Meitauer on the Crusta Genu Equincc in Epilepsy. 199 
as well as from the marked benefits following the use of to- 
nics. It is an observation worth remembering, (the truth of 
which has been often verified in the course of our practice,) 
that nervines rarely benefit when the organic tone is greatly 
depressed ; like mercurials, they are more certainly remedi- 
ate, under certain circumstances of energy of the organic 
vitality; depressed, (or exalted,) inordinately, both fail of their 
remediate effects. 
Should costiveness supervene, (which will be often the 
case,) a combination of scammony, aloes, and rhubarb is to 
be used, in doses of from two to four grains of scammony, 
about the same proportion of aloes, and from four to eight 
grains of rhubarb, made into pills. This compound should 
be given at night, and the doses so managed, as to elicit only 
one or two evacuations, the design not being to purge freely. 
In restoring the solubility of the bowels, we know of no com- 
bination so well suited to such cases as the one just recom- 
mended; its action is gentle, but effective, particularly in 
eliciting the biliary secretion, upon which circumstance the 
peristaltic movements of the intestines are mainly dependent. 
The crust, administered in either of its forms, should be 
suspended during the employment of aperients or cathartics; 
and should not be resumed, until, at least, the active cathar- 
tic movements subside. To correct the acidity which is oc- 
casionally present in this form of epilepsy, it has been found 
necessary to employ alkaline absorbents; and for this purpose 
a weak lixivium of hickory, or grape-wine ashes, has seemed 
to answer best : it should be prepared by mixing one heaping 
table-spoonful of the ashes in a quart of water; of the clear 
liquid, from jss. ^j. may be taken two or three times daily, 
after eating, or as often as may be found necessary, without 
irritating the bowels, which it will sometimes do if continued 
too long. 
In both modifications of the disease, the diet should be par- 
ticularly attended to during the whole course of the treat- 
ment, and indeed for some time after the cure may be sup- 
posed to have been effected. In the sanguineous variety it 
should be decidedly abstemious; animal or oily substances 
