he short fitful dozes
are interrupted by the return of impending suffocation, in one paroxysm
of which longer and severer than the others the infant may fall back
dead.

It scarcely need be said that the great majority of cases have no such
sad ending as I have described, but still, whenever this spasm exists,
even in a slight degree, there is always the possibility, never to be
forgotten, of a sudden catastrophe. Usually, after some tooth has been
cut which caused special irritation, or as disorder of the bowels has
been set right, the symptoms abate by degrees, and then cease
altogether, though liable to be reproduced by the same causes as those
to which they were originally due.

The seeking out and removing the exciting causes must be the care of the
medical man, but there are some special precautions which come within
the mother's own province to observe.

First of all, as sudden excitement, and especially a fit of crying, are
likely to bring on the attack, and since there is a possibility that any
attack may prove fatal, the greatest care must be taken in the
management of the child to avoid all unnecessary occasion of annoyance
or of distress.

Although the benefit that accrues from fresh air, or from a change of
air, is often very great, yet it is very important that the child should
not be exposed to the cold or wind, for I have seen such exposure
followed by a severe attack of difficult breathing, or by the occurrence
of general convulsions. Another reason for caution in this respect is
that the occurrence of catarrh is almost sure to be followed by an
aggravation of the spasmodic affection, which, though previously slight,
may thereby be rendered serious or even dangerous.

I have nothing to add to what I have already said with reference to the
treatment of the attack, when actual convulsions come on. Since,
however, in this affection convulsions may occur quite unexpectedly at
any moment, it is well always to have a basin of cold water and a bunch
of feathers handy, in order to be able at once to dash the water on the
child's face, and induce that deep inspiration which saves it from the
threatening danger. If this should not suffice, the finger must be put
into the mouth, and run over the back of the tongue in the way that I
have already explained when speaking of convulsions. Now and then it
happens, though but very rarely, that violent _general convulsions_ come
on in infancy quite independent of sp