Lectures on some points in the treatment and management of neuroses.

  • Seguin, E. C. (Edward Constant), 1843-1898.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on some points in the treatment and management of neuroses. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    toxsemic conditions, as 1 he urEemic (falsely so-called), gouty, etc. It is usually not difficult to recog-nize such cases, and to subject them to a more or less rational treatment, based upon the causal indication revealed by our analysis. But there remain many cases of epilepsy in which the most careful examination fails to reveal the presence of any gross lesion or toxa^mic state; and these go to make up tlie group of idiopathic epilepsy. The aggressions of scientific patho- logical research and perfections in diagnosis tend constantly to reduce this group. There are also cases in which, dur- ing many years, the epilepsy appears idiopathic, and finally, perhaps in the course of a few weeks or months, definite symptoms of cerebral disease appear and enable the physi- cian to properly classify the case. In this connection I. might cite the case of the wife of a physician who had for several years been under the care of Brown-Sequard, and who had been examined by several other eminent physi- cians. Her attacks consisted of grand and 2oelit mal of the most vulgar kind, usually with an epigastric ascending aura ; the spasms were bilateral and typical in kind (tonic fol- lowed by clonic movements) ; in the pctil mal, staring, drool- ing, and swallowing movements were prominent. Her facies and manner were those of a common epileptic. Yet, about the time she was placed in my hands, right hemi- symptoms (numbness, ansesthesia, and paresis) appeared, and under observation choked disc began and developed fully. Autopsy revealed a gliomatous formation involving the left thalamus and internal capsule. My belief is that the new formation was present from the very onset of the epi- lepsy eleven years before, that it at first grew very slowly, and toward the last very rapidly. Thus, a case may, owing to imperfections in our methods of diagnosis, appear as idio- pathic at one time and symptomatic or organic later on. Idiopathic epilepsy presents itself to the careful student