EPILEPSY (Lat. epilepsia, Gk. hd.aytita, epilcpsia, epilepsy, from ez-i;tapi3dituv, epilantbanein, to seize upon, from 1a1, cpi, upon + XanficivEcv, lambanein, to seize). A form of disorder, com monly termed 'the falling sickness.' It is charac terized by sudden insensibility, generally with convulsive movements of the voluntary muscles, and occasionally arrest of the breathing, owing to spasm of the muscles of respiration, and tem porary closure of the glottis. (See LARYNX.) Owing to the striking character of the convul sion of epilepsy, it was, in ancient times, sup posed to be due to the influence of the gods or of evil spirits, and was therefore called by the Romans morbus sacer. There are four varieties of this condition: (1 ) Grand mai; (2) petit mat; (3) psychic epilepsy; (4) Jacksonian epilepsy, In the ordinary form, or grand mat, the patient is seized, without reference to his condition or occupation at the moment, with insensibility, often so complete and sudden as to lead to serious accidents and bodily injuries; in the most aggra vated eases he has no premonitory sensations whatever, but falls down without any attempt to save himself, and usually with a wild inarticulate cry of some kind, immediately after which the face is violently distorted, the head drawn toward one or other shoulder, and the whole body convulsed. These convulsions follow in rapid suc cession for a few minutes, and are attended by foaming at the mouth, and by great lividity, or, in some cases, pallor, which, with the irregular spasmodic movements of the lips, nostrils, and eyes, almost invariably lead the bystanders to an exaggerated idea of the immediate danger of the fit. The immediate danger is, in reality, not great, excepting that the sudden attack may lead to an injurious or fatal fall; the tongue, however, may he bitten if protruded during the convulsion. or the patient may be so placed as to injure him self seriously by the repeated and unconscious movements of his body, or he may suffocate him self by accidentally falling with his face in water, or otherwise closing up the mouth and nostrils, or by dragging upon a tightened neckcloth. Care should, always be taken to avoid these aeeidents by keeping the epileptic as much as possible within view of persons acquainted with his eon.
(Blinn. and able to give such assistance as may be required. as well as by warning the patient himself to avoid all places in which a fall would be especially dangerous. Any attempt to rouse the patient by violent stimuli, as ammonia ap»lied to the nostrils, or by dashing water in the face. or. still more, by administering medicines hastily recommended. is almost certain to do more harm than good. The tongue should be protected, a rubber cork, or ink-eraser, or other gag being, if necessary, inserted between the teeth; the pa tient should then be placed on a mattress or other soft place near the ground; his neekeloth should be removed, and the clothing loosened round the chest; the head should be, if possible, a little raised, and a free circulation of air maintained. The ordinary course of the lit (which usually lasts from five to twenty minutes altogether) is as follows: The convulsions gradually diminish in intensity, and the patient passes into a state of deep but motionless stupor, with dilated pupils, and sometimes, but not always, with snoring or noisy breathing; the foaming at the mouth ceases, the color gradually returns, and this state leads to recovery through a more or less protracted but apparently natural sleep, the patient, on awaken ing, feeling fatigued or tender in the muscles which have been convulsed. The sensations which precede the fit in some epileptics have been termed the aura epileptica, from their supposed resem blance to a current of cold air passing over the body, and proceeding from the extremities toward the head. In some cases the aura consists of noise in the ears, or a black cloud appearing above the head, or a feeling of nausea or faint ness, or loss of breath. In some, the premonitory symptoms allow of time enough for the patient to lie or sit down, and thus avoid falling. In most cases a peculiar inspiratory noise or a moan or scream is emitted, called the cry, as the fit be gins. Not infrequently there is no aura or un usual sensation of any kind, preceding the fit. A tight bandage placed suddenly upon the limb in which the aura begins may cut short the fit, or even prevent it altogether.