EPILEPSY. 317 



conditions of the system, cannot be regarded as a distinct 

 and separate affection. Like jaundice, epilepsy is an accom- 

 paniment of several different diseased states. 



In many cases after death no organic lesion is discover- 

 able in epileptic animals, and the affection is in these 

 instances regarded as functional. 



It may depend upon disease of the brain, such, for example, 

 as the deposition of morbid growths and inflammatory 

 action, or other changes in the texture of the cerebral 

 structure. 



In some cases in man, epilepsy has been proved to be due 

 to irritation of the brain caused by the projection of pieces 

 of bone. This may also be a cause of this disease in the 

 horse in some instances. 



Finally, epilepsy may depend upon alterations in the 

 blood-supply to the brain, and may be caused by reflex 

 irritation from various distant organs in a state of disease. 



The medulla oblongata and upper part of the cord are re- 

 garded by Dr. Reynolds as the primary seat of epilepsy. 

 Some observers are of opinion that the parts primarily 

 aff'ected are the medulla oblongata, the corpora striata, and 

 other parts of the base of the brain. 



Brown Sequard has shown that epilepsy can be artificially 

 produced in the guinea-pig by section of one of the lateral 

 columns of the cord, anywhere between the medulla oblon- 

 gata and the tenth dorsal vertebra. It must, however, be 

 remembered that convulsion is by no means the most dis- 

 tinctive element in an epileptic attack. And, indeed, how- 

 ever seriously the cord and medulla and ganglia at the brain 

 base may be affected subsequently in an attack, the earliest 

 phenomena of an epileptic seizure must be connected with 

 some limited spot in the nerve-centres, which, though diffe- 

 rent in different cases, is probably always the same^ for the 

 same case (Bristow). 



