Cyclopaedia of the Practice of Medicine Volume 14 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1877 Excerpt: ... Etiology. If the causes of epilepsy are to be studied, a correct method of examination must of course be followed. This would require no special mention, if a false way of drawing a conclusion were not often made use of so soon as we have to do with a special case, in deciding from any fact whether it be the cause of the epilepsy or not. We will give an example. Some one, who has hitherto appeared well, is violently alarmed, experiences an epileptic attack, and afterwards remains epileptic; therefore, it is decided, the fright was the cause of the epilepsy. We consider this wrong. The only direct sequence furnished by the facts is that the fright provoked the epileptic seizure. In our opinion it cannot be kept too prominently before us, even in regard to the etiology, that we must draw a clear distinction between the central epileptic change, in the sense in which we have presented the idea above, and the symptomatic expression of it, viz., the seizures. The question as to the causes of epilepsy, then, breaks up into two parts: 1. What influences produce Hie epileptic change? and 2. What produce the outbreak of the symptoms? There can scarcely be room to doubt that a change such as that which lies at the root of epilepsy and constitutes its essential character, a change of so thoroughly chronic a kind, can also, in analogy with other morbid processes, develop only slowly and gradually. It is of course conceivable that some condition, having an acute and transient action, shall, on some one occasion, give the first impulse to the development of the change, just as occasionally the development of a malignant tumor may be caused by an injury; but these cases form the marked exceptions. If we analyze the individual cases of epilepsy according to the various co...