400 GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. 



long time has no traces of injury upon the tongue or peripheral parts. 

 Very often the simulation is recognizable because the patient makes a 

 bad imitation of the aura. He usually includes this symptom in his 

 comedy, believing it to be an essential one, and in enacting it often 

 makes a most wonderful exhibition. The surest sign that the fit is 

 not feigned, is the dilatation of the pupil, even upon exposure of it to 

 Bright light. This is a token which no impostor can imitate. 



TREATMENT. As a prophylactic means against epilepsy, Momberg 

 recommends that the intermarriage of families, in whom the malady is 

 hereditary, should be avoided. An epileptic mother should never 

 suckle her own child, but should intrust it to a vigorous wet-nurse. 



In fulfilment of the causal indication, the treatment 'of epilepsy is 

 extremely difficult. Apart from the cases whose history gives no clew 

 as to the cause of the malady, and even when our information is com- 

 paratively of a satisfactory nature, we can only ascertain a few of the 

 secondary causes ; and it is not at all common for the disease to sub- 

 side after they have been allayed. An epilepsy, whose first outbreak 

 was unmistakably provoked by the presence of worms in the intestine, 

 or by a neuroma, usually persists, although the worms have been ex- 

 pelled, and the neuroma extirpated. If the malady be consequent 

 upon fright, the fits nearly always recur, though the patient be screened 

 from further terrors. However, our poor prospect of success should 

 not deter us from taking account of all causes which may have contrib- 

 uted to produce the malady, trifling though their apparent effect may 

 be. Experience teaches that such practice sometimes, although rarely, 

 leads to the happiest results. In the present uncertain state of our 

 means of treatment of this disease, even such exceptional successes 

 are of importance, and may serve as a guide to our proceedings. It is 

 our duty, in assuming the charge of an epileptic, before resorting to 

 the so-called specifics, so to regulate the external relations of the pa- 

 tient, his habits, and his bodily health, that every suspicious condition, 

 to which the origin of the disease can in any way be ascribed, may be 

 corrected. Thus, as feeble, cachectic persons are more liable to the 

 disease than robust and vigorous ones, all excessive or exhausting 

 mental occupation should be forbidden to the patient, and in its stead 

 a moderate exercise both of body and mind should be advised. Epi- 

 leptic children must not sit six hours a day on the school-benches ; 

 but, if possible, should live in the country, should spend most of their 

 time in the open air, and should take cold baths under proper super- 

 vision. We should carefully ascertain whether the patient be addicted 

 to great sexual indulgence, to onanism, or to intemperance in drink 

 and, where such vices are discovered, they must be opposed with inex- 

 orable sternness. When the patient shows signs of anaemia and hv 



