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"Child`s Health" 6 (49) 2013

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Doctor Down

Authors: Nagornaya N.V., Bordugova E.V., Usenko N.A. - Donetsk National Medical University n.a. M.Gorkiy

Categories: Family medicine/Therapy, Pediatrics/Neonatology

Sections: Specialist manual

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Down’s syndrome is disease characterized by 21 trisomy of chromosome pair. According to the official statistics more than 420 children with Down’s syndrome born in Ukraine yearly. The founder of rehabilitation model for such children was a man that dedicated whole his life to people with intellect abnormalities and this syndrome was named in his honor. The name of this scientist is doctor Down.

John Langdon Haydon Down was born on 18 November 1828 year in English village Tor Point in the family of entrepreneurs. Since he was 14 years old John Langdon helped his father with trading. His work day consisted of 14 hours. In the age of 18 years old John left his house and little town and went to London, where he worked as pharmacist and surgeon assistant.

In the middle of 40-ies of XIX century he entered the learning course of chemistry and pharmacy. This qualification helped him in widening of father’s firm. Simultaneously John was making scientific work in the field of organic chemistry. In 1853 John Langdon Down decided to continue his medical education and entered Medical School by London Hospital. In 1856 he was given a qualification of doctor of the general practice. Doctor Down was elected as member of Royal Society of Surgeons. Then John Langdon Down continued his medical practice in London Hospital gynaecology department. This work was very difficult but it provided John Langdon with huge diversified experience of medical activity. He had to combine the constant patients’ observing in hospital, conduction of domiciliary obstetrics, and leading of  student practice. In 1859 John Langdon Down got a degree of Doctor of Medicine.

After working during the three years in London Hospital John Langdon unexpectedly decided to return to province, where he became a head of Royal Asylum for mental defective children in Earlswood and worked there during ten years. In this period of time the Asylum became exemplary establishment and was popular whole over the world. The more fame doctor Down got due to his own private rehabilitation institution for people with intellect abnormalities in Normansfield. During his work in Earlswood John Langdon Down started and then continued and finally adopted in Normansfield the rehabilitation programs based on socialization of people with intellect abnormalities. According to his opinion the most effective result was given by the combination of four following factors: medical care, teaching, physical growth and development and forming of the proper behavior based on the common ethic social norms. The patient rehabilitation program consisted of therapy methods developing, teaching, hygienic regime, work and art therapy. Children were divided into groups of 3-4 persons and were under care of teachers and medical staff. Asylum inhabitants were taught arithmetic, reading and writing. The patients danced, were busy with fancywork, gymnastics, music. Children had an opportunity to play in tennis, football, horse riding. The consideration was also given to table behavior rules that were cultivated from the early childhood and watched over. The hygienic regime was strictly followed in the rehabilitation centre. John Langdon Down abolished all kinds of punishment.

During the many years John Langdon Down tried to create a classification of mental deficiency. As early as in 1866 he described in the first time “mongolian idiocy”, a disease known to contemporaries as “Down’s syndrome”. These children were 10 percents of all observed by him patients with intellect abnormality. John Langdon established a link between the mental development delay and birth injuries, asphyxia, cerebral paralysis, opium consumed by parents. In part of his patients he observed the weakness of blood circulation system. In the present time it is established that 50-60% children with Down’s syndrome have congenital heart diseases.

The important role in John Down’s life played his family and relatives, who supported him in difficult situations. So his sister Sarah and her husband Philipp Crellin solved John’s financial questions, helped him with dwelling and meals during his education in Medical School; there he got acquainted with Philipp’s sister Mary, charming, clever and magnificently playing piano young lady. In 1860 Mary became doctor Down’s wife and was his support during the whole his life. His first son Everling tragically died when he was 21 years old and their two years old daughter Lillian died from pneumonia. His sons Percival and Reginald with his families also helped his father during live and continued good deals after his death. For instance, Reginald after his education in university in 1892 became father’s assistant and in two years combined it with medical practice in London Hospital, made scientific researches. Percival absolutely dedicated himself to care of Normansfield patients.

As it is well known, the history doesn’t known chances. In 1895 Reginald married Jane Cleveland. In his family was born a child with syndrome, described by his great grandfather. The mother nevertheless didn’t want to accept this fact and only after her death the child became the patient of doctor Down’s rehabilitation centre and lived there till 65 years old.

In many countries successfully work different organizations for children with Down’s syndrome. Ukraine is not an exception. The Ukrainian charitable organization “Down’s syndrome” was based in 2003 by parents of children with Down’s syndrome, it is a member of European Down Syndrome Association. The greatest achievement of this organization is opening of free Early Development Centre for children with Down’s syndrome. Unfortunately one centre in our country is not enough.  

Doctor Down suddenly died in the age of 68 years. Mary outlived his husband for four years. After their death the ashes was mixed and buried in unknown place. Probably, it is a beautiful tree in Normansfield yard, where they liked to rest together. In our time still lives the legend, according to it late in the evening on the stairs of old house appears the silhouette of man in the suite of Victorian Age. Who is it? The most mysterious patient of Normansfield? May be it is doctor Down personally? Only one thing is known for sure: the good deals of the great John Langdon Down, scientist and humanist, are continued in our days!

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