Where this is impossible, some such general plan as the following is able: Epileptics should be given some employment always, preferably physical and congenial and out-of-doors.
An epileptic child should lead a simple, regular life, as much as possible out-of doors, away from the excitement of a great city or from association with many children. Editorial (Pediatrics, May 1, '981.
The diet should be regulated to two meals a day. Plain, wholesome food simply and properly cooked should be given liberally, but not in excess. leptics should be trained to eat slowly and to thoroughly masticate all food.
Uric acid increases blood-pressure, causes headache, and increases the lia bility to epileptic seizures. The follow ing scale of diet recommended: Rice, vegetables, milk and cheese, macaroni and other farinaceous preparations, and in special cases "protene" and "glu ten." This is calculated to subserve all the needs of food and digestion. but is quite free from uric acid, and has been found to give good results. Alexander Haig. (Lancet, Aug. 20, '99).
Very little fluid should he allowed with meals. No special constant diet table is either necessary or advisable, except in individual patients in whom some special indication exists. The two meals should be given at 10 A.M. and 5 P.m. The pa tient should be required to drink water freely and at regular intervals between meals—as much as three or four pints should be taken daily. The living rooms should be light and never overheated or contaminated by impure air. Epileptics should be carefully protected from ex posure to extremes of temperature. Tonic baths at proper intervals, keeping the skin active, and assisting in general nutrition arc valuable, but there is no special system of hydrotherapy which will cure epilepsy.
As regards the drug treatment, we are still dependent upon the bromides. Ani mal extracts, antitoxins, and various other sensational specifics, including hypnotism, have been vaunted in recent years, but have failed to stand the tests of trial fairly made. (See ANIMAL Ex TRACTS.) The use of Merck's ovarian tablet, be ginning with 1 for the first day and in creasing to 10 per day, in epilepsy due to disturbed functions of the genital apparatus, may be productive of excel lent results. Karl Bodon (Deut. med.
Woch., 22, p. 72i).
The coal-tar derivatives—antipyrine, phenacetin, lactophenin, etc.—have also had their day, although their use is not altogether without benefit temporarily under certain circumstances.
Case of epilepsy successfully treated by regulating the diet and giving anti pyrine and sodium salicylate. J. Howe Adams (Southern Practitioner, Feb., '95).
Ethylene-bromide, amylene-hydrate, sulphonal, trional, curare, and solarium Cariolensis are a few among the hun dreds of new remedies recommended which have proved of only slight value or useless altogether, or, as with amylene hydrate and curare, worse than useless. Borax, preferably in the form of the bi borate of soda, is an exception in that it rarely does seem to possess a positive value, especially in nocturnal epilepsy. The dose is from 15 to GO grains once, twice, or three times daily. Very much larger doses have been given and have been well borne. In this variety of epi lepsy,.too, the hypnotics—sulphonal, tri onal, chloralamid, and urethan—have a useful purpose as occasional temporary substitutes for the bromides.
Santonin personally used for nearly twenty years in the treatment of epi lepsy. It is a valuable antispasmodic in children, and under it the average epileptic patient shows better results than under the bromides, and has proved of especial value in those cases in which the bromides failed. It does not cause •mental hebetude, nervous or cir culatory disturbances, nor disfiguring eruptions. A dose of from 2 to 5 grains of the powdered drug may be given to adults and gradually increased to the point of tolerance. Many patients take 20 grains three times a day for some weeks. The point of saturation of the system is shown by a yellow color of the urine and a varying degree of renal and vesical irritation. G. F. Lydston (Then Gaz., Feb. 15, 1900).