Convulsion

“ There are many forms of the disease,—the frank epileptic convulsion in which patients fall down, are seized with certain convulsive movements, become pale and lose consciousness for a time and then come to with an intense feeling of weariness which usually prompts them to sleep for some hours—too familiar to need further description. ”

“ I mean, likewise, that when any organ of sense is for some time affected in some one manner, if it be suddenly affected otherwise, there ensues a convulsive motion; such a convulsion as is caused when anything happens against the expectance of the mind. And though it may appear strange that such a change as produces a relaxation should immediately produce a sudden convulsion ”

“ The convulsion may be very slight—an isolated spasm of a limb or even a single group of muscles. Whether, on the other hand, it can ever be so intense that the child succumbs to it before the development of paralysis, is a question which could only be decided by repeatedly examining the cord in the cases of convulsion which have terminated fatally. ”

“ Without further warning, save that the pulse, which has become soft, with nearly the normal number of beats, all at once becomes low and hard; she is suddenly seized with another convulsion, in which she dies, or passes into a state of coma from which she never rallies. ”

“ Prognostics.—If with the flux be joined a convulsion, it is dangerous, because it intimates the more noble parts are vitiated: and a convulsion caused by emptiness is deadly. If it continues long, it will be cured with great difficulty: for it was one of the miracles which our Saviour, Christ, wrought, to cure this disease, when it had continued twelve years. If the flux be inordinate, many diseases will ensue, and without remedy; the blood, with the native heat, being consumed, either cachetical, hydropical, or paralytical diseases will follow. ”

“ Strong stimulation excites in fact a convulsion like that of epilepsy, beginning with the movement usual for the point stimulated and spreading so as to assume the proportions of a convulsion affecting the entire skeletal musculature of one half or even of the whole body. ”

“ Pains from excess, and from defect of motion. No pain is felt during vehement voluntary exertion; as in cold fits of ague, labour-pains, strangury, tenesmus, vomiting, restlessness in fevers, convulsion of a wounded muscle. 3. Of holding the breath and screaming in pain; why swine and dogs cry out in pain, and not sheep and horses. Of grinning and biting in pain; why mad animals bite others. 4. Epileptic convulsions explained, why the fits begin with quivering of the under jaw, biting the tongue, and setting the teeth ”

“ Convulsions are not at all uncommon in young children. The way in which a convulsion is produced is by the spreading of the disturbance all over from a single sense organ. What we have, then, in the nervous system is an arrangement whereby under special conditions a nervous disturbance can pass from any sense organ to any or all of the muscles, but under ordinary conditions the disturbance spreads to a particular muscle or group of muscles only. ”

“ There then may follow a condition of ecstacy, sleepiness, catalepsy, trance, or the patient may show symptoms of a delirium with the most extraordinary sights of unreal things. These convulsions may last for several hours or days. Firm pressure over the ovaries may bring on a convulsion, or if made during a convulsion may arrest it. The disease is rarely dangerous to life, yet death has followed exhaustion induced by repeated convulsions or prolonged fasting. The duration of hysteria is very uncertain. ”

“ If any substance or matter was placed there, he could describe its form and quality, its colour and smell. As long as the finger was kept on the stomach, the convulsion gradually diminished until it entirely disappeared; but if the finger were placed on the heart, the convulsion returned with increased violence, and continued as long as the finger was kept in that position. If a flute was played while the finger was kept on the stomach, the patient heard the music ”

“ The patient may become very nervous, irritable, impatient, have fits of laughing and crying, alternately, or have a feeling of a chill rising in the throat. The convulsion follows these symptoms. The patient generally falls in a comfortable place; consciousness is only apparently lost, for she frequently remembers what has taken place; the tongue is rarely bitten, In the milder forms the movements are apt to be disorderly. In the severe forms the movements are apt to be a lasting contraction of the muscles and the patient may have the head and feet drawn back and the abdomen drawn front. ”

“ Thus, an oppression of the chest, which had a pathological significance in relation to the spirit, pointed to the therapeutic necessity of beating it with the greatest violence; if the convulsionary had a sense of burning heat, he exposed himself to the flames; an acute and boring pain in the mouth, neck, eye, or any other organ required a dagger to be thrust into the afflicted part, but, strangely enough, no force could make the sharpest instrument enter the flesh or inflict a wound. ”

“ Whilst the distempers of a relaxed fibre prognosticate and prepare all the morbid force of convulsion in the body of the state, the steadiness of the physician is overpowered by the very aspect of the disease. ”

“ When the animal power is much exhausted by the preceding convulsions, so that the motions from sensation as well as those from volition are suspended; in a quarter or half an hour the sensorial power becomes restored, and if no pain, or irritation producing pain, recurs, the fit of epilepsy ceases; if the pain recurs, or the irritation, which used to produce it, a new fit of convulsion takes place, and is succeeded again by a syncope. ”

“ Nothing is more astonishing than the spectacle of these convulsions. One who has not seen them can form no idea of them. The spectator is as much astonished at the profound repose of one portion of the patients as at the agitation of the rest—at the various accidents which are repeated, and at the sympathies which are exhibited. Some of the patients may be seen devoting their attention exclusively to one another, rushing towards each other with open arms, smiling, soothing, and manifesting every symptom of attachment and affection. ”

“ This is attended by loss of consciousness, out of which she passes into a series of convulsions, gradually increasing in severity, in one of which she dies—or consciousness, partial or perfect, is regained, either, it may be, for a few minutes, a few hours, or days, during which violent headache is complained of, or she is delirious and excited, as in acute mania, or dull and sullen as in melancholia, and requires to be roused, when she is found wandering, and her speech is somewhat imperfect. ”

“ Intermittents often appear in the autumn with periodical heat and pains in the eyes, ears, jaws, and back.
11. Are there certain grades in the convulsions of the nervous system, as appears in the hydrophobia, tetanus, epilepsy, hysteria, and hypochondriasis? [21] So there are grades in fevers, as in the plague, yellow fever, small-pox, rheumatism, and common remitting and intermitting fevers.
12. Are nervous convulsions most apt to occur in infancy? So are fevers.
13. Are persons once affected with nervous convulsions frequently subject to them through life? ”

“ Among warm-blooded animals, on the contrary, convulsions are constant, and the sequence of the symptoms appears to be—dyspnœa, slowing of the pulse, giddiness, falling down, then convulsions with expulsion of the urine and fæces; dilatation of the pupils, exophthalmus, and finally cessation of the pulse and breathing. The convulsions also frequently pass into general paralysis, with loss of reflex movements, weak, infrequent breathing, irregular, quick, and very frequent pulse, and considerable diminution of temperature. ”

“ Convulsions arise from almost any cause—from worms in children, affections of the brain in adults, hysteria, and in some persons the taking of chloroform. Adults are sometimes attacked by such convulsions. Affections of the spinal cord or eating indigestible food will produce them. I know no instance in which convulsions have arisen from retching and vomiting. I agree with Dr. Copland that these convulsions sometimes end immediately in death. The immediate proximate cause of death is frequently asphyxia.
By Lord Campbell: Death from a spasm of the heart is often described as death by asphyxia. ”

“ For as the pains from excess of motion either gradually subside, or are in general succeeded by inflammation; so those from defect of motion either gradually subside, or are in general succeeded by convulsion, or madness. ”

“ CONVULSIONS, the pathological condition of body associated with abnormal, violent and spasmodic contractions and relaxations of the muscles, taking the form of a fit. Convulsions may be a symptom resulting from various diseases, but the term is commonly restricted to the infantile variety, occurring in association with teething, or other causes which upset the child’s nervous system. The treatment (plunging into a hot bath, or administration of chloroform) must be prompt, as convulsions are responsible for a large part of infant mortality. ”

“ In its fully developed form, convulsions, attended by complete unconsciousness, are the prominent feature. Among the different causes may be mentioned intense emotional disturbance in early childhood, injury to the brain or its coverings at birth or subsequently, or some irritation within the skull itself, such as tumours, &c., developing later in life. ”

“ The convulsions once started in a congregation spread quickly through it, until all the fit subjects were convulsed. Repetition greatly increased the proneness to the disorder, which was invited by the masses on the supposition that it was a true religious exercise.
These perverted muscular movements all come under the head of morbid reflex action. By the continued religious fervor, the central portions of the brain, the immediate seat of emotion and feeling, became inordinately excited. ”

“ Does it not happen that a patient dies of convulsions, spastic in the sense of their being tumultuous and alternating, and chronic in the sense of exhibiting continuous rigidity, yet after death no disease is found?—It does not often happen to adults. ”

“ The slightest irritation of the smallest nerve is sufficient to throw the whole body into a convulsion, nor is it possible to cure the pain, or remove the convulsion, but by cutting away the nerve above the injured part, and then all the parts to which this nerve joined become at once motionless and insensible. ”

“ These weak convulsions, as they are occasioned by the disagreeable sensation of faintness from inanition, are symptoms of great general debility, and thence frequently precede the general convulsions of the act of dying. ”

“ Does it not frequently happen that general convulsions, no cause or trace of which in the form of disease or lesion is to be found in the body after death, occur in the most violent and spastic way, so as to exhibit appearances of tetanic convulsions?—No instance of the kind has come under my observation. ”

“ Acute.—The first symptoms may be those of excitation, which are quickly followed by intense headache, giddiness, throbbing of the temples, and nausea followed by vomiting. Muscular weakness occurs, sensation and the reflexes are lost, drowsiness and coma follow, and in fatal cases convulsions often come on before death. The pulse becomes imperceptible at the wrist. The conjunctivæ become hyperæmic, the eyes staring, the pupils dilated and insensible. The voluntary and involuntary muscles are relaxed, the skin cold and cyanotic, and the lips covered with froth. ”

“ The convulsion picture is a stiffening of the body—sometimes arching backwards—rolling or staring of the eye-balls, blueness of the skin, a drooling mouth (often foamy mucus at the mouth) , clinched hands, biting the teeth—if there are teeth—and even biting the tongue. There is at first a succession of quick, jerking, convulsive movements of the body which in a few moments grow less and less violent and finally cease. The child begins to cry and then soon goes off into a deep sleep, while the body seems more heavy and logy than usual. ”

“ I will add here, that seeing a person in convulsions is apt to occasion them in such as are of nervous and irritable frames; and that there is reason to believe, that some persons, who have been enthusiasts or impostors, have been able to throw themselves into convulsions by a semi-voluntary power, and particularly, as it seems, by introducing strong ideas, and internal feelings. ”

“ One Secourist administered to a young woman, who was suffering under spasm of the stomach, the most violent blows on that part, not to mention other similar cases, which occurred everywhere in great numbers. Sometimes the patients bounded from the ground, impelled by the convulsions, like fish when out of water; and this was so frequently imitated at a later period, that the women and girls, when they expected such violent contortions, not wishing to appear indecent, put on gowns, made like sacks, closed at the feet. ”

“ The ideas which rule so intensely the angry or terrified man may, as rightly as Plato called the passions a fever of the soul, be regarded as convulsions of the organ of thought. These convulsions quickly extend through the nervous system, and so disturb the vital powers that they lose their perfection, and all organic actions lose their equilibrium. The heart beats violently and irregularly; the blood is so confined to the lungs that the failing pulse has barely enough to sustain it. ”

“ Too weak for wholesome restraint, she yields. The little convulsive act we call crying brings uncontrollable, or what seems to her to be uncontrollable, twitching of the face. The jaw and hands get rigid, and she has a hysterical convulsion, and is on the way to worse perils. The intelligent despotism of self-control is at an end, and every new attack upon its normal prerogatives leaves her less and less able to resist.
Let us return to the causes of this sad condition. It is a common mistake to suppose that the well and strong are not liable to onsets which cause nervousness. ”