Today, convulsions are understood to mean the involuntary rapid contracting and relaxing of muscles, which result in abnormal movements of the body. A term closely related in meaning is seizure which refers to sudden uncontrolled electrical activity in the brain causing irregular movements of the body. Convulsions and seizures are generally considered to be synonyms, though it is possible for a person to have a seizure without convulsing. The term ‘febrile convulsions’ refers to seizures in infants accompanied by fever.
Convulsions are commonly the result of the condition epilepsy. Brain injuries or diseases of the brain can also lead to convulsions. This can include brain tumours, meningitis and encephalitis (infection of the brain). In newborns, convulsions are caused by a fever or a lack of oxygen following labour. Seizures can be caused by epilepsy, strokes, brain tumours, metabolic disturbance, diabetes and withdrawal from addiction to alcohol.
Convulsions are the result of a disease, condition or injury, rather than being a disease in itself. The term convulsions has been used to describe a number of diseases over time, which have changed as the classification of diseases have developed. As a result, what the term ‘convulsions’ denotes has varied over the last few hundred years, gradually becoming more precise.
In London’s bills of mortality during the 18th century, the archaic term for infant deaths, ‘chrisomes’, fell into disuse and many infant deaths were grouped under ‘convulsions’ as a general cause of death. This meant that at the start of the 18th century, the meaning of the term ‘convulsions’ was associated with deaths in newborns. As other diagnostic terms developed during the 18th century - such as whooping cough, ‘croup’ and ‘dropsy in the brain’ - the use convulsions as a cause of death reduced. This suggests that prior to this point, convulsions had been used to describe all of these illnesses.
Diarrhoea and convulsions were two common symptoms that presented during infant deaths. This meant that diarrhoea and convulsions were often conflated and used interchangeably as a cause of death. After 1839 the Registrar's General Classification distinguished between diarrhoea and convulsions which meant that these two terms were separated on death certificates.
By 1785 it was understood that convulsions were a symptom and could be caused by a variety of diseases. In a medical glossary book written by London physician Dr Robert Hooper in 1808, convulsions are described as ‘strong convulsive motions of the limbs and trunk of the body, and spasms of the muscles’. This is what the meaning of convulsions has consistently been understood to mean since then.
Fever in infants can lead to convulsions (febrile convulsions). This may account for the large proportion of infant fatalities from convulsions within the burial registers. Infants are not able to regulate their body temperatures so are at a greater risk of contracting fever. Other infections and diseases spread as a result of overcrowding and poor sanitation may have caused infants to have a fever, in turn leading to convulsions.
‘Convulsions’ as a cause of death recorded in the burial registers is likely to be a symptom of another underlying disease, condition or injury. As listed above, there is a large variety of causes associated with convulsions or seizures. These diseases and conditions will have been more abundant in Leeds during the burial registers’ lifetime, due to a general lack of access to preventative health care and a lower standard of living conditions.
‘Convulsions’ is one of the top ten most common causes of death recorded in the Leeds General Cemetery burial registers. To find out more, visit the Leeds General Cemetery Burial Registers Index. Select ‘View key statistics’ to generate charts displaying the breakdown of who was affected.
Written by Imogen Gerard and Kelsie Root, as part of their internship with the AHRC project, 'Living with Dying: Everyday Cultures of Dying within Family Life in Britain, 1900-50s', summer 2017.