842 OF THE FUNCTIONS OF THE NERVOUS SYSTEM. 



phenomena of Epilepsy is its tendency to periodic recurrence, with a more or 

 less complete return to the normal state in the interval. This fact of itself 

 seems to indicate that the disease cannot be fairly attributed to those obvious 

 lesions of structure which are sometimes coincident with it, and which, as Dr. 

 Todd has justly remarked, are rather the signs of the altered nutrition brought 

 on by any cause which creates frequent disturbance of the actions of the brain, 

 than the causes of that disturbance ; for the influence of such lesions, if mani- 

 fested at all (and it is remarkable what an extent of disorganization may take 

 place without any obvious indication), would be rather continuous than inter- 

 mitting. It is quite certain, on the other hand, that death "may occur from 

 Epilepsy, without any appreciable lesion. It may be considered, also, as a well- 

 established fact, that the epileptic paroxysm may be induced either by an in- 

 sufficient supply, or by depravation of blood ; of this we have examples in the 

 epileptiform convulsions brought on by excessive hemorrhage in parturient 

 women, in the epileptiform paroxysm induced by asphyxia (especially by strangu- 

 lation), and in poisoning by hydrocyanic acid, the phenomena of which, in the 

 lower animals especially, so closely simulate those of the genuine disease, that 

 they may be designated as an artificial epilepsy. These and many other facts 

 in the etiology of the disease very strongly point to a disordered condition of 

 the blood as its primal source j this acting either by altering the nutrition of 

 the Encephalic centres, or by perverting their action, or in both modes conjointly, 

 as in the case of Insanity (vin.). According to the theory advocated by Dr. 

 Todd, a continual mal-nutrition of certain parts of the Encephalon occasions a 

 gradually increasing disturbance of their polar state j and this, when it has 

 attained a certain measure of intensity, manifests itself in the epileptic parox- 

 ysm, just as a Leyden jar, when charged with electricity to a certain state of 

 tension, gets rid of the disturbance of equilibrium by the "disruptive discharge/' 1 

 The fact must not be disregarded, however, that when a state of mal-nutrition 

 of the Nervous System has been established by causes which affect the condition 

 of the Blood, the Epileptic paroxysm may be induced by some excentric or pe- 

 ripheral irritation, such as worms in the intestinal canal, the pressure of teeth in 

 the eruptive stage of development against the capsule or the gum, &c. ; neither 

 cause being sufficient when acting alone. Hence, although the paroxysms may 

 be suspended and the disease apparently cured, by the removal of the peripheral 

 source of irritation (as by the expulsion of the worms, or the complete erup- 

 tion of the teeth), the liability to it still remains, as is shown by the renewal 

 of the paroxysms whenever any fresh irritation may arise. It is very import- 

 ant, therefore, not to rest satisfied with local treatment in such cases ; but to 

 have recourse to measures adapted to produce a general invigoration of the 

 system. 3 



XV. The Spinal Axis (including the Medulla Oblongata) forms a continuous 

 series of ganglionic centres, which are connected by afferent and efferent nerve- 

 trunks with the several segments of the body ; but these centres are enveloped 

 in white or fibrous strands, which not only connect the various segmental divi- 

 sions with each other, but also, there seems good reason to believe, establish a 

 continuous connection between the Nerve-roots and the Sensorial centres. The 

 independent activity of the Spinal centres is seen in the various reflex move- 

 ments which are performed after they have been cut off from all connection with 



1 See Dr. Todd's "Lumleian Lectures" in the ''Medical Gazette," May 18, 1849; and 

 the "Brit, and For. Med. Chir. Rev.," Jan. 1850, pp. 2433. 



2 The Author does not think it necessary here to devote any space to the examination 

 of Dr. M. Hall's pathological theory of Epilepsy, which makes it depend upon spasmodic 

 compression of certain muscles of the neck, producing compression of the veins and con- 

 gestion of the cerebrum ; since he considers that the fallacies of this theory have been 

 already sufficiently pointed out by Dr. Todd (loc. cit.). 



