MEDICINE. 
of the breathing and convulsive hiccup ; in 
the remissions, the pulse and respiration are 
natural, the heat of the body is commonly 
not increased, the face is generally pale, 
■with a cold sweat upon it ; the extremities 
are generally cold, and there is frequently 
a cold sweat over the whole body, some- 
times, however, when the spasms are very 
frequent and violent, the pulse becomes 
full and frequent, the face is flushed, and a 
warm sweat is diffused over the whole 
body : it is a very remarkable circumstance 
that neither the meqtal nor natural func- 
tions are considerably affected, there is 
seldom delirium, or confusion of thought, 
the appetite remains good, the urine is 
sometimes suppressed, or is voided with 
difficulty and pain, and there is costiveness. 
It is remarked by Dr. Blane, that the con- 
vulsive twitchings are sometimes even ac- 
companied with pleasure. 
This disease often proves fatal before the 
fourth day ; after that period there is gene- 
rally less danger, but, although there may 
be some abatement of its violence, it is apt 
to return vvith renovated force ; a favour- 
able terminatipn pf it is sometimes at- 
tended with a sensation of stupor, or for- 
micatio, and a sense of itching ; more fre- 
quently, however, it goes off, without any 
evident crisis; the danger will, therefore, 
be determined by the violence of the at- 
tack, and frequent recurrence of the spasms 
and general convulsions. 
The removal of this disease must be at- 
tempted by administering opium in mode- 
rate but frequent doses, and where the 
deglutition is performed with any difficulty, 
it should be thrown in by clyster ; wine 
is a most valuable auxiliary, but it should 
be taken in large quantities, and it will 
be more serviceable when given in com- 
bination with opium ; bark is recom- 
mended, but it does not appear to have 
answered the sanguine expectations that 
were to be wished for ; mercury is often of 
service, provided it is pushed so far as to 
affect the mouth ; the warm bath, or a 
bath composed of milk or oil, has been 
recommended, and has sometimes succeed- 
ed, when employed in combination with 
opium, the heat of the bath is ordered to 
be lowered or raised, so as to afford the 
sensation of gentle and comfortable warmth ; 
the most powerful remedy, however, ap- 
pears to be immersion in the cold bath, in 
the paroxysm of convulsion, taking care to 
have some warm blankets in readiness, and 
immediately the patient is taken out of the 
bath, he should be well rubbed with warnt 
flannels, and put to bed ; opiate frictions 
are particularly recommended, as the medi- 
cine can, in this way, be introduced into 
the system more readily, and without in- 
creasing the frequency of the spasms, which 
frequently occur during the efforts of deg- 
lutition ; the combination of opium with 
aether is also of great service ; the diet 
should consist of milk and broths, and if 
the nourishment cannot be received by the 
mouth, it should be thrown up by clyster. 
If the disease have arisen in consequence of 
the partial division of a nerve, it should be 
cut through ; and if from a wound, it should 
be dilated, and filled with stimulating appli- 
cations; as lint, moistened with the oleum 
terebinthin^, and we must avoid exposure 
of the part to a current of cold air : the 
pain under the ensifonn cartilage, and the 
spasms in general, will most commonly be 
relieved by applying cloths dipped in mther, 
and by gentle and uniform pressure on the 
parts suffering from spasm, by means of 
bandages, on which the mther should be 
poured occasionally, guarding, however, 
against the cold produced by the too spee- 
dy evaporation of the mther. The trismus 
of infants is a disease most frequent in warm 
climates, it generally attacks infants, within 
tlie first fortnight after birth, more ge- 
nerally, however, before they are nine 
days old ; as it, in our opinion, very fre- 
quently proceeds from a retention of the 
meconium in the primae vi®, it will be 
highly proper, in the first instance, to exhi- 
bit geiitle laxatives, afterwards wine and 
antispasmodics, and if we do not succeed 
by these means, it will be advisable to try 
the cold bath, and the remedies above 
recommended. 
Epilepsjj may be distinguished from other 
species of convulsions by the sopor, and by 
the abolition of the sensation of external 
impressions ; from apoplexy, by the increas- 
ed action of the muscles; from hysteria, by 
the absence of the globus hystericus, and 
by its not being attended with the fear of 
death. The symptomatic epilepsy is more 
easily cured than the idiopathic; the later 
in life epileptic fits are experienced, the 
more dangerous they may, in general, be 
esteemed, as the cause may be supposed to 
have ^been acquired by the patient’s habits 
of life, or by the decay of some internal 
part; hereditary epilepsy is scarcely ever 
cured ; the longer the continuance of the 
complaint has been, and the more violent 
aud frequent the convulsions are, the more 
