Epilepsy, Hysteria, and Neurasthenia | Page 2

inspiration, and the power of "seeing visions" and prophesying.
Epilepsy has always interested medical men because of its frequency, the difficulty of tracing its cause, and its obstinacy to treatment, while it has appealed to popular imagination by the appalling picture of bodily overthrow it presents, so that many gross superstitions have grown up around it.
The description in Mark ix. 17-29, is interesting:
"Master, I have brought Thee my son, which hath a dumb spirit. And wheresoever he taketh him, he teareth him: and he foameth, and gnasheth with his teeth, and pineth away: ... straightway the spirit tare him; and he fell on the ground, and wallowed foaming.
"And He asked his father, How long is it ago since this came unto him? And he said, Of a child. And ofttimes it hath cast him into the fire, and into the waters, to destroy him.
"And he said unto them, This kind can come forth by nothing, but by prayer and fasting."
Up to the present, epilepsy can be ascribed to no specific disease of the brain, the symptoms being due to some morbid disturbance in its action. Epilepsy is a "functional" disease.
GRAND MAL ("_Great Evil_")
An unusual feeling called an aura (Latin--vapour), sometimes warns a patient of an impending fit, commonly lasting long enough to permit him to sit or lie down. This is followed by giddiness, a roaring in the ears, or some unusual sensation, and merciful unconsciousness. In many cases this stage is instantaneous; in others it lasts some seconds--but an eternity to the sufferer. This stage is all that victims can recall (and this only after painful effort) of an attack.
As unconsciousness supervenes, the patient becomes pale, and gives a cry, which varies from a low moan to a loud, inhuman shriek. The head and eyes turn to one side, or up or down, the pupils of the eyes enlarge and become fixed in a set stare, and the patient drops as if shot, making no effort to guard his fall, being often slightly and sometimes severely injured.
The whole body then becomes stiff. The hands are clenched, with thumbs inside the palms, the legs are extended, the arms stiffly bent, and the head thrown back, or twisted to one side. The muscles of the chest and heart are impeded in their action, breathing ceases, the heart is slowed, and the face becomes pale, and then a livid, dusky blue.
The skin is cold and clammy, the eyebrows knit; the tongue may be protruded, and bitten between the teeth. The eyeballs seem starting from their sockets, the eyes are fixed or turned up, so that only the sclerotic ("whites") can be seen, and they may be touched or pressed without causing blinking. The stomach, bladder, and bowels may involuntarily be emptied.
This tonic stage only lasts a few seconds, and is followed by convulsions. The head turns from side to side, the jaws snap, the eyes roll, saliva and blood mingle as foam on the lips, the face is contorted in frightful grimaces, the arms and legs are twisted and jerked about, the breathing is deep and irregular, the whole body writhes violently, and is bathed in sweat.
The spasms become gradually less severe, and finally cease. Deep breathing continues for some seconds; then the victim becomes semi-conscious, looks around bewildered, and sinks into coma or deep sleep.
"...As one that falls, He knows not how, by force demoniac dragg'd To earth, and through obstruction fettering up In chains invisible the powers of Man; Who, risen from his trance, gazeth around Bewilder'd with the monstrous agony He hath indured, and, wildly staring, sighs: ..."
In a few hours he wakes, with headache and mental confusion, not knowing he has been ill until told, and having no recollection of events just preceding the seizure, until reminded of them when they are slowly, and with painful effort, brought to mind. He is exhausted, and often vomits. In severe cases he may be deaf, dumb, blind, or paralysed for some hours, while purple spots (the result of internal hemorrhage) may appear on the head and neck. Victims often pass large quantities of colourless urine after an attack, and, as a rule, are quite well again within twenty-four hours.
This is the usual type, but seizures vary in different patients, and in the same sufferer at different times. The cry and the biting of the tongue may be absent, the first spasm brief, and the convulsions mild. Epilepsy of all kinds is characterized by an alteration (not necessarily a _loss_) of consciousness, followed by loss of memory for events that occurred during the time that alteration of consciousness lasted.
Attacks may occur by day only, by day and by night, or by night only, though in so-called nocturnal epilepsy, it is sleep and not night that induces the fit, for night-workers have fits