me _unconscious_, they do not recover
again as a rule but remain so until death; delirium and stupor may
alternate with each other in certain cases, but the former process is by
far the most frequent.

_Convulsions_ appear only in the later stages. At first the interval
between the attacks are long, often as many as three or four days
intervene. Commonly however they come much oftener and may in some cases
last for hours. All extremities are affected by these convulsions, the
eyes become red, are rolled in every direction and turning way up are
fixed so that nothing but the whites is visible. After several minutes,
often after two or three hours, these general convulsions subside, the
children, now very pale, drop into a deep sleep and their general
condition appears much reduced.

Different muscular groups especially those of the face are subject to
_local cramps_. The upper lip may become distorted, convulsive smiles
have been observed, also peculiar sucking motions. The children point
their lips and flatten them again, sometimes for hours in succession.

In the latter stages a squinting of one or both eyes may be noticed but
this may again disappear.

_Grinding of the teeth_ is another very peculiar symptom which is
well-known and feared by experienced nurses. The _arms_ are subject to
various motions, at times sweeping automaton like, then again convulsive
contractions, sometimes trembling of the muscles, at others a throbbing
of the tendons. Many patients put their hands to their sexual organs and
make motions tending to onanism.

The _legs_ are not subject to cramps as much as the arms; they are
mostly bent and drawn up in a half paralyzed condition.

The _muscles of the neck and back_ are very much contracted and most
children, when raised or laid on their side, bend the head far back.

In most children an extreme sensibility at being touched is observed.
They may be handled with the greatest possible care and lifted most
tenderly, a slight pressure on the head, body or hands in changing their
position will be violently resisted with obvious expressions of pain. In
the latter stages this extreme sensibility gives way to _insensibility_.

Then the children may be pinched and poked, they may be turned and moved
from one side to the other without any consideration, they will not
resist and only give expression to the remaining sensibility by a low
whimper. The lack of sensibility may be especially marked in