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William John Little (1810–1894) was an English
surgeon In modern medicine, a surgeon is a medical professional who performs surgery. Although there are different traditions in different times and places, a modern surgeon usually is also a licensed physician or received the same medical training as ...
who is credited with the first medical identification of
spastic diplegia Spastic diplegia is a form of cerebral palsy (CP) that is a chronic neuromuscular condition of hypertonia and spasticity—manifested as an especially high and constant "tightness" or "stiffness"—in the muscles of the lower extremities of the h ...
, when he observed it in the 1860s amongst children. While
spasticity Spasticity () is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles. ...
surely existed before that point, Little was the first person to medically record the condition in writing. Thus, for many years, spastic diplegia was known as ''Little's Disease''; only later did the name change. Also, Little founded the
Royal Orthopaedic Hospital The Royal Orthopaedic Hospital (ROH) is a National Health Service specialist orthopaedic hospital situated in Northfield, Birmingham, England. The ROH specialises in bone and joint problems. History The hospital's origins in a new convalescent ...
of London.


Life

Little was born at the Red Lion Inn in
Whitechapel Whitechapel is a district in East London and the future administrative centre of the London Borough of Tower Hamlets. It is a part of the East End of London, east of Charing Cross. Part of the historic county of Middlesex, the area formed ...
. His parents John and Hannah little were the inn's proprietors.George Bentley, ‘Little, William John (1810–1894)’, Oxford Dictionary of National Biography, Oxford University Press, 200
accessed 9 Nov 2016
/ref> Little did not have any spasticity himself, but he suffered childhood
poliomyelitis Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 70% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe sym ...
with residual left lower-extremity
paraparesis Paraplegia, or paraparesis, is an impairment in motor or sensory function of the lower extremities. The word comes from Ionic Greek () "half-stricken". It is usually caused by spinal cord injury or a congenital condition that affects the neural ...
, complicated by severe talipes. This undoubtedly sparked his special interest in lower-extremity mobility impairments, as well as his medical-orthopedic inclinations more generally. As a youth he was an
apothecary ''Apothecary'' () is a mostly archaic term for a medical professional who formulates and dispenses '' materia medica'' (medicine) to physicians, surgeons, and patients. The modern chemist (British English) or pharmacist (British and North Ameri ...
's apprentice, surrendering his
indenture An indenture is a legal contract that reflects or covers a debt or purchase obligation. It specifically refers to two types of practices: in historical usage, an indentured servant status, and in modern usage, it is an instrument used for commercia ...
s at the age of 18 and entering medical school at the
London Hospital The Royal London Hospital is a large teaching hospital in Whitechapel in the London Borough of Tower Hamlets. It is part of Barts Health NHS Trust. It provides district general hospital services for the City of London and Tower Hamlets and spe ...
. He was admitted to the
Royal College of Surgeons The Royal College of Surgeons is an ancient college (a form of corporation) established in England to regulate the activity of surgeons. Derivative organisations survive in many present and former members of the Commonwealth. These organisations a ...
in 1832. Little is also known for his doctoral dissertation in 1837 on
tenotomy A tenotomy is a surgical act which involves the division of a tendon. It and related procedures are also referred to as tendon release, tendon lengthening, and heel-cord release. When it involves the Achilles tendon, it is called "Achillotenotomy ...
, the first monograph on the subject ever published, and Little became the known source of this operation, intended for the correction of skeletal deformity secondary to
neuromuscular A neuromuscular junction (or myoneural junction) is a chemical synapse between a motor neuron and a muscle fiber. It allows the motor neuron to transmit a signal to the muscle fiber, causing muscle contraction. Muscles require innervation t ...
disorders. Little later travelled to Germany to study the technique of subcutaneous tenotomy with its originator, Louis Stromeyer , who subsequently corrected Little's deformed foot by this method. Among his many publications was "On the Deformities of the Human Frame" (1853) in which he first described pseudo-
hypertrophic Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number.Updated by Linda J ...
muscular dystrophy Muscular dystrophies (MD) are a genetically and clinically heterogeneous group of rare neuromuscular diseases that cause progressive weakness and breakdown of skeletal muscles over time. The disorders differ as to which muscles are primarily affe ...
, preceding
Guillaume Duchenne Guillaume-Benjamin-Amand Duchenne (de Boulogne) (September 17, 1806 in Boulogne-sur-Mer – September 15, 1875 in Paris) was a French neurologist who revived Galvani's research and greatly advanced the science of electrophysiology. The era of mo ...
's paper on the same condition by eight years. The techniques originated by Stromeyer and applied by Little are used today in the surgical management of quite a few neuromuscular conditions today, although obviously in modern times they are quite a bit more advanced due to technological progress and improvements in surgical concepts and methods. Little was one of the first to bridge the gap between
neurology Neurology (from el, wikt:νεῦρον, νεῦρον (neûron), "string, nerve" and the suffix wikt:-logia, -logia, "study of") is the branch of specialty (medicine), medicine dealing with the diagnosis and treatment of all categories of co ...
and
orthopaedics Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...
, and his important work continues to impact both of these fields, including the fact of continually-increasing cooperation between orthopaedic surgeons and
neurosurgeon Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peri ...
s in today's management of
spastic cerebral palsy Spastic cerebral palsy is the type of cerebral palsy characterized by spasticity or high muscle tone often resulting in stiff, jerky movements. Cases of spastic CP are further classified according to the part or parts of the body that are most af ...
and similar
neuromuscular A neuromuscular junction (or myoneural junction) is a chemical synapse between a motor neuron and a muscle fiber. It allows the motor neuron to transmit a signal to the muscle fiber, causing muscle contraction. Muscles require innervation t ...
disabilities.Historical Vignette #9. Little big man: the life and genius of William John Little (1810-1894).
''Orthopedic Review'' 198; Nov. 17 (11):1156, pp. 1161–6.
Little died and was buried in the Kent village Ryarsh.


Family

He had eleven children including Edward Little, who was also a surgeon, and Archibald Little. Archibald married
Alicia Little Alicia Little or Mrs Archibald Little (1845 – 31 July 1926) was a British writer and a campaigner for women's rights and later against foot binding in China. Life Little was born as Alicia Ellen Neve BewickeIn many of her books ''Neve'' appear ...
, a writer who campaigned against foot binding in China.


Footnotes


References


Little, W.J., ''A Treatise on the Nature of Club-Foot and Analogous Distortions: Including Their Treatment Both With and Without Surgical Operation, Illustrated by a Series of Cases and Numerous Practical Instructions'', W. Jeffs, (London), 1839.
{{DEFAULTSORT:Little, William British orthopaedic surgeons Alumni of the London Hospital Medical College 1810 births 1894 deaths