Sometimes convulsions attack suddenly, without any warning; at others their approach is indicated by certain symptoms, such as coldness of the feet, or a sense of creeping, rising like a blast of cold air from a particular part of the extremities to the head; the left hypo-chondrium is sometimes affected with tensive and flatulent pains, and a costiveness attends; the urine is thin and pale; tremors and various unusual sensations are perceived, and in different patients other symptoms also attend, as the prelude to more violent ones. During the fit the motions are violent and involuntary, continuing in different cases for a longer or shorter period,and returning after different intervals, occasionally after regular intermissions. Languor, delirium, sleepiness, vomiting, or headach sometimes follow the cessation of a convulsive paroxysm; but there are cases in which little or no sensible uneasiness is perceived on recovery from it.

Infants when disposed to convulsions are affected with a cough, vomiting, or diarrhoea; their features are at times distorted; a blueness appears about their eyes and upper lip, and twitchings or starlings arc often observed, particularly a contraction of the fingers into the palm of the hand; and during the intervals of the fits they are drowsy. As death draws nigh, the convulsions are more frequent.

Convulsions, however, which have appropriate names will occur in the different articles. It is now only necessary to mention the species included by Dr. Cullen under the genus convulsio. The nine idiopathic species differ only from their causes, where there is any real distinction; for the "universal," the "habitual," the "intermittent," convulsions are varieties only, and the symptomatic convulsions are less objects of particular attention. The result is, that convulsion is a symptom only, and does not deserve a particular generic distinction. There are, however, some forms of the disease so important and dangerous, that they require a more minute attention. The first of these is the convulsio puerperarum.

Dr. Bland thinks that convulsions in pregnant women, and during labour, have nothing peculiar in their cause from those which happen to women differently situated; and though external agents, particularly violent affections of the mind, may sometimes, as at other periods, excite them, yet this will rarely happen, unless there is some peculiar vice in the constitution disposing to them. From observation he thinks he is justified in saying, that the puerperal state is far from favouring them; as women at that time will do and suffer, almost with impunity, what at any other would be attended with the most serious consequences. But whatever may be the cause, he observes, there is evidently in the fit, as in the apoplexy, a too rapid and dangerous determination of the blood to the head, which demands the most immediate and serious attention. To remedy this, blood must be immediately drawn, and, if possible, from the jugulars. The state of the labour should then be inquired into; and if the child is not too far advanced in the pelvis, it will be right to prescribe a large stimulating clyster to empty the bowels, and at the same time lessen the determination to the head; this, if not sufficient for the purpose, should be assisted by a few grains of jalap and calomel, or some other brisk purge. If the labour is far advanced, the convulsions will act upon the foetus; and if there is no impediment, either from wrong presentation or disproportion of the child to the pelvis, will, in a little time, safely expel it. If any obstacle to delivery is found, the position of the child, if faulty, must be altered; or we ought to have recourse to other necessary assistance, in the same manner as if convulsions were not present. In either way the termination of the labour will frequently put an end to the convulsions. But if this is too hastily performed before the vessels have been properly emptied, and the rapid motion of the blood in them diminished, there will be danger, from the torrent rushing too impetuously into the intestines or other abdominal viscera, of inflammation in some of those parts, inducing puerperal fever, and often death. But where the labour is not far advanced, after the exhibition of the clyster and purgative, thirty drops of the tinct. opii may be given, and repeated, interposing occasionally the clysterorcathartic, as symptoms shall indicate. See Dr. Bland's Essay on the Treatment of Convulsions during Parturition.

Though we, however, allow Dr. Bland's authority to merit every attention which his judgment and long practice demand, we think that convulsions of puerperal women are really connected with that state. They occur to those who never otherwise have been affected with the disease; and they cease when labour pains force down the child, as if its pressure on some of the nerves of the pelvis had occasioned the irritation. The necessary doses of opium also are much larger than he recommends, and even ten grains of solid opium may be given in a clyster. We have seen half a drachm ordered. Dashing cold water in the face has sometimessucceeded, according to Dr. Denman's recommendation, and the foxglove, according to Dr. Hamilton's; but the chief object is to hasten delivery. In every other respect, Dr. Bland's directions appear to us highly judicious.

Convulsions are sometimes a symptom attending fevers, and may be produced by inanition, as when haemorrhages or diarrhoea have occurred; or by repletion. Relief will most readily be procured by evacuations from the bowels in the last case; and by antispasmodics, particularly opiates, in the former. When they are caused by wounds, warm oil, or the warmer balsams, applied to the injured part, often effect a speedy cure, when stricture in the part has been previously relieved by manual operation: the causes of irritation are indeed various, and therefore different means will be required to effect this end.

Convulsions in children, from teething, require the loss of blood, particularly if the gums are swelled and painful. When depletion is the cause, cordials must immediately be administered, and a generous nourishing diet allowed.

If, as we have said, plethora is a cause of debility, suppressed evacuations, which also occasion it, become a source of irritation. The repulsion of cutaneous diseases, of the haemorrhoidal discharge, sometimes of the menses, are therefore frequent causes. In such cases, some evacuation is necessary; but so much only as will take off the immediate effects of the plethora. The other remedies must be adapted to the local fulness; these are chiefly laxatives, diaphoretics, and aloeticme-dicines, interposing in every instance opium, and, in the uterine obstructions, opium with camphor.

Convulsions in children are owing to irritation of almost every kind; to flatulence; to the irritation of the gum distended by teeth; to acrimony in the stomach and bowels, or worms. In every such instance we must guard against the peculiar irritation, as it occurs to our notice. The stomach and bowels must be certainly kept clear, and opiates then administered, either by the mouth or by clyster. When flatulence is apparently the cause, to the opium in a clyster, the asafoetida should be added. Worms are a more important source of irritation; but all children have worms: and if symptoms of irritation continue after rhubarb and calomel have been repeatedly given, worms may be fairly accused as a cause, and medicines for this purpose employed. Not to anticipate what will be the subject of more particular consideration, we may now add, that the bear's foot, the hel-leborus foetidus, is the only certain remedy.

The more general remedies for convulsions are musk and the whole tribe of fetids. These seem to act as sedatives, or rather as inirritants, a class of medicines whose nature we shall explain under that term. Warm bathing appears to relieve in a similar way. Nor can we attribute the effects of valerian to any other power. The union of the valerian with bark seems to give it an additional efficacy, from some influence which we cannot explain. The remaining observations on the remedies for convulsions have been anticipated in the article Antispasmodics; q. v. See also Spasms.

Convulsio Indica. See Tetanus.

Convulsio a nervi punctura. See Trismus.

Convulsio raphania, soloniensis, et ab ustila-gine. See Raphania.

Convulsio uteri. See Abortus.