Epilepsy, Hysteria, and Neurasthenia | Page 2

ancients imputing it to demons,
the anger of the gods, or a blow from a star.
It often attacks men in crowds, when excited by oratory or sport, hence
the Roman name: morbus comitialis (crowd sickness).

In mediæval times, sufferers were regarded with awe, as being
possessed by a spirit. Witch doctors among savages, and founders and
expounders of differing creeds among more civilized peoples, have
taken advantage of this infirmity to claim divine 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