1 – Unexpected research results
Data gathered in experiments or observations made
50 to 100 years ago do not lose their validity.  But the
field of medicine is one of the worst for forgetting its
history and therefore needing to reinvent the wheel
after a lapse of several decades.  Perhaps part of the
problem is that many libraries do not have the shelf
capacity to keep older volumes of journals readily
available.  Even at Harvard's Countway Library of
Medicine many older journal volumes, conference
proceedings, and textbooks are kept in storage and
are available only by special request.

At a conference I recently attended, one young
researcher confidently began her presentation with
the statement, "The effects of hypoxia on the brain
are not well understood."  But the effects of hypoxia
and anoxia have been very well determined.  That the
effects of oxygen insufficiency are not clearly
understood may be because the damage produced in
early experiments appeared so unbelievable and
contrary to what had been expected.

The papers by Ranck & Windle (1959), Faro &
Windle (1969), Miller & Myers (1970, 1972), and
Myers (1972) report the findings of experiments with
monkeys intended to produce an animal model of
cerebral palsy by inflicting sudden catastrophic
asphyxia at birth [1-5].  In their first experiments, a
saline-filled rubber bag was used to cover the infant
monkey's head at birth before the first breath, and
placental respiration stopped by clamping the
umbilical cord.

Surprisingly, monkeys subjected to this type of
asphyxia did not develop cerebral palsy.  The data
obtained in these experiments was so unexpected
that the researchers themselves appear to have
rejected their findings as not making much sense.

Complete cutoff of oxygen delivery at birth did not
produce the anticipated widespread damage of motor
systems of the brain.  At first no brain damage could
be found, and monkeys asphyxiated at birth exhibited
only transient delay in developing motor control.  
Manual dexterity was permanently impaired, but this
deficiency in fine motor control was considered minor
compared with the total incapacitation of movement
suffered by victims of cerebral palsy.

Windle (1969) suggested that a brief period of
asphyxia at birth might underlie the condition then
known as "minimal cerebral dysfunction" (or MCD)
[6].  This designation most closely corresponds to the
current concepts of "attention deficit hyperactivity
disorder" (ADHD) or "pervasive developmental
disorder" (PDD).  But can any cerebral dysfunction
really be considered minimal?  Can the handicaps of
attention deficits or poor manual dexterity be
accepted as minor past early childhood?

Specialists in child development and education can
be more accepting of minimal deficits than a child's
family members.  Specialists are outsiders, who bear
none of the burden, and can more easily throw
around terms like minimal or mild impairment.  
Developmental delay in childhood often precedes
difficulties in school and employment problems in
adulthood.  Special education, main-streaming,
inability to work at more than menial tasks,
assignment to a group home, and day programs, are
the fruits of a ruined life.

Medical records of patients in mental hospitals and
prisons reveal, time and again, that problems existed
from early childhood.  Mothers' comments about
oxygen insufficiency at birth are too often
thoughtlessly dismissed.  Deficiencies revealed by
patients' own laboriously scrawled, illiterate notes
often appear surprising.  The developmentally
delayed child will most often require life-long
dependency on others.  Euphemisms like mild, minor,
or minimal are not acceptable, when it's your own
child designated at the lower end of presumed
"normal limits."
  1. Ranck JB, Windle WF (1959).
    Brain damage in the monkey,
    Macaca mulatta, by asphyxia
    neonatorum.
  2. Faro MD & Windle WF (1969)
    Transneuronal degeneration
    in brains of monkeys
    asphyxiated at birth.
  3. Miller JR, Myers RE (1970)
    Neurological effects of
    systemic circulatory arrest in
    the monkey.
  4. Miller JR, Myers RE (1972)
    Neuropathology of systemic
    circulatory arrest in adult
    monkeys.
  5. Myers RE (1972) Two
    patterns of perinatal brain
    damage and their conditions
    of occurrence.  
  6. Windle WF (1969) Asphyxial
    brain damage at birth, with
    reference to the minimally
    affected child.
References
Full References
top
top
  1. Ranck JB, Windle WF (1959). Brain damage in the monkey, Macaca mulatta, by asphyxia
    neonatorum.  Experimental Neurology 1:130-154.
  2. Faro MD & Windle WF (1969) Transneuronal degeneration in brains of monkeys asphyxiated
    at birth.  Experimental Neurology 24:38-53.
  3. Miller JR, Myers RE (1970) Neurological effects of systemic circulatory arrest in the monkey.
    Neurology 20:715-724.
  4. Miller JR, Myers RE (1972) Neuropathology of systemic circulatory arrest in adult monkeys.  
    Neurology 22:888-904.
  5. Windle WF (1969b) Asphyxial brain damage at birth, with reference to the minimally affected
    child.  In Perinatal Factors Affecting Humn Development.  Pan American Health Organization,
    proc. spec. session, 8th meeting, pp. 215-221