Dr William Little (1810-1894) of London and cerebral palsy.

Correspondence to: Professor P M Dunn. William Little was born in 1810 in Whitechapel where his father kept the Red Lion Inn. He was educated at a school near Dover and at the Jesuit College of St Omer in France. A left club-foot following poliomyelitis prevented sporting activities but he excelled academically, especially in languages. In 1825 he was apprenticed to an apothecary, after which he studied medicine at the London Hospital, qualifying at the age of 20 and then entering general practice in London. However, after attending lectures at Guy's Hospital and University College, he decided to become a physician, visited Leyden, Leipzig, and Dresden and studied in Berlin, graduating MD in 1937. While in Germany, Stromeyer of Hanover had in 1836 successfully corrected his club-foot using subcutaneous tenotomy, and on returning to London, Little introduced this new technique, operating on a 15 year old boy in February 1837. Thus the treatment of deformities was brought into the province of surgery. Little was elected to the staff of the London Hospital in 1839 and the same year published a treatise on club-foot.1 In 1840 he founded the Orthopaedic Institution which through amalgamation became the Royal National Orthopaedic Hospital in Great Portland Street. He also had appointments to the Royal Orphan Asylum, Wanstead, the Asylum of Idiots, Reigate, and the Royal Hospital for Incurables. Little was a good all-round physician and excelled in clinical instruction. His outstanding written work On the Nature and Treatment ofthe Deformities of the Human Frame2 was published in 1853. The following extract concerns his classification of congenital deformities which accords the modern concepts but ran counter to the views held at the time: 'Congenital deformities are divisible into two classes. I shall hereafter describe several distortions, of variable severity, induced, in my opinion (for the most part), by derangements of the nervous and muscular systems of the foetus, independently of any absence or deficiency of parts, characterised, also, by their capability of restoration to a surprising degree of perfection. These I shall include under the head of congenital distortions. In the last category I shall consider those in which, whatever may have been the primary interruption of normal development in the foetal parts, a total absence, incompleteness, 'S' e ,X,: :,£e-