428 PRACTICE OF PHYSIC. 



depending upon a primary affection in some other part of the 

 body, such as acidity or worms in the alimentary canal, teething, 

 or other similar causes, it is obvious that such primary affections 

 must be removed for the cure of the epilepsy ; but it is not our 

 business here to say how these primary diseases are to be treat- 

 ed. 



MCCCXVIII. There is, however, a peculiar case of sym- 

 pathic epilepsy ; that is, the case accompanied with the aura 

 epileptica, as described in MCCCVL, in which, though we can 

 perceive by the aura epileptica arising from a particular part, 

 that there is some affection of that part ; yet, as in many such 

 cases we cannot perceive of what nature the affection is, I can 

 only offer the following general directions : 



1st, When the part can with safety be entirely destroyed, we 

 should endeavour to do so by cutting it out, or by destroying it, 

 by the application of an actual or potential cautery. 



2c?/i/, When the part cannot be properly destroyed, that we 

 should endeavour to correct the morbid affection in it by blister- 

 ing, or by establishing an issue upon the part. 



3dly, When these measures cannot be executed, or do not 

 succeed, if the disease seems to proceed from the extremity of a 

 particular nerve which we can easily come at in its course, it 

 will be proper to cut through that nerve, as before proposed on 

 the subject of tetanus. 



4/%, When it cannot be perceived that the aura arises from 

 any precise place or point, so as to direct to the above-mention- 

 ed operations ; but, at the same time, we can perceive its pro- 

 gress along the limb ; it frequently happens that the epilepsy 

 can be prevented by a ligature applied upon the limb, above the 

 part from which the aura arises. And this is always proper to 

 be done, both because the preventing a fit breaks the habit of 

 the disease, and because the frequent , compression renders the 

 nerves less fit to propagate the aura. 



" Prognosis. I have only to say, that this must occur to 

 you, from the consideration of the various causes I have men- 

 tioned. The circumstance, how far they are accessible to art, 

 must determine how far the disease is curable. We cannot 

 cure an exostosis in the cavity of the cranium ; we have very 

 little power in affecting the causes of the stagnation which may 



