Abstract
This paper is based on the observations of an orthopedic surgeon on approximately 1,000 children with cerebral spastic paralysis. A large portion of these children sought treatment at the Gates Hospital for Crippled Children at Elyria, Ohio. No pathologic study has been made, but impressions have been formed out of this material of clinical observations and inquiry into the history preceding birth and the history of birth and early infancy history that there are many diseases which give rise to the clinical picture of spastic paralysis. Accordingly a rather extensive study of the literature was made pertaining to etiology, and this has in a great degree substantiated these impressions. My purpose in this paper will have been accomplished if I succeed in amending the prevailing opinion among physicians that spastic paralysis is necessarily caused by obstetric difficulty or birth trauma. While the importance of birth trauma as an etiologic factor
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