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It is for this reason that I have included some description of laryngismus, although its origin is undoubtedly very different from that of the other disorders of conduct which we have examined. The ætiology of cyclic or periodic vomiting in childhood is not yet completely understood.
In a deprivation of calcium we have, in all probability, the explanation of the increased irritability of peripheral nerves and of the tendency to convulsive seizures of all sorts which is a common accompaniment of the condition. Convulsions, laryngismus stridulus, tetany, or carpopedal spasm are all frequently met with.
The symptom of laryngismus stridulus the so-called breath-holding alone need concern us, and that for a special reason. The spasm of the glottis is produced under the influence of any strong emotion in anger, for example, or in fear, in excitement or in crying for any reason.
In laryngismus in the same way we may suppose that the reflex path is made easy and the resistance lowered by constant use. Fortunately the spasms are not usually difficult to control. Calcium bromide, in doses of from two to four grains, according to age, three times daily, is generally successful with or without the addition of chloral hydrate in small doses.
Of this heightened irritability of the nervous system, to which the name "spasmophilia" has been given in America and on the Continent, the most striking symptom is a liability alike to tetany or carpo-pedal spasm, to generalised convulsions, and to laryngismus stridulus. In addition, in most cases it is generally possible to demonstrate the presence of Chvostek's sign and of Trousseau's sign.
They had come from a part of the interior where the disease called croup occasionally prevails. There was no appearance of the disease among them at the period of their visit, but the Portuguese inhabitants of that bay found that they had left it among them, and several adults were cut off by a form of the complaint called 'Laryngismus stridulus', the disease of which the great Washington died.
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