14 



Indiana University Studies 



body only, 'monoplegia'."^ The treatment for spastic paraly- 

 sis is similar to that for spinal paralysis, only the prognosis 

 is in most cases unfavorable, particularly where epilepsy 

 and mental derangement accompany the paralysis. This is 

 the one crippled condition where mental deficiency is a relative 

 factor. 'There are other conditions in which we may have 

 both the mind impaired or destroyed together with paralysis, 

 such as Hydrocephalus and Microcephalus ; but these are not 

 classified as paralyses per se."' 



Case E. W. 2,117. This is a case of an illegitimate child, 

 paralyzed in both legs, and feeble-minded — a typical spastic 

 paraplegia. He is unable physically and mentally to go to 

 school. His mother has married and her husband is unwilling 

 to support another man's child, so the boy has been entered on 

 the waiting list of the State School for Feeble-Minded, where 

 he will probably remain indefinitely. 



9. Congenital Dislocation of the Hip. This condition is 

 found more often in girls than in boys. It is a marked de- 

 formity and hinders walking. Treatment by manipulative re- 

 duction followed by plaster casts results in gratifying correc- 

 tion in many cases. 



10. Clubfoot. The commonest form of clubfoot is 

 talipes equino-varus, where there is an elevation of the heel 

 and inversion of the sole inward, with pressure on the outer 

 edge of the foot. In these cases the varus condition is con- 

 genital; and the equinus is usually acquired when the pa- 

 tient first begins to walk. The cause of the congenital condi- 

 tion is a perversion of intra-uterine development or abnormal 

 intra-uterine pressure. Treatment of the deformity consists 

 in surgical correction first of the varus condition, and then of 

 the equinus. Forced manipulation, sub-cutaneous division of 

 ligaments (tenotomy) , plaster splints, and braces all form the 

 various steps in this treatment, and provided that the patient 

 follows the treatment prescribed during the long convalescent 

 period, favorable results are attained. There are several 

 other forms of clubfoot besides talipes eqimw-varus. Talipes 

 equinus or ''horse heel" is a form acquired after infantile 

 paralysis, or from the shortening of a leg after a joint dis- 

 ease such as tuberculosis of the hip. Talipes calcaneus is 



Emerson, Essentials of Medicine, p. 200. 

 ' Quotation from Dr. John H. Oliver. 



