Many other methods which have from time to time been suggested and carried out for the cure of epilepsy may he mentioned. Surgical pro cedures for the relief of intracranial pressure or irritation have been instituted, even to the extent of removal of a portion of the cortical centres; the results do not justify such operations being undertaken for the cure of the idiopathic type of the disease, and the same remark applies to the heroic procedure of ligaturing the longitudinal sinus in two sections. Alexander's operation for the removal of the sympathetic ganglion and the operation of ligaturing the vertebral or carotid arteries have been abandoned.
Electricity has proved of little value; the continuous current has been reported as useful when applied for lung periods to the thyroid gland in some cases, but the results of the various methods of using the static and high-frequency currents and other forms of electricity are at the best evanescent, and may be attributed to suggestion as in the next procedure.
Hypnotism has undoubtedly in mild cases been followed sometimes by a marked diminution in the number of or by a long postponement of seizure when the suggestion has been made to the patient during the hypnotic state that he will not suffer from future attacks, but when a seizure does follow he is possibly rendered more susceptible owing to the blighting of his hopes.
Serum Therapy has been tried. the patient being injected by his own scrum or by the Cerebrospinal fluid from another epileptic, with the chimerical idea of rendering him immune to the influence of the unknown toxin which is supposed to produce the convulsions. Any apparent
benefits noticed after the injections are probably due to suggestion. and this remark applies to the old practice of inserting a seton into the nape of the neck, and many other long disused methods of treating the disease.
Crotalin extracted from the poison gland of the rattlesnake has been injected hypodermically with results which tempt no one to use it.
Jacksonian Epilepsy.—The convulsive attacks which begin in a particular group of muscles following a localised injury of the cranium, such as that in which a spicula of bone is driven in upon the cortical area, or where an adherent cicatrix involves this region, are known as examples of what is styled traumatic epilepsy. These focal symptoms are a clear indication for surgical interference. and as long as the convulsions remain strictly confined to the muscles associated with the injured centre there is a fair hope of the success of trephining. To lose time by bromide treatment is a serious mistake in these cases, as once the convulsions cross the middle line and have become general there is but a faint hope of success following surgical procedures. This remarl? holds true for the convulsions caused by a small cerebral tumour located in the cortex of the Rolandic area, which if removed early by a trephining operation may cause per manent disappearance of the Jacksonian convulsions. hut even if the tumour be large, palliation of the symptoms may be effected by making a large opening.