Where there is asphyxia or marked cyanosis, oxygen is a valuable agent; this is best administered to infants through a large face-piece and one straight tube. When the bowels are sufficiently cleared sedatives can be administered by the rec tum; chloral and the bromides are most used. For a six-month-old baby. 4 grains of chloral or G grains of bromide of sodium or strontium, one or both, may be given; for a baby of one year, G grains of chloral and 10 of a bromide is a suit able dose, to be repeated again at hourly intervals if needed. Authorities differ as to whether an emetic should be em ployed; but, if there is reason to believe that there is undigested food in the stomach, this should be used; and, while there may be theoretical objections, I have no reason to believe that harm has been thus caused. Emesis in children is so readily induced that there need be little fear of injurious effects unless ex cessive stimulus is employed by over dosing with emetics. So soon as the child can swallow, it is well to give a grain or two of calomel, which acts usefully in several ways, even if it does not purge. To produce a full laxation, where this seems necessary, milk of magnesia, cas tor-oil, or some other active drug can he employed. After having instituted these measures to overcome the activity of the convulsion a thorough search should be made for such sources of reflex irritation as phimosis, an approaching tooth, foreign bodies in the nose or ears, etc. As soon as possible, the history of the case should be scrutinized for remoter conditions, such as the existence of a pneumonia, the possibility of the begin ning of an exanthem, etc. It must be borne in mind that the occurrence of convulsions is much more frequent and vastly more dangerous during the prog ress than at the beginning of either pneumonias or the exanthemata. If
they arise at the end of an exhausting disease, as of those two just mentioned, or of a prolonged diarrhoea, the process is essentially different and will call for other measures. If the urine contains albumin, which must be ascertained with out delay, diaphoresis is important; but diuresis must not be neglected, and here repeated injections of warm salt solution through the bowel is of value, or also hvpodermoclysis. Among the acute con ditions which are competent to produce convulsions in healthy children are in juries to the head, which are liable to be followed by shock and are to he treated as such by external heat, cold to the head, and stimulating enemata. Sun-stroke and heat-exhaustion call for appropriate treatment; in the former, external cold is indicated, and, in the latter, heat and stimulants, of which among the best is coffee. An accidental cause may be mechanical obstruction of the upper air passages, and, if apnoea is the chief diffi culty, the introduction of a tongue-de pressor, drawing the tongue firmly down and forward, may remove the symptom almost immediately. Lastly, it must not be forgotten that convulsions may be a phenomenon of impending death, when it is impossible to expect to relieve them; although it is oftentimes admissible to make use of strychnine hypodermically and in large doses, and of other forms of stimulation.
Phosphorus in the convulsions of in fancy exerts a more decided calmative influence on the nervous system in in fantile eclampsia than does chloral or bromides. After carefully examining and cleansing the gastrointestinal tract, the drug is administered for two or three days, in doses usually employed in rickets. Lange (Semaine MCA., No. 3, 1900).