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8. Cause. Asphyxia, and the accumulation of black blood
in the encephalon and in the spinal cord.
Effect. Clonic convulsions every where, contractions of the
bowels, the bladder, and the uterus ; erection ; increase of
many secretions ; efforts at inspiration.
9. Cause. Exhaustion of nervous power generally, and of
the reflex faculty especially, except for respiration, which grad-
ually becomes normal.
Effect. Cessation of the convulsions ; coma, or heavy sleep,
after which there is extreme fatigue and headache.
Thus are shown, of course, only the more frequent phenomena,
besides which there are a great variety ; moreover, we can thus
see the bearing of those admirable researches of Dr. Marshall
Hall which first showed the important influence of laryngismus
and trachelismus in the causation of epileptiform convulsions.
And, finally, we are instructed by Dr. Sequard how asphyxia,
to which so great a share is due in the phenomena of epilepsy,
and in its most grave consequences, depends not only upon the
state of the larynx, but also on that of the chest; and that not
only cannot the blood return easily from the head, on account
of the trachelismus, but also we see that it cannot enter the
chest from either the spinal canal or the head, on account of
the fixed state of expiration; besides, the bronchia? themselves
are often contracted, and thus, all these causes co-existing, tho
blood accumulates and lingers in the base of the encephalon,
also in and about the spinal cord, from ganglionic reflex-action.
According to Dr. Sequard, there are many other nervous
affections that very often have the characteristic features of
epilepsy, at least as regards their production. He relates a
large number of facts that go to show and prove that, far more
frequently than might be imagined by most persons, there are
many forms of insanity, of vertigo, of hallucinations, of illu-
sions, and also of ecstasis, catalepsy, hysteria, chorea, hydropho-
bia, tetanus, (lockjaw,) local cramps, and even that peculiar
diffusible paralysis that is connected with insanity, which may
be due to irritations " starting " from a centripetal nerve rami-