OF EPILEPSY.-In consequence of the patient suddenly falling to the ground, on an attack of this disease, it is also called Falling Sickness; and from its affecting the mind (being the most noble part of the rational creature), it is termed, by the ancient writers, the Sacred Disease.

SYMPTOMS.-It consists in an involuntary and violent convulsive contraction of the greater part of the muscles under the immediate influence of the mind, particularly those of the extremities, the eyes, the tongue, the lower jaw, and the bladder, attended with foaming at the mouth, and total loss of sensation, and ending in a state of insensibility and apparent sleep. The patient, on becoming sensible, complains of torpor, heaviness of the head, and general lassitude. The fit often attacks suddenly, but for the most part is preceded by a pain in the head, lassitude, dimness of the eyes, and a kind of tremulous sensation, beginning in the lower extremities, often in the great toe, and ascending to the head. The fits frequently recur during sleep.

CAUSES. The dissection of epileptic persons has shown a variety of morbid appearances, as tumours in the brain or membranes; caries or preternatural projections of the internal surface of the skull-bone; collections of serum, or purulent matter; and earthy concretions within the skull: while others, who have died of epilepsy, have exhibited no morbid appearance whatever. Aneurismal affections of the arteries of the brain, I believe to be often the cause of this disease, by the pressure and irritation produced by their distention, which often ends in fatal apoplexy or palsy, from the rupture of the aneurismal sac — a termination by no means unfrequent. It is likewise produced by the irritation of worms in the stomach or intestines, particularly the tapeworm also by dentition, and by violent passions of the mind, both of the exhilarating or depressing kind, as anger, joy, terror, and grief.t

In children, epileptic fits are often attendant on dentition, and precede the eruption of small-pox and measles, and sometimes occur in females that are subject to a retention of the menstrual evacuation; but they more frequently proceed from an hereditary disposition. -- (See CONVULSIONS OF CHILDREN.) TREATMENT. Various remedies for this disease have been recommended from the time of Galen to the present period; but experience has proved fatal to their reputation. The ni

Bystanders, unacquainted with the nature of these fits, suppose the patient to be in great agony. During the convulsion, he is in an insensible state, and his sensations on recovery are often more pleasurable than otherwise. Sometimes, however, they are the reverse, and the horror some experience remains on the mind for many days.

Van Swieten's Commentaries, vol. iii p. 414.

trate of silver has lately been highly extolled as a specific for epilepsy, which, unfortunately, has not been confirmed by the experience of others, several cases having been published in which it proved of no advantage. A very great objection to the continued use of this remedy is its effects in rendering the skin of a dark copper brown, which remains for life. When the disease arises from worms, the Basilic Powder, No. 36, or the Electuary, No. 86, with the use of lime-water, and the Tonic Mixture, No. 77, will prove beneficial. (See WORMS.)

When the cause cannot be ascertained, if the patient be of an apoplectic make, and of a plethoric habit of body, bleeding will be proper, but not otherwise as the loss of blood, by inducing debility, will render the recurrence of the fits more frequent. Valerian tea, with the tincture of the Russian castor, may be tried, with the following pills:

Take of Nitrate of Silver,

Extract of White Poppies,

1 scruple.
2 scruples.

Mix well together, and divide into twenty-four pills, of which one may be taken twice a day.

If these pills afford no relief, after twelve days' perseverance in their use (for I do not conceive it safe to continue them longer, unless the patient derives very considerable advantage from them, without producing any derangement of the digestive organs or bowels), the following are worth a trial: -

Take of Vitriolated Zinc,
Essential Salt of Bark,

drachm. I drachm.

Mix; and divide into twenty pills; two to be taken twice a day, with a draught of Valerian Tea.

The following bolus, much recommended by Dr. Hugh Smith, is a favourite remedy with many routine physicians :

Take of Russian Castor,

Oil of Hartshorn,

The Confection called Paulina,

Mix, for a Bolus, to be taken every six hours.

1 scruple.

6 drops.

10 grains.

The flowers of cardamine have been prescribed with advantage by Sir George Baker: the fresh powder may be taken, to the extent of a drachm, three or four times a day.

Mr. Hodgson, of Bishop Wearmouth, has published a case of a young girl, about eight years of age, that was cured by electri

When the nitrate of silver was first recommended as a specific for epilepsy, Dr. Cheston gave it a trial at the Gloucester infirmary. The first case that occurred, was a young man that had been subject to attacks twice a day for many years. After the exhibition of two or three doses, the fits suddenly left him, and he was shortly after discharged cured. He soon experienced a relapse, for which he was re-admitted, and the same medicine administered without producing any beneficial effect whatever.

city. A young lady was cured by Citizen Portal, who had experienced a fit every day. The attack commencing in one of her toes, suggested to that able anatomist the idea of dividing the nerve, for the purpose of interrupting the communication with the brain; but he began by the application of opium to it, and that alone effectually prevented a recurrence.

The good effects of calcined zinc have been attested by Dr. Haygarth of Chester, Dr. White of York, and Mr. Bell of Edinburgh.

The following prescription, for the exhibition of this medicine, is given by Dr. Saunders:

Take of Calcined Zine,

8 grains.

Conserve of Roses, sufficient to form a Bolus.

To be taken twice a day.

A treatise on the Efficacy of the Misletoe of the Oak in the Cure of Epilepsy, was published a few years ago; by which it appears, that it has been administered in three different cases of epilepsy, with complete success; all of which, it is stated, previously baffled the skill of several eminent practitioners: and the author asserts, that its exhibition has uniformly been attended with success under his directions. A case of this disease in a lady of quality, in which it proved remarkably successful, is related by Boyle; and, some years afterwards, its use was strongly recommended by Sir John Colbach, who has published several instances of its good effects. In a few cases, in which I have known it exhibited, it totally failed to produce any salutary effect whatever, while in others it has entirely suspended the disease.

As there is incontrovertible evidence that these medicines have succeeded in certain cases, and as the disease arises from such a variety of causes, they are all deserving of trial; for, in the treatment of so distressing a complaint, no plausible remedy should be left untried.

In the Monthly Gazette of Health, several remedies are recommended by eminent physicians of the continent, which should be employed if the above treatment should not succeed.

If the patient be affected with pains in the head, a seton in the nape of the neck should not be neglected, and the feet should be kept warm by the use of flannel socks.

Mr. Mansford, au eminent surgeon of Bath, has lately published a scientific dissertation on the causes and treatment of epilepsy; in which he states that he has succeeded in curing several cases of long standing, by the Galvanic fluid. mode of application is given in the 48th number of the Gazette of Health.

The

The tincture of the seeds of the colchicum autumnale has lately been administered with great success, in cases of epilepsy of long

standing the dose is from twenty-five to forty drops two or three times a day. It may be taken in a wine-glassful of the decoction of Peruvian bark, or infusion of the wild valerian root. The Prussic acid, in the dose of one to two drops, two or three times a day, is also entitled to a trial. (See ANTISPASMODICS, p. 12, and PRUSSIC ACID, p. 175.)

The diet should be regulated according to the state of the constitution of the patient: if he be debilitated, it should be nutritious, but not stimulating. Distilled water affords the best beverage this article, though simple in itself, may, by quieting the system, and promoting digestion, prove of more real and permanent advantage than the most potent medicines. Hippocrates judiciously directs a total change in the manners of life, that former habits may lose their influence.

The seat of this disease being evidently the brain and nervous system, whatever tends to render the body irritable will favour a recurrence of the paroxysms. A great sympathy existing between the brain and stomach, epileptic patients are more affected with fits when the stomach is disordered; hence, in all cases of epilepsy, we should pay particular attention to the state of the digestive organs, and the epileptic patient should avoid every thing that has a tendency to disagree with the stomach. When the stomach of an epileptic patient is relaxed or weak, stimulants and astringents, such as lunar caustic, flowers of zinc, &c. will often succeed in preventing a recurrence of a fit; and hence many routine physicians conclude that these remedies are antispasmodic.

When the disease arises from organic mischief in the brain, he should avoid all excesses, and particularly those which have a tendency to stimulate the body or mind. He should attend to the directions given under the treatment of INDIGESTION; and, for the purpose of allaying morbid irritation of the brain, it would be advisable to wash the head with cold water every morning, for which purpose the head should be shaved. If the patient be of a plethoric habit, an issue or seton in the nape of the neck is a very important remedy. Whether the morbid irritation of the brain be connected or not with organic mischief, or any local cause, this treatment is proper.

The power of the association of ideas is, in this disorder, very, remarkable: a gentleman now resident in the city of London was always seized with an epileptic fit on entering his carriage; and Van Swieten relates a case of a child, who, after being frightened into an epilectic fit, by a great dog leaping on him, experienced a return for some time afterwards on seeing a large dog, or even by hearing his barking at a distance. It is a well-known fact, that the mentioning or recalling to the mind any particular circumstance that attended an epilectic fit, will often reproduce it.

Hence, the learned Galen very judiciously advises all things to be avoided that lead to the recalling the disorder to the memory. Others of the ancient physicians, observing how much this complaint is connected with mental affections, and how it may be reproduced by reflecting upon it, have endeavoured to abstract the mind from such ideas, by exciting impressions still more powerful. Upon this principle it was, I apprehend, advised by Pliny, for the patient to drink the warm blood of a gladiator, that issued from him in the agonies of death. Scribonius Largus directs a portion of his liver to be eaten for the same purpose; and Aretaus not only mentions these articles, but several others of the disgusting kind, as the raw heart of a coot, the brain of a vulture, &c. If these strange hideous remedies could have any efficacy, it must be owing to their absorbing the attention, and, of course, leaving no room for the apprehension and recollection of the disorder to operate; and, in this way, it is possible they may have been of service. The relics of saints, and such like trumpery, have, on the same principle, obtained celebrity in the prevention of this disease: the religious ideas connected with them, no doubt, in those superstitious times, operated powerfully on the imagination.

As the nervous system is more affected through the medium of the mind than by the effects of medicine on the body, whatever produces a serene state of mind, powerfully tends to allay irritation of the brain.

DISTINCTION. -This disease may be distinguished from apoplexy, by the convulsed action of the muscles; and from hysteric fits, by not being attended with the spasmodic contraction of the muscles of the gullet, giving the patient a sensation of a ball rising in it; and by the patient having no dread of death.

Practical Remarks. The irritation of the nervous system in this disease arises from organic mischief or partial disease of the brain, or from the irritation of worms in the intestines. In the latter case, vermifuge medicines (see ANTHELMINTICS, p. 9, and WORMS), and tonics, will succeed in preventing a recurrence of the fit. When the cause is in the head, the object is to keep the system in a quiet state, and, for this purpose, a seton in the nape of the neck is the most powerful remedy; which, with such medicines and diet as the state of the body, with respect to debility and fulness, may indicate, will answer best.

OF ERUPTIONS OF THE SKIN. - Under this head I shall include the treatment of the chronic eruptions of the skin, generally, but improperly, termed Scorbutic.

When pimples, or pustules in the face, are the consequences