purpose of accomplishing a more speedy delivery, with no alleviation of the convulsion, but have had no opportunity of testing its action since attention has been directed to this supposed influence. Results in a single case were deeply impressed upon the mind and led to the query, if powerful counter irritants remotely applied, might not in many cases with propriety take precedence of all other treatment. The case was a partially hemiplegic patient, found suffering from powerful puerperal convulsions. The hemiplegia had existed a number of years and had, as stated, supervened upon a severe attack of typhoid fever. An examination revealed labor just commencing, os beginning to dilate. The convulsion was co incident with a labor pain. The patient was very spare; no œdema, but the extremities were very cold. Coma was profound, at least no indications of consciousness could be obtained. For the want of anything better at hand a small Dover's powder was administered, more with the purpose of inducing relaxation than anything else, and the feet being cold a hot iron was ordered to them. encouraged as rapidly as possible. being received just as the labor was about completed, but one inhalation was given and the labor was accomplished. The convulsions ceased, but the patient, still unconscious, seemed very nervous. An eighth of a grain of morphine was administered. after the expulsion of the placenta. No more convulsions occuring the patient was left in quiet. Next day, consciousness had not returned, neither had she been convulsed since confineOn the second day, consciousness returning, complaint was made of soreness of one leg. On examinations the whole impress of the sad iron was found burned into the calf of the leg. The revulsive effect must have been great, yet it had been utterly impossible to restrain her during the convulsions, the limbs being sometimes drawn close to the body and again ex tended, with great violence, to their utmost. ment. The progress of labor was Chloroform was sent for and Having observed with some care, and investigated with some zeal, we are forced to the conclusion that the only sure road to success in the treatment of puerperal convulsions lies not in treatment of the paroxysm but on the prophylaxis. Eight years or more have elapsed without a single case of puerperal convulsions having come under notice, although indications of such an issue have been frequent. Among these are frequent paroxysmal cephalalgia, tinnitus aurium, giddiness, excessive nervousness, constipation, abdominal soreness, etc. Every engorgement is closely watched and inquired after, and any of these symptoms presenting are appropriately met and the convulsion averted. The headache is especially a symptom demanding attention. This may be relieved by enemata or mild laxatives combined with a nerve tonic as nux vomica and quinia or bark, together with bromides or iodides as seem with the individual case most appropriate. Of course the secretions of the kidney may be closely looked after and any uterine or vaginal irritation relieved by lotio nigra or other mild soothing lotion, or suppositories of iodoform. ECLAMPSIA. A paper read before the Wayne County Medical Society. By W. H. ROUSE, M.D., Detroit. There are few people in civil life who require more self-possession and discriminating judgment than the physician. His avocation often brings him into direct contact with cases that require immediate and judicious action. There is no time to consult either books or friends. Of the many causes of suffering and death there are few that induce greater excitement and alarm of the friends, or require more self-possession and ready knowledge in the physician, than eclampsia. This disease is most common in children of tender age, and not infrequently attacks the pet of the family. Its onset is often unsuspected till the short, sharp shriek of the sufferer in the stillness of night summons the friends to witness the convulsed and frightful appearance of their unconscious darling. All is excitement and alarm, except the physician, who, being hastily called, is expected to act with the utmost coolness and discrimination, and by his actions say to the perturbed household, "peace, be still." Definition.—Eclampsia is any disease in which involuntary, clonic contractions of some or all of the voluntary muscles constitutes a prominent feature. As there are various diseases analogous to this, any one of which may at times more or less modify its symptoms, it is not strange that various definitions have been given, none of which, however, are free from objection The convulsive movements which constitute so prominent a part of this ailment, are but the expressions of derangement in some other part of the system. Yet, while this is true, it seems to require a nervous system of peculiar susceptibility for the full development of eclampsia; for a trifling irritation of the stomach, from change of food, for instance, may induce violent convulsions in one child, while gastritis, obstinate constipation, etc., seems to have no such tendency in another. CAUSES.-Since the convulsive movements are but the outward manifestations of some internal or remote irritation or disease, it has been found convenient to classify the causes under different heads, according to the location or source of the irritant that induces them. For convenience, I will adopt the following classification: 1. Predisposing. The Cause of Convulsions may be 2. Exciting. I. Age. 2 Temperament. 3. Hereditary tendency. 1. Essential, Idiopathic or Emotional 2. Centric or Symptomatic. 3. Eccentric or Sympathetic. 1. Of the predisposing causes, age is probably the most prolific. This probably arises from the rapid development of the nervous system during the first few years of the child's life-the couvulsions being comparatively rare after the eighth year. 2. As convulsions arise through nervous conditions, the more susceptible the nervous system, the greater will be the probabilities of eclampsia from any given cause. Some children are so excitable that comparatively trifling causes may induce uncontrollable actions. This cause is closely allied to 3. The hereditary tendencies which seem to play an important part in inducing this disease. Some families hardly know what convulsions are, while others, from their frequent recurrence in nearly every child, probably for several generations, seem to become somewhat accustomed to their recurrence, and look for them as others would for falls while the child is learning to walk. (a.) About two months ago I was called to see a child in convulsions in a large family. This was the only case that had been observed by the parents, either in their own family or in those of their relatives. These children, eight in number, have usually been healthy, but not remarkably strong. (b.) I saw another case in another family several months before this. The general appearance of the childrer. was far superior to that of the preceding, but convulsions were commonone had died, and nearly every member of the family had suffered from eclampsia. 4. Essential, idiopathic, or emotional convulsions are those in which post mortem examinations can detect no pathological condition that could act as an exciting cause, and in which the clinical history points directly to mental emotion strongly excited. I have never seen such a case. Authors report them, but I presume they are comparatively rare. 5. Centric, or symptomatic convulsions, are those in which the clinical history and post mortem examination, when admissible, indicate that they arise from disease in the brain, spinal cord, or their membranes. They are the most fatal, and may arise from inflammation, pressure, plethora, anæmia, as from excessive hæmorrhage, exhausting diseases, etc., rupture of blood vessels, or from any other cause which directly interferes with the action of these organs. In most cases the child has been It may fretful for some time, but not so ill as to excite alarm. have been placed in bed at night in apparently better health than usual, but before morning the parents are aroused by the short, sharp shriek of their child. It is found in convulsions, the pu pils are strongly contracted or dilated and insensitive to light; the eyes appear prominent and staring. If relief is not soon obtained, the child dies. About two years ago I saw a child of about three years of age, which had retired in good health and spirits, according to the report obtained from the friends, but they had observed considerable irritability for a day or two previously. About two in the morning the peculiar shriek of children with cerebral disease awoke the family. The child was in convulsions. I was in attendance in a short time and believing it to be a grave case, asked and obtained assistance. The usual treatment was adopted, but the child died in about six hours. Similar cases are too frequent to require further illustration. 6. Eccentric or sympathetic convulsions are those in which the clinical history and post-mortem examination indicate that the cause is in some other part of the body than the cerebrospinal system, as in the case of centric convulsions. These are by far the most common, and there sources might be called legion, for they are many. Irritation in almost any part of the body may induce them. The mere mention of some of the most frequent causes must suffice. In the alimentary canal might be mentioned dentition, unusual, irritating, undigested or indigestible food, worms, inflammation, or in fact, any disease or other cause that induces irritation of the nerves distributed to these parts. I have seen but few cases from dentition. Improper food has in my practice been quite common. Constipation is not an unusual cause. I saw a boy of five years of age some time ago in very violent |