asmodic croup, not preceded nor
attended by any sign of disease of the brain, and which end in the
course of some hours or of a few days in death, the child being partly
worn out by the violence of the muscular movements, partly by the
disturbance of breathing which each fit occasions. Happily, however, in
most of these instances the convulsions by degrees lessen both in
violence and frequency, and the child recovers.
=Epilepsy.=--There is one other point of view from which convulsions in
infancy and early childhood must be looked on with apprehension, and
that is from their being frequently followed in after years by
_epilepsy_. In nearly a fifth of all cases of epilepsy in childhood that
have come under my notice the first occurrence of fits dated back to
early infancy, and this, even though an interval of years had passed
between the last fit in infancy and the first in childhood. It seems,
indeed, as though there were in these cases a peculiar abiding
sensitiveness of the nervous system, which, dating back from very early
life, dependent often on hereditary predisposition, was kindled into
activity by any special cause, such as the cutting of the second set of
teeth, or the transition from boyhood or girlhood to manhood or
womanhood.
In the child, just as in the grown person, epilepsy manifests itself in
two different ways; either by momentary unconsciousness, or by violent
convulsions, in which latter there is little distinction from the
occasional fit which may be observed at any period of infancy.
The attacks of momentary unconsciousness often pass long unnoticed.
They occur, perhaps, when the child is at play or at meals; it stops as
if dazed, its eye fixed on vacancy; if standing, it does not fall, nor
does it drop the toy or the spoon which it was holding from its hand. If
speaking, it just breaks off in the midst of the half-uttered sentence.
Then, in less time than it takes to tell, it suddenly looks up again,
finishes what it was saying, or goes on with its play, or with its meal
as though nothing had happened; or it suffices to call the child and the
cloud passes from its face, and it is itself again; and the nurse or
perhaps even the mother, thinks that it is some odd trick which the
child has got. By degrees the attacks become more frequent, and may
continue to recur several times a day without any obvious cause, even
for months; and this without any change in their character. By degrees,
however,
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