TREATMENT OF GENERAL PARALYSIS, TABES, ETC. 229 



Twelve cases were free from attacks for a period of 18 months, 60 for 

 one year. As a rule from 4 to 6 months were required for treatment. 

 In 13 cases the result was not a complete cure, but merely an improve- 

 ment. 



Edgeworth's series was smaller and the course of treatment shorter. 



In the series of twenty-three cases a 5 per cent, solution of pep- 

 tone was used, made up according to the prescription of Auld. It 

 was injected. If a fortnight went by without the occurrence of an at- 

 was 5 minims. In succeeding weeks 7, 10, 15 and 20 minims were 

 given unless toxic symptoms occurred. No dose greater than 20 minims 

 was injected. If a fortnight went by without the occurrence of an at- 

 tack, the dose was not further increased. If no results were obtained 

 after three doses of 20 minims the treatment was given up. In four cases 

 toxic symptoms were observed, rigor, vomiting, temporary pyrexia, 

 either as an isolated phenomenon, or in any combination. If this 

 happened, the next dose was lessened. In such cases it was found 

 that the dose could be increased later to the old figure or even beyond 

 without the occurrence of any untoward symptoms. In three cases 

 of posthemiplegic epilepsy no improvement occurred. In eleven cases 

 of epilepsy without signs of any gross cerebral lesion no permanent 

 arrest was produced. In four of these the fits ceased but subsequently 

 recurred, though in lessened severity, and in two cases the frequency 

 was lessened. The average age of the patients was 18 years, the 

 average duration of the disease ten years, and the average frequency 

 of attacks,, once a*week. In nine cases of epilepsy without physical signs 

 of any gross cerebral lesion the attacks ceased. This arrest has now 

 lasted more than a month in all cases, and in. some as long as three 

 months. Five of the patients were mentally defective in one of these 

 cases no mental improvement occurred, in three some improvement, 

 and in one considerable improvement was noted. The average number 

 of injections given was five and one-half. 



Geyelin has recently reported that fasting may at times be followed 

 by the cure of epilepsy. Whether the therapeutic effect is dependent 

 on the acidosis involved in the method, and thereby related to other 

 nonspecific shock effects, has not been established. 



