Should in the newspapers the account of a young child, already folded in its be by shroud and placed in a chapel, who was found the next day sitting up ве and amusing itself with the precious objects which were shut up with cerit. This is one of those errors of which I have reported so many instances in my researches upon apparent death, and which only happen All to the ignorant and to persons unacquainted with medicine.* Care must then be taken not to arrive at a conclusion too hastily, and every ultati precaution and every convenient attention must be made to bear upon the verification of the decease. The reality of death should only be atch confirmed after the complete and prolonged disappearance of the beatings of the heart as ascertained by auscultation. -4 recovery is dead. The eclampsia which is not sufficiently violent to occasion death, does not always end without leaving traces of its occurrence. Some children recover their usual serenity immediately after the attack, and do not appear to have been ill. Others experience a slight febrile attack, which soon vanishes; they have often pains in the convulsed limbs, with ecchymoses on the surface of the skin, and a small number become deformed. The origin of certain permanent contractions which bring on deviation of the head or of these parts, retraction of the limbs, Sue Sly Lilie Steh paralysis, dec., must be referred to the convulsions of the 3 have seen several children in whom torticollis had no other cause. The drooping of the upper eyelid, strabismus, irregularity of the mouth, several contractions of the limbs, often depend on this influence. These accidents are consequences of essential as well as of symptomatic convulsions; their relations with alterations in the brain is not more decided than are certain cases of facial and nervous paralysis noticed amongst hysterical persons. Post mortem examination does not reveal their cause in a clearer manner than that of the convulsive phenomena themselves. It is the same with eclampsia, amongst certain very susceptible children, as with the nervous phenomena observed in hysterical women; relapse is very common. Supposing the general constitution has not been modified, it manifests itself under the influence of the most fugitive causes. A first attack predisposes to a second, and those te it who are subject to these conditions are a prey to these accid several times at least in the course of their infancy. When, amongst other subjects, the convulsive themselves in the course of an acute disease, th delirium, and cease, to appear no more as e 412 produced them has vanished. DIAGNOSIS. The convulsions of eclampsia, *Traité des signes de la mort easily distinguished from the convulsions produced by diseases of the meninges, of the brain, and of the spinal cord, in consequence of the particular phenomena, febrile or otherwise, which constantly accompany these different affections. One disease alone, epilepsy, so nearly approaches that which we have just described, that, according to some authors, amongst whom must be reckoned Sauvages and Cullen, it is impossible to establish any distinction between them. The convulsive phenomena are nearly the same in both cases, only that in epilepsy, the attacks are of less duration, and are only reproduced at very distant intervals. Besides, they are manifested during the whole period of infancy, and continue beyond this epoch for the remainder of life. PROGNOSIS. Under the head of their prognosis, eclamptic convulsions must be divided into two classes; those which are primary, independent of a morbid state which is about to appear, or indicatory of this morbidas state, and those which are secondary, intimately allied to an acute disease which they are sometimes about to terminate. The primary convulsions caused by dentition, intestinal worms, slight pains, heat, Cariss are the least important. Those which result from the bad quality of Eustilins the milk of the nurse or from deviations in regimen yield less easily and often lead to death. But those which announce the commencement of certain eruptive fevers, and especially of small-pox, are of good omen. They predict, says Sydenham, a favourable eruption, slightly confluent, the progress of which will be natural and the termination always favourable. As to secondary, terminal convulsions, those which lea manifest themselves in the course of pneumonia, hooping cough, small-4pox, &c., it is seldom that death does not prove their natural termination.. h medicine state, with t means of curing a ng a little salt on the Brush diculous it may appear, ath; it shows the variety the disease we are now strating that which it : nion cannot be more r of cases of eclampsia, apoplexie et le tétanos. Mémoires i, p. 301, et suiv. Juk out from the nature of their causes, remain distinct from those which the Cause must be left to themselves. These merit a special attention. How often these attacks have disappeared in consequence of the removal Lemons of a patient to a room less heated than that in which it previously was; how often after the removal of the pressure produced by a too tightly laced dress; lastly, how often after the cessation of pain occasioned by a pin which was so placed as to pierce the skin. it. If the above attentions are not sufficient to calm the convulsive phenomena, we can, with some chance of success, try to produce a violent shock in the sensations of the little patient, by exposing it, stripped of its clothes, for several minutes in the open air, or by laying it on a marble table. So lively and so penetrating a sensation as this seldom fails to produce its effect. When there is reason for supposing that the attack is the result of the introduction of too great a quantity of alimentary matter into Z the digestive apparatus, or of the introduction of indigestible food, an emetic should be given, or vomiting should be brought on by tickling the fauces with the end of a feather. A great number of Ce au cases of this nature in which this treatment has been crowned with Give are success may be met with in authors and in medical periodicals. Stuitio Copious evacuations bring to light lumps of apple, carrots, undigested beans, &c., which by their presence in the stomach had caused a severe internal disturbance and were quickly followed by the nervous phenomena to which we have alluded. When defecation is habitually difficult, and when there has not been any motion for several days, the abdomen must be felt and we must endeavour to find out by this examination if the intestines are distended by excrementitious matters. In this case a purgative should be given. Calomel in a dose of from one to three grains; manna dissolved in milk, two to four drachms to two ounces of fluid; emulsion of castor oil, in doses of from 3i to 3iij, are the most convenient means to employ amongst young children. If the child constantly voids fragments of tænia or of lumbrici, and even of ascarides, vermifuge medicines should be administered and their use persisted in until the entire disappearance of these entozoa results. If the convulsions come on during dentition, and if the examination of the gums proves the existence of considerable tension of these parts, which the pain would imply, it may be reasonably supposed that a relation exists between the nervous phenomena and the dental evolution. It may be convenient to lessen the tension of the gums by a crucial incision or by excision at the point compressed by the tooth which is ready to pierce through. This operation, easily practised, attains a double end; it favours the dental evolution, and by the slight loss of blood which it causes, diminishes the congestion of the gum. Congestion Sometimes convulsions accompany a similar determination of blood to the brain, if we may judge of the congestion of this organ from the congestion of the face. If the convulsions continue a long time, and if the colour persists without intermission, it is necessary to employ bleeding. The encephalic congestion has been the consequence of the first convulsive attack; once established it becomes a cause in its turn, and this it is which brings on the attacks. It ceases very quickly after the application of leeches. Two at most are sufficient; it is seldom two ch necessary to increase the number, which indeed may be afterwards decided on if necessary. They are to be applied behind the ears, but more advantageously at some distance from the head, to the condyle of the femur or to the malleoli, as M. Chauffard recommends, in order to cause a revulsion of blood. The convulsive phenomena must then be treated by means of cluti: anti-spamodic medicines. Orange flower water in a glass of sweetened water is the first thing the child should take. Then the oxide of zinc may be given either alone or combined with the extract of hyoscyamus, as recommended by M. Brachet. This medicine is very much in favour with those physicians who have turned their attention to the diseases of children. It should be given in a powder, to young children, mixed with sugar in the dose of one and a half to three grains in the twenty-four hours. Oxide of zinc Mix: divide into five or six doses. 1 to 3 grains. The oxide of zinc has been combined with musk by MM. Guersant and Blache. These physicians have obtained very favourable results from it. Camphor, valerian, assafoetida in glysters are also employed with variously appreciated and very uncertain advantage. Most of the other anti-spasmodics have been in turn made use of without any one of them acquiring unanimous favour by its real value. The successful results of their exhibition can be reckoned up, but the unsuccessful cases are not mentioned. Opium has been very often used in the treatment of convulsions; it appears to be especially efficacious in long-continued convulsions, and in those cases of convulsion which follow lacerations of the skin, pricks from a pin, &c. But here, as is always the case in the child, the employment of this medicine requires extreme prudence and very great precautions. It is likely to increase the cerebral congestion, and to bring on those nervous phenomena which we are desirous of curing. Besides, it causes a more or less obstinate constipation which is not always without danger. When M. Trousseau gives opium to children at the breast, he prefers laudanum in the dose of two drops to 3j of the liquid vehicle. A+ Convulsions which are consequent upon anæmia and which are observed in children who have sustained considerable losses of blood, are advantageously treated by preparations of iron. The sub-carbonate of iron (Locock), well powdered filings may be indifferently used. Both of these substances are easily swallowed by children, when mixed with sugar or with an agreeable preserve. They may be given in doses of two to five grains a day. 122. delirium. APHORISMS. In early childhood, hallucinations and eclampsia replace 123. In young children, the hallucination is characterized by movements of fear, and by gestures which seem to drive away or attract the object of prepossession. 124. Eclampsia results from a direct or sympathetic, primary or consecutive, disturbance of the nervous functions. 125. Eclampsia may be present without any material or appreciable lesion of the nervous system. 126. Eclampsia is generally hereditary. 127. A first attack of eclampsia predisposes to a second. 128. A sudden and rapid convulsion, unattended by fever, is not at all dangerous. 129. The eclampsia which attacks early infancy, and which continues to the period of childhood, becomes changed into an epilepsy. 130. Eclampsia causes partial paralyses, and these produce deformities. 131. Sudden, violent convulsions, followed by a prolonged drowsiness, but without fever, are indicative of epilepsy. 132. A sudden and violent convulsion, followed by fever, is always symptomatic of the incubation of an eruptive fever, or of a visceral inflammation, and announces great danger. 133. Convulsions at the commencement of small-pox are of good augury for the favourable termination of the disease. 134. The convulsions which terminate an acute or chronic visceral disease are nearly always symptomatic of a consecutive lesion of the brain and of the meninges. 135. The convulsions which accompany an acute disease are very serious. 136. The convulsions which appear as complications of pneumonia are fatal. 137. Fresh air, cold, and the sprinkling of the face with cold water are sufficient to ward off an attack of convulsions, but when once it has commenced they do not arrest it. 138. Those who pretend to cut short an attack of convulsions by |