The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 2).
- Date:
- 1849-59
Licence: Public Domain Mark
Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 2). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
78/812
![epilepsy, when unaccompanied with iluforniiu^ of the cranium or imbecility of mind, incurable, un- til, first, they shall have endeavoured to correct in the patient every function which is disordered, and until, secondly, they shall have exhausted the whole armoury of the em[)iric. Indeed, it would seem that all those diseases which have been termed opprohria medicinse ought to be revised with care, were it only to seek for new and more effectual palliatives. Every year, by the industry and ingenuity of the naturalist, the chemist, and the mechanist, new agents or more refined expedients are discovered for abatniy: the discomforts caused by infirmity and pain ; and nothing is more conmiendaUle in a physician than being familiar with all those resources of art by which incurable diseases can be alleviated. The euthanasia is a subject worthy of increased atten- tion. The name of Ferriar, who wrote a paper on the treatment of the dying, ought never to be mentioned without an honourable addition, on ac- count of the humanity which guided his pen upon that occasion. There exists yet another reason whj' epilepsy should be investigated with renewed attention. This disease has often brought candour and cun- ning, science and ignorance, into conflict: in the treatment of epilepsy, the empiric, ignorant and bold, and often confident in proportion to his igno- rance, is, in the estimation of the world, superior to the physician who is influenced by true princi- ples of science and morality. The physician ought to use all proper means of preserving epileptics from falling into the hands of the designing, whose nets are ever extended to catch the unwary. He ought to avail himself not merely of science and observation, of the advantage which he obtains from being enabled to prognosticate where an ig- norant person can only guess, but also of prudent reserve, time, and favourable contingencies; * and he ought not to forget that epilepsy will ofien spontaneously terminate, which favourable termi- nation nine-tenths of the community, educated and uneducated, patients and their friends, in s])ite of a disclaimer on his part, will attribute to the last medicine prescribed, according to that esta- blished aphorism of popular wisdom, post hoc, ergo propttr hoc. Epilepsy, fCT'Xfcit?, (from h( and y^aji^dvzc&ai,') so termed from the suddenness of the seizure. Synonyms. Morbus divinus, M. hercukus, M. sacer, M. comitialis, M. caducus, falling sick- ness, rnal endue, &c. Many of these appellations prove the dismay with which the spectator is af- fected upon witnessing this frightful disease. When a person, with whom, perhaps, one was engaged in agreeable conversation, and who ajjpa- rently was in perfect health, suddenly losing all sense, is thrown down and reduced in appearance to a state of hopeless agony, it is not wonderful that, in the days of ignorance, general amazement * Tlie following are instances of these contineencies Puer decern annoruni, jam a tribus annis epilcpticiis' friisira adiiiliitis iniiltis, remrdiis, corripitiir febre, epi- deniica. pluribiis molestiri syinptomatibus stipata et f6li- citer siiperat hunc morbum, et postea ab epilepsia ini- miinis inanet. Miscell. Cur. Dhc. iii. Ann. 7 and 8 p. 296. Fuere qiiibns excilatus ninrbns, et nijtriins opipara ac desidiosa vita, subita fi<rlunariiin jactura per oninem vil.'am, baud conteninenda plane conipensatione, silue- r\' t»e Haen, pars V. Rationis Med. cap. V. should have been the consequence ; nor that, du. iiig the reign of superstition, the frij-rhtful scream and struggle of epilepsy should seem to argue the interposition of an offended deity, in this cmi^ha- tic manner testifying disapi)robation of passing events. Thus did the most politic nation of an- tiquity interpret the occurrence of epilepsy during public business, nor did they hesitate to dissolve a meeting the moment that so apparently porten- tous an eruption took place. Even now, when the mind is strengthened by true religion, which, by calming the spirit, adds to the powers of observation and of reasoning, and is destructive of superstition, and which, moreover, imparts just views of the divine govern- ment, the occurrence of epilepsy is productive of awe in those who are gifted with reflection ; not as manifesting any disturbance in the established order of nature, but as a striking and salutary evidence of the uncertainty of health, a gift gene- rally prized by mankind above ail others. Paroxysm.—The scream with which epilepsy usually commences is one of the most startling sounds that can be uttered. In female auditors it has produced an hysteric fit, abortion, or as it has been said, eclampsia. We have known it pro- duce in an animal an effect which, although not without something ludicrous in its nature, is cal- culated to exemplify its astounding harshness. A young lady, while in the drawing-room of an eminent phjsician, waiting the assembling of a consultation summoned to consider her case, was suddenly attacked with epilepsy. She uttered a scream so piercing, that a parrot, himself no mean performer in discords, dropped from his perch, seemingly frightened to death by the appal- ling sound. When, horror-struck by the scream, we turn to the patient, we often find him labouring under a general spasm, more especially of the extensor muscles; his eyes may be discovered fixed and staring, his eye-brows contracted and lowering; he appears to draw back from the beholder with a fixed and threatening look, which, however, it immediately becomes apparent, is but a senseless gaze. The complexion in some epileptics is leaden, in others it is flushed even to duskiness ; the mus- cles are in alternate relaxation and vehement con- traction, the spasms being what are called clonic. In a girl who was for some time under our care, so violent were the muscular contractions, that her arm was found dislocated after every fit, until, by a proper bandage, which she always afterwards wore, this accident was prevented. Burserius describes a similar accident, and tells us that he once attended a young lady whose jaw was found dislocated at the end of a paroxysm ; and several authors have observed the teeth fractured by the violent contraction of the muscles which elevate the jaw; the tongue is often protruded, and is then almost always bitten, sometimes nearly through; frequently the sides of the tongue, aftei the fit, are found ragged and bleeding, having been gnawed by the teeth; from the wound in the tongue, the frothy saliva which is forced from the mouth IS often tinged with blood ; the neck ap- pears swollen ; the eyes roll, or are fixed in a hide- ous squmt, which sometimes continues after the paroxysm is over, and even has been perma-](https://iiif.wellcomecollection.org/image/b21116817_0078.jp2/full/800%2C/0/default.jpg)
