CASE OF EPILEPTIC ASPHYXIA.

To the Editors of the London Medical and Physical Journal. GENTLEMEN: Should the following case appear to you of sufficient interest to merit publication, be so obliging as to give it a place in your valuable periodical.

3, Foley place; 16th January, 1833.

Yours, sincerely,

E. W. DUFFin.

On the evening of the 19th October last, I was requested to visit Mr. R., ætat. seventy-three years, of a sanguine temperament, slender and delicate form, and, for his age, a man of more than ordinary acuteness of intellect. I was informed that for the last four years he had been liable to fits, which recurred at irregular intervals, as often as three, four, or five times in the course of the year; that he had that morning, about eleven o'clock, been seized in the street, carried home, and cupped freely at the back of the neck; and that, since that time, he had experienced several more attacks, varying in duration from five to fifteen minutes each. On my entering his chamber, he was seized with a more than ordinarily severe paroxysm, which presented the following phenomena: At the moment of attack, he uttered a faint exclamation; his face flushed a little; his eyes became fixed; his breathing laborious, but not stertorous; and his whole frame slightly convulsed, more especially the muscles of the face and upper extremities. His pulse beat only twenty-eight in the minute, was free, soft, and easily compressed. In this condition he continued for about five minutes, his pulse becoming gradually slower and more feeble, until it beat only at intervals of twelve seconds, and then ceased altogether, at the heart as well as at the wrist simultaneously. His respiration, in like manner, became gradually less laborious, and was repeated at very long intervals, till it finally ceased. The colour that had remained in his cheeks now completely fled, the lighter parts of the skin assumed a leaden hue, and his lips a purple tint; the whole muscular system was relaxed, the lower jaw dropped, (for he was sitting supported in an easy chair,) the extremities became livid and cold, and I concluded he was dead.

As I was informed by his friends that he had repeatedly during the day, and on former occasions, exhibited similar phenomena and revived, I kept my finger applied to his pulse, and my hand over his heart, and requested an attendant to hold my watch before me, that I might ascertain how

long animation would remain in a state of suspension. At the expiration of four minutes and a half, a single feeble pulsation was again felt, both at the heart and wrist, and the colour of his face began to return. In the space of six seconds, another pulsation was felt, and again after a lapse of four seconds: this third beat was much stronger and more decided in every respect than the two preceding ones. He then made an effort to breathe; and gradually from this time, in the space of about eight minutes, was perfectly restored, and his intellect became as clear as if nothing had happened to him.

For several days afterwards he was attacked, as often as ten times within the twenty-four hours, with fits of asphyxia similar to that I have just described, though only on one occasion of so long duration; and experienced in all, before recovery, forty-six paroxyms.

It is worthy of remark, that his pulse generally averaged twenty-eight beats in a minute during the intervals, and that afterwards, when in perfect health, it never exceeded thirtythree. For a few seconds before each fit, he generally complained of fulness and constriction of the head, and observed that, at the moment of seizure, a sudden determination of blood to the head, accompanied by a rushing noise, gave him acute pain, and was the cause of the exclamation he uttered at that time. Upon one occasion during his illness, he was very much distressed with spasm of the diaphragm, intercostal, and sterno-costalis muscles, which created difficulty of breathing to so great an extent that I feared he would be suffocated.

Neither at this time, however, nor at any other, could I, by the most careful examination of his chest, detect any symptoms of disease of the heart: it always beat with the utmost regularity and tranquillity, and, if its slowness be excepted, naturally in every respect: but of this peculiarity he was aware, and informed me that it was natural to him, and had always been observed by every medical man that had attended him during his life. Nor did there exist any symptoms of organic disease of the brain: on the contrary, his mind, during the intervals and afterwards, was always clear, his memory good, and his judgment correct; and, unless for a moment or two before the accession of each fit, he never suffered headach nor other cerebral inconvenience.

From the history he gave me of certain dyspeptic symptoms, that had always apparently been the cause of his former attacks, combined with the existing foul and furred state of his tongue, loaded and obstinate bowels, and the

insufferably offensive nature of the first discharges that were procured from them, I concluded that his attacks depended upon a surcharged and disordered state of the primæ viæ. Hence, as his pulse did not warrant further depletion, the treatment consisted of the administration of stimulating purgative clysters, repeated doses of calomel and compound extract of colocynth, and black draught; cold applications to the head, previously shaven; blisters to the nape of the neck; and, during the paroxysms, active friction over the whole body, and sinapisms to the feet. So soon as his tongue became clean, and the alvine evacuations had assumed a natural character, the fits ceased, and in ten days' time he was as well as he had ever been for years.

On the 20th of December following, he was again seized with another series of fits, for which, as his friends had seen him apparently so much worse and recover, they did not at first deem it necessary to send for medical aid, or pursue any active means to effect his restoration. In the course of the evening, however, observing him paralysed, I was requested to visit him; but it was too late; he died in a few hours afterwards.

It is to be regretted that permission could not be obtained to examine the body after death.

FACTORY LABOUR.

On Factory Labour. By JOHN MALYN, Esq., Surgeon. (Read before the Westminster Medical Society.)

An inquiry into the influence which labour exerts on the animal economy, when that labour is pursued, during the process of maturation, in a heated and polluted atmosphere, in an erect and slightly varying position, and with but brief remissions for refreshment and rest, would possess considerable attraction, even as a speculative question, totally unconnected with the actual condition of beings who had been subjected to the implied experiment. It inspires, however, a deeper interest when its object is not only to demonstrate that the moral as well as physical degradation of such as are so exposed, is the natural and unavoidable consequence of their employment; but also, by fairly and dispassionately stating the grounds on which that conviction is founded, to offer such evidence of the iniquity of the system as to secure, in the design of its improvement, the co-operation even of those persons who, regarding it as a mere commercial question, have hitherto been opposed to the benevolent attempts which have been made to mitigate the abiding misery of the

poor.

Great as is the evil, and widely and severely as it has been extended, even to the alteration of character, the engendering of disease, and the abridgment of the natural period of life, it is yet of comparatively recent origin.

Before the ingenuity of the mechanic had called into existence those potential instruments of manufacture which bring forth wealth in unbounded profusion, and cast into shade the former humble and unassisted operations of man, the different fabrics of the country were produced in the cottage of the artisan. Surrounded by those in whom he took a direct interest, he laboured in his vocation with advantage to himself and family: his daughters became qualified for the discharge of domestic duties; his sons assisted him in his work, to the extent of their infantile powers; and the minds of both were preserved from contamination, and imbued with those hallowed sentiments which formed the seductive character, of which we have all read, but few seen specimens, in which the chief attractions are, singleness of heart and sincerity of purpose; cleanliness and health combined; devotion from affection, not fear for their superiors; attachment to their kind, and a modest pursuance of that moral line of rectitude from which no well-regulated mind would ever have desired to see them deviate. Then it was that infancy was passed in innocent recreation, until the system was so far developed as to justify the appropriation of its powers, not as a matter of gain, but to qualify it for its part in life. The circumstances by which the child was surrounded were salutary; its introduction to labour was gradual; its powers of endurance were never exhausted, and it therefore flourished and attained strength, like a plant in appropriate soil and genial atmosphere. Acknowledging the responsibility of a parent, a workman of those days would have spurned the idea of consuming, in its youth, the manhood of his child, or of coining into money its health, its happiness, its life.

But their condition changed. Machinery was introduced, and it brought forth abundantly. The application of steam was effected, and its mighty energies multiplied the product. The cottage was swept away, and the social hearth made desolate. Men were congregated together in large establishments, to aid the operation of the engine, of which they now became the mere instruments. It was soon discovered that, as direct strength was not required, women might be serviceable; and, accordingly, for this employment they abandoned their household labours. Untiring in the pursuit of wealth, the employer failed not to observe that a child, nay, an

infant, (and that without distinction of sex,) might supply the place of an adult; and the fields and the playgrounds ceased to resound with the noisy hilarity of youth. But the evil ended not here. Individuals, whose thirst for gold was insatiable, gradually extended the period of labour. Exaction begat exaction to such an extent, that not only did the term of exertion frightfully exceed that allotted for rest, but the intervals for refreshment were at first curtailed, and afterwards, in some instances, abrogated altogether, food being taken as opportunity might serve, while they were executing their duties. It mattered not that this abuse had a local origin: having been commenced by a few, others were constrained to follow in their wake, by the coercive influence of competition. Hence have the habits and condition of these unfortunate people undergone a revolution which it is deplorable to contemplate. Their habitations are neglected and unhealthy; their food is poor and innutritious; their persons are dirty and slightly clad; their language and conduct are of the most repulsive character; females are no longer qualified for the discharge of the duties of a wife or a mother. domestic life having lost its charms, husbands seek other society and other pleasures, by indulgence in which their minds are brutalized; the children of such parents rise hours before daylight from their wretched pallet, to encounter, with scarcely any clothing, and without any food, the frost, the snow, the rain, or the bleak winds of a winter's morning. The action and reaction of these conditions aggravate each other, and produce a state of debasement that we cannot witness without concurring in the fear of the late Sir R. Peel, "that the great effort of British ingenuity, instead of being a blessing, would prove its bitterest curse.'

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Some reformation was effected in the cotton factories by this gentleman, who endeavoured, and, to a certain extent successfully, to check the premature employment of children. He obtained for their protection an Act of Parliament, by the provisions of which, children under nine years age were deemed inadmissible, and the period of labour was fixed at twelve complete hours out of the twenty-four, independent of the time allotted for meals. The Act, however, did not extend to other descriptions of factories. In them is exhibited a melancholy specimen of the atrocity which cupidity will justify, nay, defend; and they show how completely man may forget that his less fortunate fellow-creatures partake of the same nature and are formed by the same hand as himself. Thus, for instance, it was stated in the