Cerebral Palsy in the Regency
Just as the Industrial Revolution brought rapid changes during the Regency era, medical knowledge made significant improvements as well. Unfortunately, technology was slower to evolve, so there were still many mistaken beliefs held by medical doctors and other providers simply from an inability to probe further. Without imaging or electrical testing techniques, little was known about the nervous system, for example, and how it impacted various diseases.
Therefore, before 1837, cerebral palsy was lumped with various other conditions in a general diagnosis of “deformity.” A more specialized doctor may diagnose a patient with “spastic paresis” (involuntary jerking of muscles) or paralysis, with or without “idiocy” or “imbecility.” Imbecility at the time meant a minor mental handicap, while idiocy was a permanent, irreversible state of mental incapacity without intervals of proper function (as opposed to mental illness).
These definitions sound harsh to us today, but because doctors of the time had very little knowledge of how the brain worked they could only identify issues from how a person appeared or acted. Children with intellectual disability or quadriplegia were often sent to asylums, where there supposedly were more resources for proper care. But these facilities varied widely in quality of care, depending on funding and the involvement of trustees, so outcomes were not always positive.
Children with only motor dysfunction, like Mr. Noyce in my book Forlorn Hope, could more easily be cared for at home and had a good prognosis for health and happiness. In the 1830’s, Dr. John Little, himself affected by neural disease, made the first focused study of cerebral palsy, though he connected neural defects with injuries or lack of oxygen at birth. But he got members of the medical field thinking, and due to his pioneering work, what we know as cerebral palsy was termed “Little’s Disease” until 1887, when Dr. William Osler—the next “big player” in the development of treatment—coined the term we use today.
Sources:
Panteliadis C.P., Vassilyadi P. “Cerebral Palsy: A Historical Review.” Cerebral Palsy. Springer, Cham. 2018.
