Dr. Charles West: a 19th century perspective on childhood aphasia
Paula HELLAL and Marjorie LORCH
Dr. Charles West founded the first English specialist pediatric hospital, the Hospital for Sick Children in Great Ormond Street, London in 1852. He remained the hospitals senior physician for 23 years, devoting a great deal of his energies to describing the nervous diseases of infants and children. In 1871, West delivered the prestigious Lumleian lectures, the last of which concerned disorders of the nervous system in childhood. West divided this talk into two parts, the first concerning speech the highest endowment of our race the second, the mental and moral peculiarities of childhood.
Loss of speech in the child, West believed, was almost always a transitory condition. He had seen only one case in which the pattern of aphasia in a child was similar to those described in the adult literature. This particular case concerned a 5 year-old girl who, after sunstroke and a coma lasting a fortnight, was found to have right-sided hemiplegia and loss of speech. West describes the recovery of the paralysis (excepting the arm) and the child's attempts at vocalisation. She remained at the hospital for a number of months and was readmitted on 3 occasions during the following 3 years allowing West to follow her progress. He relates this case in the lecture because hers is the earliest age at which, as far as I know, aphasia, accompanied with paralysis of the right side, has been recorded.
Of greater interest to West were cases of temporary aphasia. Loss of the power of speech in the child would be absolute for a while, returning completely, and being independent of any grave disorder of the intellectual powers. He had no theory to offer to account for this state but observed that it occurred with greater frequency in the child than the adult.
West's lecture was delivered only a decade after the first papers on Broca's aphasia appeared in the medical literature. Throughout the 19th century cases of aphasia in childhood were overshadowed by reports of aphasia in adults. It was not even universally accepted that the condition could exist in children. West's lecture was an early attempt, based on his decades of clinical experience, to classify and categorise language loss and disturbance in children. The transitory nature, in many cases, of aphasic symptoms in childhood, already noted by West, was to become an important feature of the traditional picture of acquired aphasia in children by the turn of the century.
Session III -- Neuropsychology, Language and Cognition
Los Angeles, California, USA