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Convulsive Diseases

disease, blood, children, person, muscles, time, spasm, warning and convulsions

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Convulsions may be simply an incident of a disease, as in epilepsy and hysteria, or they may be the disease in themselves. As an in dependent ailment they affect both grown-up people and children, but the latter are specially liable to them because of reasons that will be explained in dealing with convulsions occurring in children. (See DISEASES OF CHILDREN.) They occur in women associated with pregnancy or childbirth. (See DISEASES OF WOMEN.) They consist in violent contractions of the muscles of the body, and are beyond the control of the will. Sometimes the spasm remains for some time, and the affected muscles are felt to be rigid; at other times the spasm quickly relaxes and then recurs, so that jerking movements are produced. The former is called tonic spasm, the latter clonic spasm.

The causes of convulsions in adults (those of children will nob be dealt with here) are various. Affections of the brain, such as in flammation, tumour, and injury, will produce them. Great loss of blood, producing sudden great deficiency of blood in the brain, causes them. Besides these, poisons may rise to them, whether the poisons have been intro duced into the blood from without, such as strychnine, the poison of syphilis and hydro phobia, or whether they have accumulated in the blood from disease of organs, as, for ex ample, from disease of the kidney, preventing that organ from separating certain waste sub stances from the blood.

The symptoms are chiefly the sudden spas modic movements of the muscles, either all the muscles of the body or groups of them only— the muscles of one side, of one leg or arm, of the face. The spasms may be slight or severe, and unconsciousness, more or less complete, attends them. Distortion of the face, staring eyeballs, or eyeballs drawn to one side, grind ing of the teeth, wideness of pupils of the eyes, which are not affected by light, are some of the symptoms that may occur. The gravity of the case is dependent on the cause.

The treatment also depends on the cause, which it is often difficult even for a physician to ascertain. All that others can do is to place the person in bed, and loosen the clothing. To save the biting of the tongue, a piece of cork, or the handle of a horn spoon, should be placed between the teeth. Nor yet can a mistake be made by securing a speedy movement of the bowels, obtained readily by an injection of salt and water. (See ENEMA.) Cold water or ice may be applied to the head, and warmth to the feet and over the stomach. This is all that can be done till the cause of the convulsions is ascertained, which will determine the further treatment.

Epilepsy (falling-sickness, Greek epilepsia, a seizure) is a disease of which, in its fully developed form, convulsions, attended by com plete unconsciousness, are the prominent feature.

The causes of the disease are not accurately known. It is certain, however, that the ten dency to epilepsy runs in families, along with other nervous diseases, such as insanity, hys teria, and St. Vitus' dance. Cases have been attributed to excesses in drink and in other directions, and in children to fright. Whether fright can actually produce it may be ques tioned, but at least the disease may by fright be suddenly started in children who were liable to it, and who, but for the Sudden shock, might have passed the danger.

The symptoms of a typical case are that the person becomes deadly pale, suddenly utters a horrible cry, and falls to the ground. He may be seen to be drawn to one side, his face dis torted, his eyes turned up, revealing the white, and his tongue, perhaps, caught and severely bitten by the teeth. The spasm passes over his whole body, so that in a few seconds he is quite rigid, and his breathing is stopped. From the first he is quite insensible. In a very short time his face becomes swollen and con gested ; jerky spasmodic movements of muscles commence, the limbs being jerked, the head and mouth twitching, and the eyes rolling, the tongue probably being caught by the move ments of the jaw ; the breathing returns, but is noisy and difficult ; froth and blood from the injured tongue escape from the mouth, and the urine may be discharged. Profuse sweating occurs, and iu a little longer time, at most two or three minutes, the spasmodic movements slowly cease, the person sighs deeply, and shows signs of returning consciousness. Sensibility may return at once or slowly, and the person be dull and exhausted for some time after wards, or a deep sleep may succeed the fit. The attack is often preceded by a warning, which may take very curious forms. In one form it is a tingling which creeps up from an extremity towards the head—the epileptic aura, it is called ; in another case it is some pain, sense of coldness or heat starting upwards from a point of the body. To some persons the warning is in the shape of a hallucination. One patient, previous to a fit, always saw a little old woman in a red cloak. The warning may be sufficient to enable the person to get out of some dangerous position, to get down from horseback, to get off the street, &c. One man, whom the writer met, who was very sub ject to the attack, after a warning in the street, started to run, and ran till he could not go a step further, and so succeeded in preventing the attack. Rarely the warning is a consider able time before the attack, showing itself by depression or some change of feeling, or by excitement in the person.

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