Title:
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Epilepsy : a theory of causation founded upon the clinical manifestations and the therapeutic and pathological data
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In striking contrast to the elucidation of the cause and progress of various diseases by modern methods of examination the phenomena of epilepsy, although long and widely studied, remain to a large extent obscure. Since the terse description of the malady by Hippocrates and the accurate and picturesque account of a convulsive seizure by Lucretius, many theories of causation have been advanced have obtained for a time and then been unremembered. In recent years, however, some definite although dissociated facts have become known and abiding views formed from therapeutic and pathological data and from the investigation of the heredity of those affected. Although these facts may be comparatively few in number,it is surprising that no attempt is made Oven in the most recent text -books to correlate such facts as are known and accepted and to formulate a comprehensive theory which could be tested by experiment and further and independent observation. The observed and verified features of the disease which require correlation are these: The convulsive seizure or "Grand Mal "; • The minor attack or "Petit Mal "; • The occurrence in many cases of a warning,mental or sensory in character,of an impending convulsive attack,termed the aura; also the'so called "psychical" epileptic states of emotional instability and erratic conduct. • The post-convulsive states of stupor sleep or excitement. The production of the epileptic phenomena and habit by trauma,gross cerebral lesion and cardio -vascular degeneration (senile epilepsy). • The regular incidence of fits in many cases, especially during certain stages of sleep, also the occurrence in some subjects of a fit at the inception of sleep called the pre-dormitial fit. • The strong hereditary factor in the disease and its relation to various types of insanity. • The changes of a structural and biochemical type found after death in the cells of the cerebral cortex and in the lymph spaces and capillaries. • The abnormalities of epileptic blood in regard to Alkalinity, Agglutinability, Coagulability and the formed elements. • The changes in relation to t he convulsive state in the urine, especially its content of uric acid and phosphates and the occurrence of post-paroxysmal albumosuria and mucinuria. • The effects of various therapeutical substances,in particular the bromides and alkalies. • The benefits derived from the restriction of certain forms of food and especially the Purin bodies.
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