the more because there is in a fit of
_convulsions_ something so intensely painful to behold that it is easy
to exaggerate its danger, and to lose all presence of mind in panic.
First, then, it is well to bear in mind that real disease of the brain
rarely, very rarely, I do not say never, begins with convulsions; and
next, that their real danger is in general in exactly opposite relation
to the frequency of their occurrence. Convulsions now and then return
thirty, forty, or more times in twenty-four hours, and continue to do so
sometimes for three or four days together. They are, indeed, not without
peril, for the perpetually returning disturbance of the circulation may
give rise to an overfilling of the vessels of the brain, or to a
stagnation of the blood within them, or the spasm may affect the muscles
which open and close the entrance to the windpipe, and the child may die
choked as in a paroxysm of whooping cough, or in a fit of spasmodic
croup, or lastly the violent and frequently repeated muscular movements
may at length exhaust its feeble frame. But still, such frequently
recurring convulsions are in themselves no evidence that the brain is
diseased; they do but show that the irritability of the spinal cord is
increased to a degree which the brain is no longer able to control, and
which therefore manifests itself in violent convulsive movements.

It is thus that the poison of scarlet fever or of small-pox sometimes
displays its influence over the whole system by producing violent
convulsions at the outset of those diseases; thus that they follow on
some indigestible article of food, or that the mother, over-heated by
violent exertion, or overwhelmed by the news of some unexpected
calamity, sees her babe, to whom she is in the act of giving the breast,
suddenly seized by a violent convulsion.

In every instance, therefore, the first business is to ascertain the
cause of the convulsion, to determine the seat of the irritation which
has excited the nervous system to such tumultuous reaction. The
convulsion which ushers in any one of the eruptive fevers in the infant
or in the child, is only an exaggeration of the shivering which precedes
the onset of fever in the adult. Has the child been exposed to the
contagion of measles, small-pox, or scarlatina? is it teething, and if
so, when did its last tooth appear? of what did its last meal consist?
when were its bowels last open? has it been exposed to the sun with its