396 GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. 



severe attacks, I have been able fully to confirm Rorribercfs observa- 

 tions, that tbe reflex action is not arrested. The patient closes his 

 eye if the conjunctiva be touched, and winces if his face be sprinkled 

 with cold water. One observation of Basse's is exceedingly strange 

 and difficult of explanation. In a patient of his he found the electric 

 contractility was extinguished in the muscles of the thorax and ex- 

 tremities. After the fit has lasted for ten minutes, or, at most, for a 

 quarter of an hour (although it may seem much longer to the by 

 standers), either it subsides, the twitching gradually growing weaker 

 and weaker, and finally ceasing, or else it may stop suddenly, the con- 

 vulsions being all at once followed by complete muscular relaxation. 

 The fit often terminates by a long, sighing expiration ; more rarely by 

 vomiting, by passage of gas upward or downward, or by a profuse 

 evacuation of the bowels. 



It rarely happens that a severe epileptic seizure is immediately 

 followed by complete recovery ; after the attack is over, generally, 

 unless violently roused, the patient falls into a deep sleep, with pro- 

 longed stertorous respiration. If awakened from this, he usually looks 

 blankly or anxiously around him. He does not know what has hap- 

 pened, and can scarcely account for his being in a strange place, or in 

 bed, or wounded. His sole desire is to be allowed to sleep. Next 

 morning, though still somewhat unwell and low-spirited, and com- 

 plaining of confusion about the head, he has recovered his faculties, 

 and all traces of the attack vanish in course of the day. 



Many epileptic fits differ considerably from the typical seizure 

 above described, varying in duration, violence, and in the extent of the 

 convulsions. The variation of the condition which immediately suc- 

 ceeds the paroxysm is of more importance. While, as a rule, the pa- 

 tient is able to attend to his business the day after his fit, there are 

 instances in which every attack, or else each severe one or rapidly 

 recurrent succession of them, is followed by mental derangement, and 

 other disorders of innervation. The former may consist of well-marked 

 fits of mania. It is often necessary to protect both patient and by- 

 standers from violence, to put on a strait-jacket, or even horrible to 

 relate there is no other resource but to confine the patient in the 

 mad-house, even during his lucid period, because it is known that his 

 madness will recur with his next paroxysm. In other instances the 

 fit is succeeded by a condition usually called partial insanity : for ex- 

 ample, the patient may have an irresistible inclination to run. In 

 other cases, the patient may be in an irritable mood, which is quite 

 foreign to him on ordinary occasions, breaking out into violent rage 

 upon the slightest provocation. Sometimes the memory and mental 

 acuteness are impaired for some days. We may also mention that, in 



