134 PHYSICAL EXPRESSION. 



developmental conditions commonly found in 

 children, it seems necessary, first, to arrange and 

 examine cases of gross and obvious deformities, 

 where the kind of ill-developments, and any co- 

 existing defects and consequent deviations from 

 normal function, may be easily observed and re- 

 corded. For this purpose I have abstracted from 

 my case-books the notes of twenty-three cases, 

 imbeciles and idiots being generally passed over. 

 These are arranged as follows : 



GROUP I. 



Case 1. Heart-defect Fingers clubbed Cya- 

 nosis Palate cleft. 



Case 2. Heart-defect No cyanosis Deformity 

 of hands Epilepsy in family. 



Case 3. Mitral and tricuspid disease No cya- 

 nosis Malformation of hands. 



Case 4. Heart-defect Congenital cyanosis 

 Left hemiplegia, dependent upon defect of right 

 hemisphere Bell's paralysis on right side of face, 

 with deformity of right ear. 



Case 5. Heart-defect without cardiac symptoms 

 No cyanosis One ear deformed. 



Case 6. Congenital heart-defect, with a varying 

 bruit No cyanosis Patency of inter-auricular 

 septum Want of power in legs from birth, with 

 some rigidity of left. 



Remarks on Group I. This series of six cases 

 illustrates the concurrence of congenital defect of 

 the heart with other deformities, e.g. cleft-palate, 

 defects of hands, ill-formed ears, congenital defect 



