Volume 2

On the cerebral diseases of children : with regard to their early manifestations and treatment / [Walter Cooper Dendy].

  • Dendy, Walter Cooper, 1794-1871
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: On the cerebral diseases of children : with regard to their early manifestations and treatment / [Walter Cooper Dendy]. Source: Wellcome Collection.

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    irritation alone. I believe that this convulsion may take place in a _ few instances without warning; but these are exceptions to the rule, and occur usually after a full meal, or when the child awakes startled from its sleep, especially if it has been exhausted, and its head has laid on a low pillow. But in watching suspected children carefully, we shall constantly observe, it may be slight, premonitory symptoms; such as twitching, smiling, the infant fixing often eagerly on the nipple, and then rejecting it without sucking; the rolling of its head, and fretting, and startling on the slightest alarm, the eye turned inwards, often out of slight distortion of feature and slight coma. There may be a livid, dry state of the lips, some degree of dysuria, and absence of biliary flow, the state of bowels being in one extreme or the other. With many of these symptoms, if slight, a sudden crow may be the first cause of attention or alarm on the part of the mother. Of this alarm the child evidently partakes, for it screams with the most anxious expression, as if to implore relief. in very slight cases a change of position, or even patting on the back, will immediately relieve; a short inspiration and deep expiration, and the child will for a time be well. If the spasm continue or recur, the face will become more livid, the brow frowning, the distress greater; opistho- tonos may be so intense that the body will be a rigid bow. Air is drawn in with extreme effort; there is then for a time a shrill squeak, until the child dies in the convulsion. I believe Dr. Marshall Hall correct when he affirms the remote causes to be irritation of the extreme fibrille of the nerves, inducing reflex action, and thus spasmodically affecting the respiratory valves; the various excitements of the pneumogastric, the trifacial, or spinal, all tending to one focus, the constrictor laryngis. There has been much discrepancy of opinion, and several hypotheses have been adduced regarding this affection. _ It is probable that isolated cases may occur in which encroachment of a gland on the recurrent nerve may cause irritation and spasm, but this cannot be firm.or com- plete compression, which would produce paralysis rather than spasm, as we find in the case of tumours'on the neurilema. If Dr. Ley’s notion were always correct, we should not find the frequent remission or recurrence, nor the sudden. relief and, recovery with which we are so often gratified. I believe, in the majority of cases, the malady 1s excited through the spinal system, but excitement of the cerebrum primarily, and, from mental, influence. alone, especially sudden alarm or fright, wall often induce it in children predisposed. It is probable that gastric irritation, especially when aided by See is more influential than mere dentition; for when the bowels are duly regulated and fresh air inhaled, we very rarely witness this affection.