The clinical symptomatology and pathologic anatomy of the cerebral birth palsies remain even today an open chapter in medicine. This is because there are many diseases that may give rise to the clinical picture of infantile palsy. Numerous investigators have attempted to classify all of the various causes; others claim these palsies to be due to hemorrhage or injury at the time of birth. Collier1 considered them all due to a "primary degeneration of the cerebral pyramidal neurones." Investigations of the neuropathology of cerebral birth palsies, taken in the wider sense as described by Freud,2 has convinced me that it is impossible to bring all of the various causes under one heading.
The confusion in the field was greatly increased by the work of Dr. Sarah McNutt3 who, in 1885, described a case of "double infantile spastic hemiplegia" in a child born in difficult labor. A second