The Mother's Manual of Children's Diseases

by Charles West

In neither this case, nor in that in which the hot bath is employed, is the result of the agent as magical as people sometimes seem to expect. It is rarely that convulsions cease while a child is actually in the bath. For the most part the influence of the bath is limited to abating their severity, shortening their duration, and indisposing to their return.

The bath, then, is to be used when either a stimulating or a soothing influence on the surface is likely to be of service, and only then. In cases where the fits are produced by constipation, by improper food, or by the irritation of a tooth pressing against the gum, it is idle to use it, and equally so in instances where many fits have been recurring in the course of the same day. Where that is the case it must be self-evident that, be the cause what it may, it must be one over which either a hot or a tepid bath can have no influence, and that, painful as it must be to wait a passive spectator, that position is far wiser than that of a mischievous meddler. It is some consolation, also, to know that unconsciousness to suffering attends convulsions.

There is one agent, chloroform, which often has a very remarkable influence in controlling frequently repeated convulsions. It is an agent, however, too hazardous to be trusted out of medical hands, and even when the doctor administers it himself, the parents must fully recognise the fact that, inasmuch as the child may die during a fit quite independently of breathing chloroform, so the occurrence of that catastrophe during its employment is not to be made a subject of self-reproach to them, or of blame to the doctor.

But you may ask whether there are no signs of that disturbance of the nervous system, by which you can judge beforehand that the occurrence of convulsions is probable. In proportion to the tender age of a babe, the greater is the probability, as I have already stated, that convulsions will be induced by slight causes, especially by such as digestive troubles. Unless you are aware of the phraseology that used at any rate to be common among nurses, you may be much alarmed at being told that the child who had seemed scarcely unwell has been very much convulsed, when all that is meant is that the child has shown some of the signs that threaten convulsions—has had, in short, what in the time of our grandmothers used to be called inward fits. A child thus affected lies as though it were asleep, winks its imperfectly closed eyes, and gently twitches the muscles of its face—a movement especially observable about the lips, which are drawn as though into a smile. Sometimes, too, this movement of the mouth is seen during sleep, and poets have told us that it is the angels' whisper which makes the babe to smile—I am sorry that its meaning in plain prose should be so different. If this condition increases, the child breathes with difficulty, its respiration sometimes seems for a moment almost stopped, and a livid ring surrounds the mouth. At every little noise the child wakes up; it makes a gentle moaning, brings up the milk while sleeping, or often passes a great quantity of wind, especially if the stomach is gently rubbed. When the disorder of the digestion, on whatever cause it depended, is removed, these symptoms speedily subside, nor is there much reason to fear general convulsions so long as no more serious symptoms show themselves. There is more cause for apprehension, however, when the thumbs are drawn into the palm, either habitually or during sleep; when the eyes are never more than half-closed during sleep; when the twitching of the muscles is no longer confined to the angles of the mouth, but affects the face and extremities; when the child awakes with a sudden start, its face growing flushed or livid, its eyes turning up under the upper eyelid, or the pupils suddenly dilating, while the countenance wears an expression of great anxiety or alarm, and the child either utters a shriek, or sometimes begins to cry.

When a fit comes on, the muscles of the face twitch, the body is stiff, immovable, and then in a short time, in a state of twitching motion, the head and neck are drawn backwards and the limbs violently bent and stretched. Sometimes these movements are confined to certain muscles or are limited to one side, and I may add that such cases are of more importance as far as the state of the brain is concerned than those in which the convulsions are general. The eye is fixed and does not see; the fingers may be passed over it without its winking, the pupil is immovably contracted or dilated; the ear is insensible even to loud sounds, the pulse is small, very frequent, often too small, and too frequent even for the skilled doctor to count it; the breathing hurried, laboured and irregular; the skin bathed in abundant perspiration.

After this condition has lasted for a minute, or ten minutes, or an hour or more, the convulsions cease; and the child either falls asleep, or lies for a short time as if it were bewildered, or bursts out crying, and then returns to its senses, or sinks into a state of stupor, in which it may either be perfectly motionless, or twitching of some muscles may still continue; or, lastly, it may, though this seldom happens, die in the fit.

It seems then, from all that has been said, that convulsions, though one of the most striking, are by no means one of the most conclusive signs of brain disease; that they are even more commonly the result of disorders of the nervous system from causes seated elsewhere, than of actual disease of what may be termed the great nervous centre.

We may now therefore pass to the examination of these diseases, which for the purposes of this book may be considered under the two heads of congestion and inflammation.

I am forced to use these terms in somewhat of a popular sense, for to attempt in a little book like this to define everything with strict scientific accuracy would simply confuse and mislead.

Congestion of the Brain.—By congestion of the brain is meant a condition in which its vessels are overcharged with blood; a condition which if it exists in an aggravated degree, ends either in the pouring out of blood on, or into the brain, on the one hand, or in inflammation on the other. Either of these terminations, however, is so rare in the previous healthy child, that I shall confine my remarks entirely to congestion of the brain, an affection specially liable to occur in children during teething. A certain degree of feverishness almost always accompanies teething. It is, therefore, not difficult to understand how, when the circulation is in a state of permanent excitement, a very slight cause may suffice to overturn its equilibrium, and occasion a greater flow of blood to the brain than the organ is able to bear. Congestion of the brain, however, is not by any means limited to this season, but may occur at other times without any obvious exciting cause, and with no other explanation than is furnished by the well-known fact that all periods of development such as childhood, are periods during which the growing organs are most apt to become disordered.