Epilepsy, Hysteria, and Neurasthenia | Page 9

bring on a recurrence of the malady after it has apparently been cured;
or, very rarely, induce a temporary or permanent cure.
Epilepsy may be due to abortives. These drugs wreck the constitution
of the undesired children, who contract epilepsy from causes which
would not so have affected them had they started fairly. In many
families, the first child, who was wanted, is normal; some or all the
others, who were not desired and on whom attempts were probably
made to prevent birth, are neuropaths, as are many illegitimate children.
It cannot too emphatically be stated that there is no drug known which
will procure abortion without putting the woman's life in so grave a
danger as to prevent medical men using it; legal abortion is always
procured surgically. Dealing in abortifacients would be a capital
offence under the laws of a rational community.
Self-abuse may perhaps play some part in epilepsy commencing or
recurring after the age of ten.
The onset of menstruation often coincides with the onset of epilepsy,
and in some cases irregularity of 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 anæmia 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.
* * * * *

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