270 THE TREATMENT OF DISEASES. 



Where the case is urgent, a dose may be given every ten minutes for an hour, and 

 subsequently hourly ; but when it is more chronic, a dose every three or four hours 

 will suffice. 



Sulphate of copper is given in preference to belladonna when the face, during an 

 attack, is pale and the convulsions are very severe. It should be given in small 

 doses frequently. 



Oxide of zinc sometimes does good in epilepsy ; two of the oxide of zinc pills 

 (Pr. 66) may be given three times a day. 



Inhalations of nitrite of amyl often prove useful in epilepsy. A few drops may 

 be poured on a pocket-handkerchief and cautiously inhaled. The full effects of the 

 drug are not obtained until the face flushes and a sense of pulsation is felt in the 

 head. Until you learn exactly how to manage the drug it is as well to lie down 

 whilst inhaling, but when you get accustomed to it you may take your inhalation 

 wherever you happen to be. The best way is to take a good sniff at the nitrite of 

 amyl bottle directly you feel any warning of a fit. Even when the convulsions have 

 commenced, nitrite of amyl will sometimes arrest them. On several occasions nitrite 

 of amyl has rescued patients from that desperate plight called status epilepticus, a 

 condition consisting essentially of a succession of fits linked together by intervening 

 unconsciousness, the fits recurring with increasing frequency till, at last, no sooner 

 is one fit ended than another begins. Sometimes nitrite of amyl succeeds better 

 when given internally instead of in the form of inhalation. 



In conclusion we must say that bromide of potassium is undoubtedly the best 

 remedy for epilepsy. We should always begin with it, and should not be in a hurry 

 to give it up in favour of another drug. 



Attention to diet and regimen during the intervals of the attacks is important. 

 The patient should strictly avoid indigestible food, and should have his meals with 

 regularity. Plenty of exercise should be taken in the open air, although excessive 

 fatigue should be avoided. There is no reason to interdict horse-exercise, if the 

 patient has been accustomed to ride, for, curiously enough, a fit very rarely occurs 

 on horseback. Many epileptics have been relieved of their nocturnal attacks by 

 being made to sleep with the head and shoulders well supported. It is a good plan 

 to have a bed-rest which can be adjusted to any angle, instead of being contented 

 with an ineffectual arrangement of pillows and bolsters. Then about baths they 

 should be taken for the purpose of cleanliness and to produce a healthy action of the 

 skin, but they will do no more. Baths will not cure epilepsy, and shower-baths, 

 sitz-baths, and so on, usually do more harm than good. It is very important not to 

 let the feet get cold, especially at night. Thick woollen socks, a fire in the bed-room, 

 plenty of blankets, and a hot-water bottle to the feet, will obviate all difficulty on 

 this score. Then about mental work. The parents of an epileptic child are often 

 told that he must not do anything of any account he mustn't go to school, he 

 mustn't learn anything, and mustn't read, and so on. This advice, we are sure, is 

 very bad advice. Excessive mental work might, of course, prove injurious, but it is 

 of no use running to the other extreme. A boy must have something to occupy his 

 time, or he will be sure to get moody and morose, and to worry about himself and 

 his misfortunes. A couple of hours' lessons in the morning, and as much in the 



