On the second day a sharp galvanic current was applied to the boy's spine. After this experience he had no more attacks of convulsion.
Epileptic fits which occur in the night only are often overlooked. In such cases the fact that a child suddenly begins to wet his bed at night is suspicious, and if a neurotic tendency exist in the family, the symptom should lead us to make further inquiries.
Prognosis.—Cases where the attacks are well developed and occur infre quently are more hopeful than the modified seizures which continually re turn. Certainly they are more amenable to treatment. The age at which the affliction first manifests itself has less influence on the curability of the disorder than it is said to have at a later period of life. On account of the difficulty in following out these cases (for if no immediate improve ment is noticed the patient is very apt to be lost sight of), my experience in this matter is too limited to enable me to speak positively ; but I am in clined to believe that the appearance of the disease during the first two years of life is of less favourable import than when it begins later. There is no doubt that at this age its influence upon the mental development of the patient is more hurtful, especially as such early appearance implies in many cases a strong neurotic predisposition.
The earlier treatment is begun after the onset of the disease the more favourable is the prognosis ; for while the affliction is still recent, we may have hopes of putting an end to the attacks. In confirmed cases, espe cially if there is strong hereditary tendency, the child's prospect is but a gloomy one.
Treatment.—It is so seldom possible to discover and remove the cause of epileptic seizures that little hope of curing the patient by this means can be entertained. It is not, however, the less desirable to relieve the child of all irritants, and to shield him from all influences which experience has shown to be injurious. Worms should be inquired for ; the state of the bowels should be regulated ; evil habits,, if indulged in, should be con trolled ; and the child's whole mode of life should be arranged according to the laws of health. All sources of excitement, whether in games, chil
drens' parties, or public amusements, should be strictly forbidden ; and although monotony of life is to be carefully avoided, pastimes which do. not over-excite the brain are to be preferred. The influence of quiet and of healthy recreation upon the disease is often seen in hospital patients. A child who has been admitted with a history of severe epileptic seizures, occurring daily for months, may pass several weeks in the wards and be eventually dismissed without any symptom of his disease having been detected. Careful gymnastic exercise is of value in promoting healthy change of tissue, but care should be taken to stop short of actual fatigue. With the same object pursuitS which occupy the mind while they give employment to the hands should be encouraged, such as gardening and carpentering. A useful plan is to send the child, under proper supervision, to a farm-house, where the tending and feeding of animals, and all the pur suits incidental to healthy country life, will be found of infinite service to him. At the same time the patient should be kept under strict control ; any taste he may have for music, drawing, etc., should be cultivated ; and without fatiguing the mind by mental labour, much valuable instruction may be conveyed by conversation and the reading to him of suitable books. Dr. West recommends simple chants, such as are easily acquired, as a useful means of improving imperfect articulation, and suggests drill ing to the accompaniment of music as valuable in correcting slovenliness of gait and aiding the child to regulate voluntary movement.
The question of food is a very important one, as the frequency of recur rence of the attacks may be determined to some extent by the judgment with which his diet is selected. It is a generally recognised fact that an abundant meat diet is injurious to epileptics, for the brain-tissue which it helps to build up is of a more highly irritable composition than if a less stimulating dietary were enjoined. Butcher's meat must be taken spar ingly, and the food should consist principally of milk, vegetables, poultry, game, and white fish.