2G4 THE TREATMENT OF DISEASES. 



epileptic vertigo, and will then suddenly become the subject of ordinary epileptic 

 fits. The two forms may intermingle, the milder happening sometimes, and sometimes 

 the more severe. Between these two extremes there are many links of gradation. 

 Sometimes the patient does not fall, but there is a momentary loss of consciousness, 

 accompanied by slight spasm. Sometimes the sufferer sinks or slides down quietly 

 and without noise, is simply pale, is not convulsed at all, but is quite insensible. It 

 will readily be imagined, from what we have said, that it is no easy matter to speak 

 very definitely as to the duration of epileptic seizures. Sometimes the attack is 

 slight and does not occupy more than a moment of time ; at others it is more severe, 

 and may last two or three minutes. An epileptic fit lasting more than five minutes 

 is a rarity. It may seem to you to be much longer, but if you take out your watch 

 and time it you will find that it is not. When an attack is said to last an hour or 

 more it probably consists of a series of fits separated by incomplete intermissions. 



Next, as to the frequency of the fits. Many people have distinct bouts of fits 

 that is, they have two or three in a day, and then go a week or two without 

 having any more. It is rare to find that there is any accurate periodicity in epilepsy, 

 but you may often notice that the recurrence of the attacks has some kind of 

 relation to time as marked by its natural division into days or weeks. It is not 

 meant that the attack occurs exactly to the day that is very rare but rather that 

 the fits occur about once a fortnight, or once a month, or whatever it may be. Most 

 people who are subject to epilepsy have an attack oftener than once a month. The 

 actual number of attacks in the year varies very much in different cases there may 

 be two or there may be two hundred. A high rate of frequency is not determined 

 by an enfeebled state of health, for, on the contrary, it often happens that those 

 whose general physical condition is excellent have a great many fits, whilst those 

 who are weak and poorly have them at longer intervals. 



Between the attacks the patient may be perfectly well, but such is not often the 

 case. Very commonly the memory is bad, the patient forgets his engagements, and 

 cannot even remember where he dined yesterday. Lowness of spirits is of frequent 

 occurrence, and this may continue for a long time, and finally run on into a state 

 bordering on imbecility. Sometimes the patient suffers from headache and giddiness, 

 or from noises in the head, or perhaps he sees specks floating before his eyes. 

 Epileptics usually have but little power of resisting cold, their circulation is feeble, 

 and they have cold, damp, frog-like hands. The face often wears a peculiar 

 expression, which is difficult to describe. Yery often there is a curious immobility 

 of the countenance, and a strange staring appearance about the eyes. 



Epilepsy is not hereditary, or, if at all, but slightly so. It occurs with equal 

 frequency in men and women. The first attack in the majority of cases makes its ap- 

 pearance between the ages of thirteen and seventeen. Sometimes the first attack occurs 

 about the time the second teeth are cut. Often enough it is not repeated, and probably 

 is then rather of the nature of a convulsion than of a true epileptic seizure. In young 

 people fits are sometimes induced by a sudden fright. A child, for instance, breaks 

 something, and is greatly alarmed at the thought of a scolding. In one case, a little 

 girl slipped from the top of a large stone staircase to the bottom ; she was apparently 

 unhurt, and was congratulated on her escape ; but a few days after epilepsy set in, 



