Epilepsy and other chronic convulsive disorders : their causes, symptoms, and treatment.

  • Gowers, W. R. (William Richard), 1845-1915.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Epilepsy and other chronic convulsive disorders : their causes, symptoms, and treatment. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    observation of individual cases I have been strong-ly im- pressed by the frequency with which heredity exists in the \ cases in which treatment has the most marked effect. The fact is clearly brought out by a comparison of cases. Of 33 in which no improvement was obtained from treatment, heredity existed in ten only, or 30 per cent. Of 100 cases in which the fits were arrested by treatment, heredity existed in forty-five,or 15 percent, more than in the other series. Thus heredity seems to render it easier to obtain a cessation of the fits. The explanation \ may be that a slighter exciting influence is effective in such predisposed cases, and is more easily counteracted. It does not of course follow that a permanent cure is more readily effected in such cases. The greater readiness with which the fits are arrested may be counterbalanced by a \ greater tendency to relapse. A similar fact has been observed with regard to insanity ; heredity does not lessen the probability of recover}^ from a given attack. Illustrations of this fact are often met with, such as was strikingly presented by the following case:— A joung man, whose mother's two sisters and one brother were epileptic, had his first fit at nineteen, and soon afterwards came under treatment. The attacks were at once arrested, and they remained absent for two years. Then, at twenty-one, they reciu-red, and, having had two fits in one week, he came back to the hospital. Each fit was preceded for an hour or two by a ' nasty feeling of numbness in the tongue,' but there was no immediate warning. In the fit consciousness was lost, and his tongue bitten. A scruple of bromide twice a day was ordered, and he had no other fit, and after two years' treatment he was discharged. The fits remained absent for a year, and then he had some more, and again came to the hospital. The attacks at once ceased under the same treatment, but ho had occasional ' sensations' in the tongue, which be- came more frequent when the same dose of bromide of sodium was ] substituted for bromide of potassium, but on the resumption of the latter with Indian hemp, although only once a day, the sensations ceased, and he has now (April, 1881) had no symptom for a year. An equally striking illustration was presented by the patient, men- tioned on p. 11, fourteen of whose relations sufiered from epilepsy. The attacks commenced at ten years of age, and she was thirty-seven when 8he came under treatment. The interval, before the treatment commenced, was two weeks'. The attacks occurred during sleep only, and never