390 GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. 



clysters containing a drop of laudanum, and, if the spasms be very 

 severe, chloroform may be administered, but with great caution. 



CHAPTEE III. 



EPILEPSY FALLING SICKNESS MORBUS SACER HAUT-MAL. 



ETIOLOGY. Unlike chorea and tetanus, epilepsy cannot be called 

 a purely motor neurosis ; since the interruption which takes place, both 

 in consciousness and insensibility, is quite as essential an element of 

 an epileptic fit as the convulsions. The absence of one or other of 

 these symptoms renders the seizure imperfect. 



We may assume that the excitement of the motor nerves, of which 

 the convulsions are the exponent, proceeds from the medulla oblongata 

 and the portion of the brain lying upon the base of the skull. This is 

 shown. 



1. By the interruption of the functions of the hemispheres, which 

 accompanies the convulsions. It is not probable that motor impulses 

 proceed from the hemispheres at a time when the irritability of the 

 other ganglion-cells and nerve-fibres is extinguished. 



2. Because convulsions, similar to epileptic convulsions, can be ex- 

 cited by continuous excitement of the basilar portion of the brain by 

 means of the induction apparatus, while no such result is obtained by 

 a like irritation of the various parts of the hemispheres. 



3. Because l&issmaul and Tenner, in then* experiments upon ani- 

 mals, could still produce convulsions of a decidedly epileptiform char- 

 acter after extirpation of both hemispheres. 



4. Schroeder van der IZolk has found that, in all bodies of epilep- 

 tics where the disease had been of long standing, besides numerous 

 inconstant lesions, there was alway a dilatation of the arterioles and 

 capillaries of the medulla, with thickening of their walls. The influences 

 which tend to produce this condition of the medulla oblongata, where- 

 by it throws the nerve-fibres passing through it or originating from 

 it into such intense excitement, and which, for brevity's sake, we call 

 a state of irritation, are probably of a manifold character. It is true 

 that the experiments of Eussmaul and Tenner have proved that 

 epileptiform convulsions may be induced by cutting off the supply of 

 arterial blood from the brain ; but they do not prove that arterial 

 anaemia of the brain is the sole cause of epileptic fits. Schroeder van 

 der Kolk believes that epileptic convulsions depend mainly upon an 

 increased afflux of arterial blood to the medulla oblongata. There is 

 no doubt, moreover, that the morbid irritability of the medulla which 

 occasions epilepsy may arise without any increase or diminution of its 



