wanting instances where, in connection with a mere 'nervous- 

 ness ' of the ancestors, epilepsy made its appearance in the 

 descendants." 



I have already stated that in hereditary epilepsy the first 

 occurrence of its symptoms is, according to Reynolds, not 

 later than the twentieth year ; and to this I may now add 

 that an individual who has inherited a predisposition to 

 epilepsy may escape its development altogether if his general 

 health remains satisfactory up to this period. This latter 

 statement depends, of course, upon the assumption that the 

 attack is produced entirely as the result of the inherited pre- 

 disposition, and does not affect the occurrence of epileptic 

 seizures from other causes. Although epilepsy may be 

 caused by many factors, such as alcoholic and sexual excesses, 

 prolonged mental strain, disturbances of nutrition, as pro- 

 duced by defective nourishment etc. ; external injuries, etc., 

 yet none of these are so effective in exciting " the central 

 epileptic change" as hereditary predisposition. Why this 

 inherited tendency should be so much more active during 

 youth from the seventh to the seventeenth year we really 

 cannot satisfactorily explain, notwithstanding the many 

 theories which have been propounded to account for it : we 

 can only at present accept the fact, and trust that time may 

 throw some further light upon this interesting question in the 

 future. With regard to prognosis, Reynolds maintains that 

 those cases are least amenable to treatment in which the 

 source of the disease is involved in the greatest obscurity. 



Chorea. As in hysteria, epilepsy, etc., there is a marked 

 hereditary predisposition to chorea i.e., "an hereditary 

 transmission of a special susceptibility to irritation an 

 impressionability of the nervous system" generally asso- 

 ciated with constitutional debility. Thus, as quoted by Von 



