. Thecircumference of the head was nineteen inches. ( KIUlnRAL PARALYSIS. 797 Present Condition.—The skin is cool, with a tendency to cyanosis. The bodyis emaciated; there is a flaring of the ribs, and the spleen shows a distinct scoliosis. The mouth is open so that the saliva constantly dribbles. The jaws are de-formed and the face presents a starched appearance. There are contractures andspasticity in both upper and lower extremities. The reflexes are exaggerated. In-telligence nil. Symptoms and Diagnosis.—The following symptoms are common to allforms of palsy: Eigidity of the muscles, contraction of tendons, and exagger- Text Appearing After Image: Fig. 271.—Infantile Cerebral Paralysis. (Kindness of Dr. A. C. Cotton.) ation of all the deep reflexes. Convidsions and coma commonly precede thediseased state. Most cases of dipU\o-ia and paraplegia are congenital, whilemost cases of ha3mip)ogia arc acHjuired after birth. Palsies nsnally follow a dinicult labor. Strabismus and facial )>aralysisare frequently noliccnl. Aphasia may be )uvsent in children that hadpreviously learned to talk. Tbe reflexes on tbe atVeeted side, knee andelliow, are usually exaggerated (Teterv^on, Taylor, and AVells). When athetosis is found, it is usually associated with imbecility andidiocy. Ill associalcd niorofiwn!,^ ilic iwiwl iinilation of iJic p(irali/:cd hand 798 DISEASES OF THE NERVOUS SYSTEM. and fingers of voluntary movements made hij the normal hand and fingerstalcs place. Choreiform movements, called by Weir Mitchell post-paralyticchorea, are frequently mistaken for chorea. Peterson^ describes two con-genital hasmiplegias—a hitherto mmot
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