Epilepsy. Epileptic Fits.
This disease has been sometimes called the falling sickness, but generally passes under the more vague title of fits.
Symptoms. The disease is characterized by a temporary loss of consciousness, strong spasms and intervals between the fits. The attack is sudden, generally without warning, and attended with a loud cry, when the patient falls down, is senseless and convulsed, struggles violently, breathes with embarrassment, has a turgid and livid face, foams at the mouth, bites his tongue, has a choking in the windpipe, and appears to be at the point of death. Presently, in from five minutes to half an hour, and by degrees, these symptoms diminish, and at length cease; and the patient falls into an apparent sleep. In a short time more he recovers, and is apparently well. These attacks. come again and again, and at irregular intervals.
This is the worst form of the disease; there is another class of cases in which the symptoms are much lighter, there being no turgesence of the face, no foaming at the mouth, no cry, no convulsions; but merely a sudden and brief suspension of consciousness, a fixed gaze, a feeling of confusion, or a totter, from all of which the recovery is speedy.
Causes. These are numerous, as worms, disturbance from indigestible food in the stomach and bowels, difficult teeth cutting, nervous irritation, either direct or by sympathy, sexual excesses and masturbation, disease or injury of the brain or spinal marrow, gall stones in the excretory duct of the liver, stone or gravel in the kidneys and bladder, fright, distress of mind, passion, great loss of blood, and many others.
Treatment. But little can be done during the fit, except to protect the patient from being injured by the violence of the convulsions and especially for unusual accidents that may happen while the victim is falling unconscious, such as burying the face in the pillow at night, choking due to the food stopped in the throat or falling of the body on hard substances causing breaking of the bones, even fracture of the skull. There is little fear that death will result. Cures are seldom obtained but the violence of the convulsions may be greatly diminished by proper treatment and the time occurring between attacks of greater length. The most important drug and the one tried which has given the largest number of happy results is the bromide of strontium, which drug as well as any chosen must be used over a long period of time and even after the improvement has been noticed. The use of the drug must be continued even over a matter of years in the dosage of 10, 20 and even 30 grains well diluted with water, three times a day, and in all probability an improvement may be expected. If as in a certain proportion of cases an attack is preceded by a premonition of its onset, the inhalation of the vapor of nitrite of amyl which can be purchased in pearls, and crushed in a handkerchief, the attack can be prevented.
In all cases, indeed, the diet should be carefully regulated, being light, nutritious, and easy of digestion. The sleep should be taken at regular hours, and daily exercise in the open air be insisted upon. The bowels must be kept regular, by the food, if possible; if not, by mild laxatives. Apply along the spinal column 195, once a day, rubbing it well in; also, now and then, mustard poultices.
In addition to these remedies, give pills of iron and quinine (72). one after each meal, also oxide of zinc (270), which is one of our very best remedies. Of the pills, one should be taken three times a day. Bromide of sodium, 1 dram in 24 hours, mostly at bedtime.
We can seldom go amiss in giving medicine calculated to relieve nervous irritation, and to build up the general system. For this purpose, the valerianate of quinine, and the extract of black cohosh (79) are well adapted Citrate of iron and strychnine (316), is a very valuable remedy.
It is said that a black silk handkerchief thrown over the face of a person in a fit, will immediately bring them out of it. It is an experiment easily tried; and having seen it in a respectable medical journal, I give it for what it is worth. The bromides in large doses, long continued, sometimes cure epilepsy (367).
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