Cerebral Palsy Pioneers

Every effort to treat or eradicate a medical condition has its heroes, and Cerebral Palsy is no exception. Committed individuals inside and outside of the medical field have worked hard and enjoyed incredible victories in not only the fight to find new remedies for the condition, but also in the effort to create a better world for people with special needs.

William John Little (1810-1894)

First to study and attempt to define spastic Cerebral Palsy

Dr. William John Little, the first man to define Cerebral Palsy as a brain injury caused by oxygen deprivation at birth, turned his illness-ridden childhood experiences into a lifelong desire to help others through his practice of medicine.

Path to innovation

As a child, Little battled mumps, measles, and whooping cough, three diseases that still claim lives today. A bout with polio left Little with a clubfoot, a physical impairment in which the foot turns inward. At the age of 15, his childhood illnesses and foot impairment began to fuel an interest in medicine. By age 27, he had earned his degree as a doctor of medicine.

During his studies, Little met Dr. Georg Friedrich Louis Stromeyer, a German orthopedic surgeon who was performing innovative reconstructive surgeries. Using his new techniques, Stromeyer was able to correct Little’s clubfoot; the procedure was so successful that Little performed it in England and helped establish the field of orthopedic surgery in Great Britain. Many of his practices are still used in medicine today.

The “Beginnings” of Cerebral Palsy

Little’s work on Cerebral Palsy, although unnamed at the time, actually started in the late 1830s when he lectured on birth injuries. In 1853, he published his research in a document titled, “On the Nature and Treatment of the Deformities of the Human Frame,” noting congenital birth defects and “their capability of restoration to a surprising degree of perfection.”

His work on Cerebral Palsy culminated in 1861 when Little attempted the first definition of Cerebral Palsy in a paper presented to the Obstetrical Society of London. In it, he stated that “abnormal forms of labor,” in which the “child has been partially suffocated,” injures the nervous system and results in spastic rigidity and sometimes paralytic contraction.

It was here he first defined what is now known as spastic Cerebral Palsy. His work was so groundbreaking that spastic Cerebral Palsy was first known as ‘Little’s disease.’

Little’s 1861 paper also discussed the value of treatment and early intervention. “Many of the most helpless have been restored to considerable activity and enjoyment of life,” he wrote.

A family passion

Little continued to practice medicine until 1884, but his legacy did not end there. Two of his sons followed their father’s footsteps into orthopedic surgery. Muirhead Little became the first president of the British Orthopaedic Association in 1918.

Sir William Osler (1849 – 1928)

Wrote first book about Cerebral Palsy and coined the name for Cerebral Palsy

Sir William Osler is regarded as one of the most notable contributors in the history of medicine. He was also one of the most significant early researchers of Cerebral Palsy and is often credited as first to use the term ‘Cerebral Palsy.’

While Dr. William John Little began the study of Cerebral Palsy, then named ‘Little’s Disease,’ his work referred to only one form of Cerebral Palsy as defined today. Osler’s book, “The Cerebral Palsies of Children,” explores many other forms of the impairment. The book is a summation of Osler’s lectures, which present numerous case studies and highlight possible causes of impairment. Much like Little, Osler’s final conclusions indicate that proper treatment can greatly increase quality of life.

Father of medicine

Sir William Osler is considered by many to be the father of modern medicine. In 1889, the same year he wrote “The Cerebral Palsies of Children,” Sir Osler became Chief of Medicine at what was then the recently-established Johns Hopkins medical school. His textbook, “The Principles and Practice of Medicine: Designed for the Use of Practitioners of Students of Medicine,” was published in 1892 and translated into four languages. It became one of the most important medical textbooks used over the following forty years.

Sir Osler also revolutionized North American medical education when, while at Johns Hopkins, he began following new European practices of teaching students about medicine at patient bedside, rather than in classrooms and amphitheaters. He went even further, establishing post-graduate programs that defined medical training and set a course still followed today.

In 1905, he was offered the preeminent position in the English speaking world of medicine: Regius Professor of Medicine at Oxford University. It was an honor that may have seemed unsurpassable until 1911 when he was knighted for his contributions to the medical field.

Sigmund Freud (1865-1939)

First to group a wide range of motor impairments

Dr. Sigmund Freud, a neurologist, was first to state that Cerebral Palsy might be caused by abnormal development before birth. Prior to that, orthopedic surgeon Dr. William Little had postulated that Cerebral Palsy was acquired at birth due to difficult labor. Freud disagreed, stating that difficult birth is “merely a symptom of deeper effects that influence the development of the fetus.” At the time, this conclusion was virtually ignored. It wasn’t until decades later that researchers began to support Freud’s theories.

Freud on the cause of Cerebral Palsy

Freud disagreed with Little’s findings and fueled a debate that is still argued in courtrooms and researched within the medical community today. Freud noticed that many children who experienced birth asphyxia went on to develop normally with no indication of Cerebral Palsy. Little believed that birth asphyxia caused Cerebral Palsy.

Little’s background was orthopedic surgery, and Freud believed that this limited both the type of patients that Little saw and the way Little viewed their condition. Also, Freud was studying the brain and its pathways, which allowed him to see a connection between Cerebral Palsy and other conditions such as intellectual impairment and seizures. All this led Freud to state that these conditions were likely caused by problems occurring very early in the development of the brain and central nervous system, certainly before birth.

Despite this observation, researchers and doctors continued to follow Little’s conclusions. Freud wasn’t proven correct until almost a century later when research indicated only a small percentage of Cerebral Palsy cases, approximately 10 percent, were caused by birth asphyxia.

Freud first to unite motor impairments under one term, ‘infantile Cerebral Palsy’

Although the term ‘Cerebral Palsy’ was not used in the mid-1800s, Freud was first to unite the wide range of infantile motor impairments caused by abnormal brain development under one term: infantile Cerebral Palsy. This grouping is still relevant today, although Freud intended it as a temporary classification; one that would be proven outdated by future research. Today, doctors and researchers continue working toward better methods for classifying Cerebral Palsy.

The peculiar birth of Sigmund Freud

Ironically, Freud was protected from asphyxia at birth. He was born in a Caul, which means he was born inside an intact amniotic sac. This happens most often in preterm birth, and can allow a baby to develop as if they were still inside the womb, not needing to breathe, protected from infection, and taking nourishment from amniotic fluids. According to the folklore of Freud’s day, birth in a Caul was an omen of future success. He was destined to be a great man.