Diseases of the nervous system : a text-book of neurology and psychiatry . therefore it can be seen that one isdealing not only with a stoppage of development, but with a diseaseprocess which, while it is in operation, is producing symptoms ofits own. The most useful classification of the feeble-minded is a clinical one. 762 IDIOCY, IMBECILITY, AND DEFECT GROUPS It would be quite as absurd to enter into a discussion of the generalpsychology or the general pathology of defectives as it would be of theso-called insane, and therefore in this chapter the different well-definedforms will be briefly
Diseases of the nervous system : a text-book of neurology and psychiatry . therefore it can be seen that one isdealing not only with a stoppage of development, but with a diseaseprocess which, while it is in operation, is producing symptoms ofits own. The most useful classification of the feeble-minded is a clinical one. 762 IDIOCY, IMBECILITY, AND DEFECT GROUPS It would be quite as absurd to enter into a discussion of the generalpsychology or the general pathology of defectives as it would be of theso-called insane, and therefore in this chapter the different well-definedforms will be briefly and separately described. Clinical Varieties.—Amaurotic Family Types (Tay-Sachs Disease).—This is a disease which generally affects more than one child in thefamily and appears to be confined in its incidence to the Jewish etiology is unknown. Its pathology is in general a degenerationof certain elements of the brain, more particularly the cortical elementsand pyramidal tracts, including particularly the optic nerves. It hasbeen described in three stages:. Fig. 317.—Adenoma sebaceum. The skin affection associated with tuberous sclerosisof the brain, a profound degree of mental defect and various tumors of the viscera,especially the kidneys. (Courtesy of Dr. Martin W. Barr.) First Stage.—The infant is usually all right at birth and the diseasedoes not make itself manifest for some few months thereafter, usuallyat about the fourth month. At this time the first symptoms observedare some weakness in the neck muscles and indications of dimness ofvision. If the fundus is examined during the fourth or fifth monththere will be found a whitish-gray symmetrical patch, oval in shape,with a horizontal axis occupying the macula lutea. In the center ofthis patch is seen the fovea centralis which appears as a dark cherry-red spot. Optic atrophy follows, and later total amaurosis. Secondstage: In this stage the weakness of the neck muscles is more markedand the head falls bac
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