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Updated: May 3, 2025
In the worst cases, when the apnoea lasts a very long time, there may be convulsive twitching of the muscles of the face, or the attack may even terminate in general convulsions. Very occasionally the spasm is actually fatal. In all fatal cases which have come to my notice the child at the moment of death had been alone in the room.
In these children every burst of crying, however produced, whether by a fall, by a fright, by the entrance of a stranger, or by a visit to a doctor, is apt to be ushered in by a long period of apnoea, due to spasm of the glottis and of the diaphragm. The first few expirations are not followed by any inspiration.
For the sake of great accuracy in the statement of our prognosis are we to add a hundred times to the mother's alarm by stating the possibility of death? In each case we must use our own judgment. I believe that in a child over a year old the risk is almost negligible. Fortunately in all save the rarest possible instances the apnoea yields and a deep inspiratory movement follows.
I think it more likely that the cat may have awakened them in fright, and that the emotional excitement, giving rise to the spasm, was the cause of the suffocation. That the apnoea in these extremely rare instances should end fatally produces a difficult position for the doctor. It need hardly be said that the seizures are alarming to the parents.
The history of surgery fails to record a recovery from such a fearful wound and I have never seen or heard of any other person with such a wound, and injury to the sinus of the brain and to the brain itself, who lived even for an hour. As the President did not then revive, I thought of the other mode of death, apnoea, and assumed my preferred position to revive by artificial respiration.
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