Bernstein: Microcephalic People 



31 



through idiocy and imbeciHty to simple 

 'feeble-mindedness,' which is not infre- 

 quently associated with small-headed- 

 ness. Microcephalus, however, does 

 not depend solely upon diminutive size 

 of head, as ascertained by measurement; 

 and in our opinion the limitation of the 

 term proposed by some to cases in 

 which cranial circumference does not 

 exceed seventeen inches, is scarcely 

 scientific. There is a characteristic 

 form, as well as size, of microcephalus 

 heads; such, for example, as a narrow, 

 rapid receding forehead, a somewhat 

 pointed vertex, and a flat occiput. 

 Though of course the frontal and parie- 

 tal lobes are on a small scale, it is in the 

 occipital and temporosphenoidal that 

 we usually find the most striking evi- 

 dence of arrest in development. A 

 remarkable case ('Freddy'), for twenty 

 years under the authors observation at 

 Lancaster, was anatomically reviewed 

 by Dr. Telford Smith and Professor 

 Cunningham, of Dublin. His brain 

 weighed only 12^^ ounces; the convolu- 

 tions were simple, though fairly dis- 

 tinguishable in the anterior lobes, but 

 became rudimentary posteriorly, the 

 occipital and temporosphenoidal lobes 

 being indeed very imperfectly de- 

 veloped. This 'Aztec' like youth, who 

 had large bright eyes, an aquiline nose, 

 and somewhat receding chin, mani- 

 fested good powers of observation, but 

 was only able to express himself in a 

 few monosyllabic words. He had con- 

 siderable will power, and though it was 

 found impossible to train him to much 

 that was useful, he was in no sense a 

 low-grade idiot. We have repeatedly 

 seen boys and girls w^ith heads measur- 

 ing only nineteen inches, taught to read 

 and write, and to do industrial work. 

 Quality of brain is an important factor, 

 as well as quantity, and in cases of 

 microcephalus what little there is is 

 usually fairly active." 



There were five of these children — 

 four boys and one girl — among a family 

 of ten children variously interspersed 

 as regards age. 



These three boys' heads measured in 

 in circumference 15", 15^" and 16". 

 They were all three able to dress and 



make their own toilet, and two of them 

 learned to assist in dining room work, 

 washing dishes and setting tables, and 

 knew the difference between eight or 

 ten plates on the table and the corres- 

 ponding number of forks, spoons, and 

 knives for a like number of places. 

 They knew this not from counting — 

 they were unable to count — ^but from 

 relative position and habit of repetition. 



Many cases have come to our atten- 

 tion where operation (craniectomy) had 

 been done on the skulls of these indi- 

 viduals, hoping thereby to allow the 

 cranium to expand and the brain to 

 grow and develop, it being assumed that 

 the sutures and fontanels had ossified 

 and closed too early in life and thus con- 

 fined and prevented the brain from nor- 

 mal growth. The results of these 

 operations were never successful or 

 promising and no experienced surgeon 

 does the operation these days. 



Many times as a result of pressure 

 on the brain from scar tissue resulting 

 from the operation, convulsion and 

 paralysis ensue. 



Due credit is to be given Miss Mar- 

 jorie Fulstow for collecting this family 

 record as follows: 



FAMILY HISTORY OF THE PIN BOYS 



The representatives of this family in 

 the Rome School are August P. (IV, 

 13), Charles P. (IV, 14), and Raymond 

 P. (IV, 17), all microcephalics of a pro- 

 nounced type. The record states that 

 August P. was born in New York 

 State in 1888, and that he cannot read 

 or write or learn anything; is clean in 

 his personal habits, can speak a few 

 monosyllables indistinctly and tries to 

 tell his name. He was brought here 

 from the School at Syracuse. When 

 admitted to the R. S. C. in 1905, he 

 tested three years mentally. He is 

 employed in the patients' dining-room 

 and is seldom disturbed; he was once 

 known to strike an attendant. 



Charles P. (IV, 14) was born in New 

 York State in 1890, a microcephalic. 

 In 1903 he tested four years mentally, 

 while in 1914 he tested three years. He 

 also was transferred from the Syracuse 

 school to this institution. 



