But the fit and its treatment form only a part of the anxieties which arise out of a case of epilepsy. The ultimate danger of the disease has little relation to the severity of the individual fits, except in the modified sense explained above; the frequency of the attacks being apparently much more apt to influence the duration of life than their character. Indeed, although epileptics may survive several severe paroxysms at dis tant intervals, and recover in the end with an apparently unbroken constitution, it rarely happens that very frequently repeated attacks, even of the petit mal, are unat tended by some permanent depreciation of the powers of mind or of body. The most frequent, perhaps, of all the more serious consequences of confirmed E. is insan ity (q.v.), sometimes assuming the form of acute mania or monomania following the attacks, but quite as frequently tending to gradual imbecility without any acute seizure. Sometimes the developmentof the epileptic insanity, or dementia, is attended by palsy, and other indications of structural disorder of the brain; in other instances, no such consequences occur, and the brain after death may be found to have very little tangible disease, or only such disease as is found in numerous other cases of functional derange ment. Very often, even when the mind remains tolerably entire, there is loss of memory, and a certain want of acuteness and depression of spirits, which unfit the individual for the regular business of life. Disorders of the digestion are also not uncommon; and there is frequently a want of tone and vigor in all the bodily functions, which commu nicates a habitual expression of languor and reserve to the epileptic. Added to this, it can hardly be matter of surprise that the knowledge of his infirmity should deeply influ ence the mind of the epileptic, and produce a distaste for active occupations, especially for such as expose him to more than ordinary observation.
The causes and the radical cure of epilepsy are almost equally involved in mystery.
It has been supposed by some to be dependent on an increased affiux of blood to the brain; while by other observers and pathological authorities it has been attributed, with about equal force of reasoning, to precisely the opposite condition. Certain cases undoubtedly depend upon organic disease, as tumors or injuries to the brain and its membranes, more especially near the surface. Local sources of irritation in other parts of the body have also been supposed to be exciting causes of E.; and cases are recorded in which the disease has been cured by the amputation of a finger or the divi sion of a nerve. The attention of recent observers has been especially directed to the medulla oblongata and spinal cord (q.v.), as being the most probable physiological seats. of a disease so decidedly marked by convulsive movements. But as yet little more than the most vague theoretical inferences can be drawn from their researches as to the cause either of the morbid tendency in E. or of time paroxysm. One of the most curious and suggestive of these recent facts is the experiment of Brown-Sequard, showing that E., or a state closely resembling it, may be induced in certain animals by division of cer tain portions of the spinal cord, the artificial disease continuing long after the primary effects of the injury have ceased. A still more curious and inexplicable phenomenon has resulted from the multiplication of such experiments; for Brown-Sequard has shown that in Guinea-pigs this artificial E. is sometimes propagated to the offspring, becom ing, like the natural disease, a hereditary and congenital morbid tendency. On these strange facts it would be premature to indulge in speculation in this place, but their great importance can hardly be overlooked.
The condition of the epileptic seems to be favorably affected by everything which conduces to a quiet and hopeful state of the mind, and to a vigorous condition of the body. The treatment of the disease should therefore, in general terms, be of the kind.
termed tonic (q.v.), and should be adapted with care, and after very minute and careful inquiry', to the removal of all the special bad habits, and occasional causes of depres sion, which tend to bring the system into a condition below par, in the individual case. The influence of a happy and quiet domestic life, without unhealthy excitement, and with proper occupations, varied by amusement and exercise in the open air, can hardly be overestimated. The marriage of epileptics is, however, not too readily to be sanc tioned, as it has been known to be followed, not only by an increase of the disease, but by its transmission to a considerable portion of the family. On the other band, a too absolute rule on this subject is not without its dangers, and perhaps the practical diffi culties of the question are not to be met by any defined or dogmatic expression of opin ion, founded on the general pathology of the disease. If the tendency exist, even slightly developed, upon both sides in such a connection, it needs hardly be stated that the dangers of transmission to the descendants is increased in a very great degree. Hence, intermarriages within epileptic families must be regarded as always in the highest degree imprudent. Parents and guardians are undoubtedly justified in making this disease an object of special solicitude, and reserve or concealment on this subject on either side, in the case of a proposed marriage, should be regarded as equally dishonor able with any other form of deception in a matter so important to the welfare of society and of the parties concerned.
According to one of the oldest and most respected of American physicians (Dr. Jackson, of Boston), the epileptic tendency may often be successfully treated by the systematic use of an exclusively vegetable diet, or by a very considerable reduction of the proportion of animal food. Among the innumerable remedies recommended by authorities, the salts of iron and zinc have perhaps the largest amount of experience in their favor; and counter-irritants (q.v.) applied to the nape of the neck, or between the shoulders, either by blistering, the use of the seton, or even actual cautery, has been often followed by prolongation of the intervals, or decrease in the severity of the fits. Almost all the accredited remedies, however, have been observed to produce a tempo rary relief of this kind, even when without any permanent influence on the course of the disease.
Some of the lower animals are subject to epileptic fits. The disease is common in dogs and highly-bred pigs. The creatures writhe with involuntary spasms, and are for the time without sight or hearing. Sometimes the muscles of the throat are.so involved that fatal suffocation occurs. The attack is generally preceded by dullness, and lasts from ten to thirty minutes. It is generally traceable to torpidity or irregularity of the bowels, worms, debility, or plethora. In dogs, it is a frequent sequel of distemper. In cattle, it usually occurs in connection with the engorgement of the first or third stom achs; they throw themselves violently about, bellowing loudly, but seldom die. It is rare in horses, and differs from megrims, for which it is often mistaken, but in which there are no spasms. The treatment consists in freely opening the bowels, removing worms, if any are present, enjoining bleeding and spare diet, if the patient's condition is high, and generous feeding and tonics where it is low. The best preventives are carefully regulated diet, an occasional laxative, with a course of tonics, and especially of arsenic.