EPILEPSY. 401 



ircemia, a nourishing diet, an abode in the open air, wine, and iron, are 

 the proper remedies. If the impoverishment of the blood and cachexia 

 depend upon scrofula, rachitis, or tertiary syphilis, appropriate treat 

 ment must be employed. Should there be suspicion of plethora, let 

 the diet be reduced, and made to consist more of vegetables, and cause 

 the patient to drink plenty of water and to exercise freely. On the 

 other hand, avoid general blood-letting ; for epileptics, though quite 

 tolerant of medicines (particularly the nauseants), do not bear bleed- 

 ing well. If a scar, foreign body, or tumor be found pressing upon a 

 peripheral nerve, or if a neuroma be discovered upon it, an operation is 

 indicated. This applies especially to cases in which an aura arises from 

 the affected spot. As positive benefit is sometimes obtained by such 

 operations, the knowledge that in many cases neuromata and tumors 

 are extirpated in vain, should not deter us from operating again. The 

 application of setons and moxas, and the use of pustulating ointment 

 to the nape of the neck, are measures which are much in vogue in the 

 form of epilepsy dependent upon structural disease of the brain and 

 skull. Inunction of pustulating salve upon the scalp, and even trepan- 

 ning, has also been advised in such cases. We refer to the principles 

 laid down in the second part of this section with regard to this subject. 

 Where a tumor, a spicula of bone, an exostosis, or other disease, 

 encroaches upon the cavity of the cranium, and compresses the cere- 

 bral vessels, we can comprehend why trepanning should be of benefit, 

 especially to the convulsions, upon the supposition that the operation 

 affords more room for the brain and its vessels. When there is reason 

 to suspect that the epilepsy is induced by the presence of intestinal 

 worms, anthelmintics are indicated. We must be cautious, however, 

 how we encourage the too sanguine hopes of recovery, in which a 

 patient is too apt to indulge who has discovered joints of tape-worm 

 in his stools. 



For other forms of abdominal epilepsy a cure may perhaps be found 

 at the baths of Karlsbad, Marienbad, etc. (Bomber g). In uterine epi- 

 lepsy, chronic uterine infarction and excoriation of the os must be 

 treated according to rules already laid down. It is in this form of all 

 others that the causal treatment affords the best results. 



In order to meet the indications from the disease itself, Schroeder 

 van der IZolk urgently recommends repeated application of cups and 

 leeches to the nape of the neck, followed by blisters, issues, and 

 setons. This author regards the above as the only rational treatment^ 

 believing that it alone is capable of reducing the morbid irritability of 

 the medulla oblongata, and of relieving its congestion,, He considers 

 that all other remedies tend merely to promote the cure by their action 

 upon the remote cause of the disease, by benefiting any morbid condition 





