ADDITIONS TO THE HE VISED EDITION OF 1880. 



437 



absolutely necessary to keep the patient's " courage to the sticking- 

 point " of resisting the craving which exists even when the dose is 

 not being reduced. During the treatment appetizing food should 

 be offered and mental and physical occupation provided. Addition 

 of atropin to the opiate, occasional hot baths for the extremities, and 

 frictions with alcohol, seem to check the pain and sweating in the 

 hands and feet.] 



ADDITIONS TO THE REVISED EDITION OF 1880. 



SECTION IV. GENERAL NEUROSES, OF UNKNOWN ANATOMICAL 



ORIGIN. 



1. P. 405. 



Occasionally the urine passed a few hours after an epileptic 

 seizure contains albumen. Sometimes there is temporary mental 

 perturbation instead of a regular epileptic fit. The seizures may 

 be followed by paresis or paralysis, in which case we may suspect 

 disease of the brain ; or there may be aphasia, aphonia, dysphagia, 

 asthenia, etc. 



The investigations of Reynolds oppose the general view that the 

 disturbance of intelligence is in direct proportion to the number and 

 severity of the seizures. Nothnagel even thinks that the mental 

 disturbance in the majority of cases is not the result of changes 

 in the pons and medulla oblongata, but accompanies them ; i. e., the 

 epilepsy and psycopathia are both due to some neuropathic dispo- 

 sition. 



It is always important to decide whether any given case is idio- 

 pathic or secondary to some other disease, and this must be de- 

 termined by a careful examination of the whole body and of the 

 surrounding circumstances. We may suspect organic disease of the 

 brain when there is a permanent partial spasm, or when it always 

 begins at the same part of the body. 



Attention has been called to pain in the hypogastric region, 

 which was attributed to the ovary ; this pain may be spontaneous 

 or induced by pressure over one or both ovaries (oftenest the left). 

 It is said that an hysterical aura is often induced by this pressure 

 a feeling of constriction about the stomach and neck, nausea, 

 palpitation, tinnitus, disturbance of vision on the side of the pain- 



