EPILEPSY. 403 



the patient must take one daily during the first month ; with every 

 succeeding month he is to raise the dose one pill up to five, ten, fif- 

 teen, and twenty pills or more. The entire dose is always to be taken 

 at once. When any improvement takes place, the last dose is to be 

 continued for a while, and then gradually reduced in quantity. The 

 prime condition of success is patience on the part both of physician 

 and patient. Instead of the pills, we may use a solution of atropine 

 (atropine gr. ij in spirit vini. rectif. 3 ijss), a drop of which corre- 

 sponds to one of the pills. We, therefore, begin with one drop, and 

 gradually increase to twenty. Of the metallic preparations, those of 

 zinc have the greatest reputation. Latterly, instead of white oxide of 

 zinc, formerly given to the extent of two drachms daily, the salts 

 of zinc have corne into use, especially the valerianate and hydrocya- 

 nate, and, above all, the acetate. The dose of the latter is twelve grains 

 a day at firSt ; subsequently more. This remedjr is said to be most 

 efficacious in young subjects, and in so-called abdominal and uterine 

 epilepsies. Heim and Rorriberg recommend nitrate of silver in doses 

 of two to four grains, but it must not be continued long enough to 

 produce argyria ammoniated sulphate of copper and arsenic are now 

 little employed. Of the vegetable nervines, artemisia vulgaris and 

 valerian have the best reputation. Five or ten grains of the former 

 are to be given in powder, or else an infusion of one or two drachms 

 in beer. Of the valerian we at first may give a drachm daily, in pow- 

 der or electuary, gradually increasing the dose to half an ounce. 

 Quite recently, bromide of potassium has been one of the most gener- 

 ally employed articles in the treatment of epilepsy ; many say they 

 have used it with remarkable success, while others report its absolute 

 failure. 



My experience of the efficacy of bromide of potash in epilepsy has 

 been greatly increased of late, and I can now speak much more 

 decidedly on the subject than two years ago, when preparing the 

 seventh edition of this work. The following circumstance induced me 

 to use the remedy in as many cases as possible, and to watch the 

 results : I heard that two cases of inveterate epilepsy, that I had for 

 years treated without any benefit, had been completely cured by a 

 so-called specialist, whose advertisements were to be found in the 

 columns of almost every newspaper. I investigated the subject more 

 closely, and found that in one patient, whose governess had for years 

 kept an accurate journal, and whom I had not lost sight of, the 

 attacks had been absent for several months, and that the general 

 health, which had been much impaired, was decidedly better. This 

 " specialist " refused the petitions of numerous patients of limited 

 means to moderate the high price of his medicine or to give a pre- 



