268 THE TREATMENT OF DISEASES. 



not so easy to answer, and for its solution there are a good many things to be taken 

 into consideration. In the first place, how long has the patient been suffering from 

 epilepsy ? If he has had it for a very long time for years and years we can 

 hardly hope for a perfect and permanent cure, although of course we may be able 

 to do him a great deal of good. But when the disease has been recently established 

 when the patient has had only a few fits we are much more hopeful about it. It 

 should always be remembered that the longer the patient has been suffering, the 

 greater the difficulty and improbability of cure. Then there are other questions to 

 be considered. Is the epilepsy hereditary did either the father or mother suffer 

 in the same way 1 If so it is a bad omen. When the fits set in early in life, the 

 chances of cure are better than when the sufferer is well on in years before they 

 begin. Then the condition of the general health is not without its influence. 

 Contrary to what might be expected, some of the most obstinate cases are those in 

 which the general health is good ; some of the most tractable are those in which 

 there is a disturbance that may be corrected. Again, when the intervals between 

 the attacks are much prolonged they are less amenable to treatment than when they 

 exhibit a more rapid recurrence. 



Now as to the treatment of epilepsy. What should you do when a person is in 

 a fit ] Lose no time in loosening his collar and necktie, so that his throat may be 

 quite free. A little care will prevent him from injuring himself by striking the 

 floor or furniture. Put a piece of cork or india-rubber between the teeth, as it will 

 prevent the tongue from being bitten. The windows should be opened, and all 

 crowding round the patient should be avoided. Cold water thrown on the patient 

 does no good. If you have a bottle of nitrite of amyl, hold it under the nose until 

 the face flushes. Beyond this there is nothing to be done. After the attack is over, 

 get the patient on to the bed, and let him sleep with his head and shoulders well 

 supported. 



When there is a distinct aura, it may be possible, as we have seen, to arrest the 

 coming paroxysm by making pressure on the part ; or by constricting it by means 

 of a ligature. 



What is to be done to prevent the recurrence of the fits in other words, what 

 should you do in the intervals of the attacks 1 The great remedy for epilepsy is 

 bromide of potassium. It must be given in good large doses to do any good from 

 ten to thirty grains three times a day. The bromide of potassium mixture (Pr. 31) 

 contains fifteen grains in two table-spoonfuls. It is usually best to give it on an 

 empty stomach say half an hour before meals as it is less likely to produce 

 flatulence. Bromide of potassium nearly always does good in epilepsy. In some 

 instances it has completely cured the patient, there never having been another attack 

 after taking the medicine. In others it has arrested the attacks so that none have 

 occurred for periods varying from a few months to two or three years. It is a most 

 wonderful drug, and we should strongly advise every epileptic who has not tried it 

 to do so without a moment's loss of time. In some cases its effects are little less 

 than marvellous. Even when small doses have failed, large ones m?y succceed. It 

 sometimes happens that the administration of five grains will diminish the frequency of 

 the attacks, or prevent their occurrence for a long time, and that then, the medicine 



