EPILEPSY. 397 



stead of the latter condition, an opposite one has been reported by 

 certain observers, the intelligence of the patient becoming remarkably 

 acute. With regard to the other disturbances of innervation, we have 

 already alluded to the transient and permanent paralysis of the ex- 

 tremities, which perhaps is due to exhaustion of the irritability conse- 

 quent upon excessive nervous excitement. The fit may also be fol- 

 lowed by aphonia, by dysphagia, or by asthmatic attacks, etc. 



Two forms of the incomplete epilepsy are recognized (especially in 

 France), slight convulsive movements accompanying the lapses of con- 

 sciousness in one, and being absent in the other. In the former, the 

 genuine " petit mal," the patient is seized with giddiness, often amid 

 business or conversation. He has time, however, to seat himself, or 

 staggers, and sinks slowly to the ground, without outcry. His face is 

 pale, his eyes fixed. A few convulsive twitches play over the face, 

 and the extremities, especially the upper ones, are slightly tremulous. 

 In a few minutes, however, the patient recovers ; looks wildly around 

 him, not knowing what has happened, sometimes making confused 

 utterances ; then, after the lapse of a few minutes, all perturbation sub- 

 sides ; there is no somnolent stage, and the patient is once more in 

 a condition to resume his vocation. 



In the still milder and more rudimentary form, the vertige epilep- 

 tique, the patient does not fall. His consciousness alone is clouded ; 

 his eyes stare, and his countenance is pale. He does not twitch, but 

 lets fall whatever he may have in his hand, and halts in his speech. 

 The attack passes off in a few seconds, and the patient proceeds with 

 nis conversation or business, as if nothing had happened. There are 

 many intermediate stages between epileptic vertigo, the petit mal^ 

 and complete epilepsy, a description of which we forego. 



It would be quite difficult to furnish a concise account of the gen- 

 eral course of the disease, and of the condition of the patient between 

 the paroxysms. We have stated already that epilepsy is a chronic 

 affection. Hence cases in which one epileptic fit is not followed by a 

 second one ought not to be counted as epilepsy, but rather should be 

 regarded as belonging to the eclampsia, a form of disease only distin- 

 guishable from epilepsy by the acuteness of its course. The pauses 

 which intervene between the fits differ greatly in different individuals. 

 In some patients, a year or even several years elapse, and, in many, 

 months and weeks pass away, ere a new attack occurs, while in other 

 patients one or more fits occur daily. Very often, during a period of 

 four or six weeks, there is not a single attack ; this is followed by a 

 series of fits, recurring at short intervals. As a general rule, however 

 the pauses between the paroxysms in the same individual remain toler- 

 ably uniform ; although, as the malady progresses, especially in young 



