408 GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. . 



often last until he arrives, while the latter usually pass over while the 

 messenger is still seeking him. A year or two ago I saw a child in an 

 eclamptic fit, which lasted for twenty-four hours, without interruption, 

 although there were occasional remissions. The fit usually terminates 

 with a long-drawn deep expiration, often, too, by a profuse evacuation 

 from the bowels. This rarely occurs suddenly during the height of the 

 attack, but more usually after its violence has somewhat subsided. 

 The child then falls into a deep sleep, and if, next day, we do no* 

 make our visit too early, -we may find it playing busily, as if nothing 

 had occurred. But it frequently happens that there is more than one fit. 

 A series of them often succeed one another at short intervals. A 

 repetition of them may be anticipated, when the sleep is not sound 

 after the first one has subsided, and when the children throw them- 

 selves about, gnash their teeth, and when their limbs twitch from time 

 to time. The subsequent fits resemble the first one in all essential 

 points, differing only in their degree of violence and in their duration. 

 Many children never have more than one eclamptic attack. In others, 

 they recur from time to time. The more plainly it can be shown that 

 these recurrences are the result of fresh irritation, so much the less 

 doubt will there be that we have an eclampsia to treat, and not 

 epilepsy. And, on the other hand, the less distinctly demonstrable 

 the exciting cause of the repeated paroxysms is, so much the more 

 doubt will there be whether they are eclamptic or epileptic. This 

 point can never be determined at the first fit, since its exciting cause 

 often enough eludes detection. Death may occur, during the fit, from 

 arrest of the respiration, and acute carbonic-acid poisoning, from ex- 

 haustion, or during the subsequent period of coma. Eclampsia is a 

 very dangerous complaint among children during the first months of 

 life, and a large proportion of those attacked die. In older children 

 the prognosis is more favorable, and the disease usually terminates 

 hi recovery. It will be readily understood that both children and 

 older persons are apt to die where the convulsions, with loss of con- 

 sciousness, are an accompaniment of grave disease of the brain or 

 spinal marrow, although in such instances it can hardly be said that 

 they die of eclampsia. The same may be said of the so-called sequelae 

 of eclampsia. When seizures of this nature are followed by idiocy, 

 palsy, squinting, or other grave disorder, it certainly is more than 

 probable that they, as well as the fits, depend for their origin upon 

 autritive disorder of the central organ. 



TREATMENT. I believe that it is very difficult, and often quite im- 

 possible, to determine whether an attack of convulsions, accompanied by 

 loss of consciousness, depends upon anaemia or hypersemia of the brain. 

 or whether either of these conditions exists. If the previous health of 



