Epilepsy, Hysteria, and Neurasthenia | Page 9

the menses seems to be a secondary or exciting cause.
Exciting Causes aggravate the trouble when present, causing more frequent and severe seizures. The chief are irritation of stomach and bowels (from decaying teeth, unchewed, unsuitable, or indigestible food, constipation, or diarrhoea), exhaustion, work immediately after a meal, passion or excitement, fright, worry, mental work, alcoholism, sexual excess, nasal growths, eye-strain; in short, anything that irritates brain or body.
Theories as to Cause. Epilepsy is usually classed as a _functional disorder_; that is, the brain cells are physically normal, but, for some unknown reason, they act abnormally at certain times. This term is a very loose one, and there is reason to believe that the basis of epilepsy is some obscure disease of the brain which has not been detected by present methods.
The new school of psychologists regard the malady as a mental _complex_--a system of ideas strongly influenced by the emotions--the convulsions being but minor symptoms.
Fits are most frequent between 9-10 p.m. the hours of deepest repose. One school says this is due to an?mia of the brain during sleep. Clark traces the cause to lessened inhibitory powers owing to the higher brain centres being at rest, while Haig claims to have explained the high incidence at this hour by the fact that uric acid is present in the system in the greatest amount at this time.
Some doctors have thought, on the contrary, that excess of blood in the head was the cause, but results of treatment so directed did not bear out the sanguine hopes built on the theory.
The fact that convulsions occur in diabetes and alcoholism, suggested that epilepsy was due to poisons circulating in the blood, and thus irritating the brain. Every act uses up cell material and leaves waste products, exactly as the production of steam uses up coal and leaves ashes. Various waste products have been found in more than normal quantities in the blood of epileptics, but it is uncertain whether accumulation of waste products causes the seizure.
A convincing theory must satisfactorily account for all the widely diverse phenomena seen in epilepsy, and the problem must remain largely a matter of speculation, until research work has given us a far deeper insight into the biochemistry of both the brain cells, and the germ-plasm than we have at present.
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CHAPTER V
PREVENTION OF ATTACKS
In health matters, prevention is nine points of the law.
Some patients are obsessed by a peculiar sensation (the "aura") just before a fit. This warning takes many forms, the two most common being a "sinking" or feeling of distress in the stomach, and giddiness. The character of the aura is very variable--terror, excitement, numbness, tingling, irritability, twitching, a feeling of something passing up from the toes to the head, delusions of sight, smell, taste, or hearing (ringing, or buzzing, etc.), palpitation, throbbing in the head, an impulse to run or spin around--any of these may warn a victim that a fit is at hand. Some patients "lose themselves" and make curious mistakes in talking.
The warning is nearly always the same each time with the same patient, and is more common in mild than in severe cases. Rarely, the attack does not go beyond this stage.
When the patient becomes conscious of the aura he should sit in a large chair, or lie down on the floor, well away from fire, and from anything that can be capsized. He must never try to go upstairs to bed. Some one should draw the blind, as light is irritating.
If the warning lasts some minutes, the patient should carry with him, a bottle of uncoated one-hundredth-grain tabloids of
Nitroglycerin, replacing the screw cap with a cork, so that they can quickly be extracted. When the warning occurs, one--or two--should be taken, and the head bent forward. The arteries are dilated, the blood-pressure thus lowered, and the attack may be averted.
The use of nitroglycerin is based on the theory that seizures are caused by an?mia due to vasomotor constriction. Success is only occasional, but this is so welcome as to justify the habitual use of the method.
If the aura be brief, buy a few "pearls" of Amyl Nitrite, crush one in your handkerchief, and sniff the vapour. This has the same affect as nitroglycerin, but the action occurs in 15 seconds and only persists 7 minutes. A headache occasionally follows the use of these drugs, and they should not be employed without professional advice.
When the warning is felt in the hand or foot, a strap should be worn round the ankle or wrist, and pulled tight when the aura commences. This sometimes aborts a fit, as biting a finger in which the aura commences may also do.
If a victim feels unwell after a meal, he must never eat the next meal at the usual time, simply because it