UC-NRLF 
 
 B 3 Ififi ^ 01 
 
LIBRARY 
 
 OF THE 
 
 University of California. 
 
 GIFT OF 
 
 zAccessiM 8.6./L2J Clasi 
 
A 
 
 PRACTICAL TREATISE 
 
 ON 
 
 EPILEPSY; 
 
 ITS 
 
 Sumssful Crtatamtt aafo Cart, 
 
 WITH ESSAYS ON 
 
 GIDDINESS, SENSATIONS AND FAINTS. 
 
 S. BERRY NIBLET.T, M.D., 
 
 Licentiate of the Royal College of Physicians, &c, &c 
 
 Wincit Omnia Wtxit&g. 
 
 NEW AND REVISED EDITION. 
 
 All Rights Reserved. 
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HOURS OF CONSULTATION. 
 
 TUESDAYS, WEDNESDAYS, AND THURSDAYS, 
 
 FROM 10 A.M. TO 1 P.M. 
 
 BURWOOD HOUSE, 11, BURWOOD PLACE, 
 HYDE PAEK, LONDON. 
 
 I make no charge for consultation to patients desirous of 
 taking rny remedies. 
 
 To prevent disappointment and inconvenience, patients 
 residing at a distance and wishing to consult Dr. Niblett 
 had better make an appointment before coming. 
 
 Medicines may be obtained daily from— 
 10 a.m. to 6 p.m. 
 
 Saturdays — 10 a.m. to 4 p.m. 
 
 Burwood Place is situated five minutes' walk from tlie Marble 
 Arch, -Oxford Street; it is the fifth turning up the Edgware Road 
 on the left hand side. Nearly all the City and West End 
 Omnibuses pass the door. 
 
p 
 
 ONTENTS, 
 
 PAGE 
 
 On Epilepsy or Fits . . . . 5 
 
 Grand Mai 6 
 
 Nocturnal Epilepsy . . . . . . - . . . 13 
 
 Masked „ .. ., 17 
 
 Petit Mai 20 
 
 ^Etiology of Convulsion . . . . . . . . 22 
 
 Treatment of Epilepsy 26 
 
 Sensations . . . . . . . . . . . . 53 
 
 Faints .. ..57 
 
 Liver Pills 59 
 
 Chorea or St. Vitus's Dance . . . . . . 61 
 
 Neurasthenia of the Brain . . . . * . . . . . 67 
 
 „ „ Spine 69 
 
 Giddiness or Vertigo 71 
 
 Observations on Diet .. •• *<> «. ..75 
 
ON EPILEPSY OK FITS, 
 
 SOMETIMES CALLED FALLING SICKNESS. 
 
 (A Chronic Convulsive Disease.) 
 
 This disease is called by the German physicians 
 Fallsucht ; by the French, L'Epilepsie ; by the 
 Italian professors, Mai Caduco, or falling sickness. 
 Epilepsy was termed by the ancient Greeks 
 "the sacred disease/' on account of the magni- 
 fy tilde of the evil, or because persons labouring 
 under it have been thought possessed by demons. 
 It was said that Hercules was subject to it, there- 
 fore it was denominated the Herculean disease ; 
 but Galen says it was on account of its form or 
 magnitude. 
 
 The Komans termed this affection "morbus 
 comitialis," because it frequently occurred in 
 crowded assemblies in which the passions of the 
 people were often much excited, and it was 
 customary to dissolve the comitia if during the 
 sitting any person should be affected by it. 
 
 Many sufferers from epilepsy are possessed of 
 high intellectual power ; the classical cas£S_o£Julius 
 
 86771 
 
6 EPILEPSY. 
 
 Cresar, Mahomet, and the first Napoleon, each of 
 whom suffered from the disease, may he cited as 
 examples. 
 
 From time immemorial epilepsy has Ven one 
 of the most inscrutable of diseases. All sorts of 
 vague notions have existed regarding the nature 
 of the affection. There are probably few physi- 
 cians who have not sought, even longed with a 
 desire almost passionate, to read its terrible secret. 
 
 I have now for a period of twenty-five years 
 made the treatment of epilepsy my special study, 
 and my experience in this disease is, I believe, 
 almost without a parallel at the present clay. 
 
 Two varieties of epilepsy are ordinarily recog- 
 nisecl 3 th3 "grand mal," or severe seizure, and 
 the "petit mal," or slight attack. The first is 
 characterised by convulsions, spasm, or agitation ; 
 the latter by a very transitory loss of conscious- 
 ness ; there may be little or no spasm, and the 
 attack may be so unpronounced as to escape the 
 notice of those who may happen to be present. 
 
 i I shall first consider the "grand ma]," known 
 as\ Epilepsia Gravior, or severe seizure. 
 
 Major Fits. — An attack of epilepsy is generally 
 sudden in its invasion ; the person may have been 
 but the instant before in perfect health, when he sud- 
 
EPILEPSY. 7 
 
 denly utters a most terrific cry and falls senseless and 
 convulsed ; he then strains and struggles violently ; 
 he has convulsive motions of the limbs and trunk 
 of the body; spasms of the muscles of the face 
 and eyes, producing varying distortions of the 
 countenance ; the brows are knit, the eyes fixed 
 and staring, or turned up beneath the lids so as to 
 display the whites, the hands are firmly clenched, 
 the arms tossed about ; the breathing becomes 
 gasping and difficult ; the heart beats violently ; 
 the face is turgid and livid ; the jaws are contracted 
 with great force ; there is gnashing of the teeth, 
 so that the under lip, or the tongue if protruded, is 
 apt to be severely injured ; he foams at the mouth 
 occasionally ; a choking sound is heard in the 
 windpipe ; he appears to be at the point of death. 
 But presently and by degrees these alarming 
 symptoms diminish, and at length cease ; the 
 patient is left exhausted and comatose, but his 
 life is no longer threatened, and in a short time he 
 is to all appearance perfectly well The same 
 train of morbid phenomena recur, however, again 
 and again, at different and mostly at irregular 
 intervals. The epileptic attack or fit comes on 
 suddenly, as we have just observed, and without 
 warning; but it is not very uncommon for persons 
 
8 EPILEPSY. 
 
 to have some premonitory symptom, with which 
 they become familiar, so as to be aware of the 
 approach of the fit. In some instances there is 
 vertigo, or confusion of intellect ; sometimes there 
 is unusual irritability of temper, which may exist 
 for several days previous to the fit ; and in some 
 instances there is an inordinate appetite for food. 
 Thfi-iace of the sufferer from epilepsy frequently 
 wears a peculiar expression which it is difficult to 
 describe. In many cases there can be observed 
 an immobility of the countenance, a sort of fixed 
 state of the muscles, with a strange staring appear- 
 ance about the eyes : there is frequently a want 
 of brightness about the eyes, and a disposition to 
 suffer from attacks of headache. Associated with 
 epilepsy we often find dyspepsia, constipation, 
 sleeplessness, great nervousness and depression. 
 
 The fit is frequently accompanied by certain 
 premonitory symptoms, such as pain in the head, 
 lassitude, disturbance of the senses ; sometimes a 
 bright circle of colour appears before the eyes, or 
 a loud noise in the ears, or it may be a bitter taste 
 in the mouth, with some unusual dread. But in 
 the majority of cases the fit is not preceded by 
 any warning : it may occur either in the day, or at 
 
EPILEPSY. 9 
 
 night ; there are often several attacks in the 
 twenty-four hours ; in other cases there are 
 intervals of weeks or months. Repeated attacks 
 of a severe kind are liable to enfeeble the memory, 
 impair the intellectual faculties, and in some 
 instances, unhappily terminate in imbecility. It 
 is the liability of such a termination as this that 
 invests the disease with such painful interest. The 
 peculiar features of an epileptic seizure are due toi 
 the gradual collection of the morbid material in 
 the blood, the accumulation going on until it has 
 reached such an amount as to act upon the brain 
 and explode in a fit. 
 
 The average duration of the fit is three or five 
 or eight minutes ; it may, however, last for half 
 an hour or more. There is often a respite from 
 attacks for three or four months ; this freedom is, 
 however, frequently followed by a bad day, on 
 which as many as half a dozen fits may quickly 
 succeed each other. In recent cases especially, 
 the seizures often take plnce in the night, either 
 on just going to sleep or on awakening in the 
 
 ming. 
 
 Premonitory sensations of epilepsy are for the 
 most part disagreeable, sometimes accompanied by 
 great depression ; " fear," " terror," and " horror/' 
 are words used by the patient to describe it. 
 
10 EPTLEPSY. 
 
 A patient can sometimes resist the fit, or shake 
 it off by moving briskly about; he may thus fight 
 against it, and stop it altogether. 
 
 The "aura," or warning, is a striking and remark- 
 able phenomenon; it sometimes commences in the 
 limbs, and travels upwards towards the head; when 
 it reaches the brain convulsions occur. 
 
 The aura commences in some instances by 
 drawing up of the leg, and in others by jerking of 
 the arm ; sometimes a stabbing pain in the arm 
 precedes the attacks ; and muscular twitchings 
 occur before the convulsive movements. 
 
 There are some cases of a very aggravated 
 nature, where the whole nervous system is unstrung, 
 and where the chief complaint is of the head. These 
 patients complain of much uneasiness and apprehen- 
 sion; they are afraid to be left alone, and are likewise 
 afraid to go out by themselves. If a knock comes 
 to the door it startles them. They frequently suffer 
 from severe headache, and life is a burden to them. 
 
 Case. — The following is one of Grand Mai or Major 
 Fits ; it is one of the most remarkable examples of 
 recovery that I have ever witnessed, and one of the 
 worst cases that have ever been cured : — A Clerk, a^t. 45, 
 had for nearly twenty years been subject to severe fits 
 occurring irregularly by night and by day, sometimes 
 
EPILEPSY. 11 
 
 attended by biting of the tongue. The usual interval 
 between the fits had been a fortnight, and on no 
 occasion had a longer period than six weeks elapsed. 
 The patient's mental capacity had become consider- 
 ably enfeebled, eo much so as to make it necessary 
 for hitn to leave his situation. He began to take 
 my medicines, and continued them without any pause 
 for some time. The result of this treatment was an 
 entire cessation of the fits, and there has been no recur- 
 rence of the disease. His mental vigour has returned, 
 and he has since resumed his occupation, and been 
 busily engaged in business. 
 
 The seizures in this case arose from functional 
 derangement of the brain. 
 
 The look of dread and apprehension which he wore 
 when first seen gradually disappeared, and in its place 
 there grew up a look of recovering self reliance. Mental 
 and physical quiet was insisted on, and the patient 
 rapidly recovered. 
 
 I never use lowering treatment; my remedies are 
 strengthening, and etfect cures by permanently improv- 
 ing the nervous system, and renovating both mind and 
 body. 
 
 Case. — This lady consulted me by letter ; she writes : 
 — "I have been recommended to write to you for advice 
 respecting my son, who of late has been subject to fits, 
 which I will describe to you as well as I can, and if you 
 think you can prescribe for or send medicine that will 
 result in curing, or at any rate do him good, I shall be 
 glad to communicate with you further. The fit usually 
 
12 EPILEPSY. 
 
 comes on in the morning, say from 4 to 7 o'clock, before 
 rising, and the first symptom is a twitching of the 
 muscles, &c, of the face, very often drawing his mouth 
 on one side ; then the head is drawn back, and gurgling 
 and a choking comes on in the throat. Then the twitch- 
 ing extends more or less all over the body, the fingers are 
 clenched somewhat tightly, but relax in a few minutes. 
 The time of the twitching is usually about five minutes. 
 
 "As soon as the head canbe movedforward,a mixture 
 of blood and water runs from the mouth, say about a 
 '"ablespoonful or so. 
 
 " He is usually cold at the commencement, but after- 
 wards turns hot, and sweating breaks out; this leads 
 into a fast sleep, with heavy snoring for about an hour, 
 and it is always nearly that time before he recovers full 
 consciousness ; and after this he feels very sick for a 
 few hours. 
 
 ** His age is fourteen years. 
 
 *• The fits commenced about four months since ; he 
 has had three fits in one week, but not so many of late — 
 he has been so much as seven weeks without one ; but 
 they seem to have returned again during the last five 
 or six weeks. 
 
 " He has always seemed a little delicate in constitu- 
 tion, and it may be that he has, as we should term it, 
 overgrown his strength. There is no violent movement 
 of the body during the fit more than the twitching of 
 the muscles. 
 
 " I shall be glad to hear from you at your early con- 
 venience." 
 
EPILEPSY. 13 
 
 This patient speedily recovered under my plan of 
 treatment. 
 
 Noctuknal Epilepsy, in which the attacks occur 
 at night only, is very common, for a great many 
 patients never have seizures at any other time. A 
 considerable number of persons are attacked just 
 as they awaken in the morning, and these usually 
 occur between five and nine o'clock. On the 
 other hand some sufferers are liable to be attacked 
 at all times, both during the day and in the 
 night. 
 
 Case. — This is an interesting one of nocturnal and 
 diurnal epilepsy combined. The following is a suffi- 
 ciently characteristic example : — A lady was suddenly 
 seized with giddiness and fell on the ground ; convul- 
 sions occurred which were rather severe ; after a few 
 months these attacks came on during the night (noc- 
 turnal epilepsy). She only knew of their occurrence by 
 finding the tongue bitten and a splitting headache in 
 the morning. When the seizures came on in the day- 
 time, there was a slight aura or warning, which 
 appeared to commence in the stomach : she described it 
 as if everything was turned upside down. They often 
 came on at the catamenial period, or a day or two 
 after. Her aspect was dull and the memory bad. The 
 attacks were occasionally followed by hysteroid con- 
 vulsions, in which she was said first to jerk and then to 
 struggle, a rigid spasm then came on, and the back was 
 
14 EPILEPSY. 
 
 arched and the limbs extended. Under appropriate 
 treatment the attacks, both nocturnal and diurnal, 
 ceased at once, and there has been no relapse. 
 
 Case. — The following is of great interest as exhibit- 
 ing morbid derangements of the nerve centres. A lady 
 writes : — " I have a daughter twenty years of age, who 
 has been subject to fits about five years, that is, she has 
 had six or seven falls in that time, three within twelve 
 months. 
 
 " She is frequently subject to a twitching or starting, 
 particularly when in a very light room, and her face is 
 turned to the window, or more particularly when she first 
 goes into the open air. She drops anything she may 
 have in her hands, and sometimes makes a false step and 
 staggers. She has always fallen in the open ah, and not 
 more than three hundred yards from home, and has 
 generally been unconscious for a few minutes; when 
 she gradually recovers, and then falls off in a sound 
 sleep. She does not struggle much in the attack. 
 
 " In dull weather she is not so bad ; sometimes she 
 does not start at all." 
 
 The patient was very persevering ; she followed my 
 instructions most particularly, and was rewarded by an 
 entire removal of the disease. I have lately seen her, 
 and she looks the picture of health. 
 
 It is only by a careful discrimination alone ot 
 the many peculiarities of a case, and a judicioiib 
 consideration of remedial means, that a successful 
 issue can be obtained. 
 
EPILEPSY. 15 
 
 Persons subject to attacks of epilepsy frequently 
 suffer from headaches, with general prostration of 
 nervous power; the pain is often severe, the 
 patient feels weary and weak, and the circulation 
 is depressed. The pain is sometimes dull, some- 
 times shooting, occasionally accompanied by nausea 
 or even vomiting. The amount of pain varies in 
 different instances; but women suffer more often 
 from this kind of headache than men. 
 
 After an attack some patients pass into a 
 profound sleep, and if roused they appear stupid 
 and confused, and soon lapse again into sleep, and 
 when they awake they are irritable or pe evish . 
 Sometimes the paroxysm occurs without any sub- 
 sequent stupor, but this is exceptional. 
 
 The stupor which follows a severe fit may be 
 trifling or very profound, and its duration varies 
 from a few minutes to several hours, ranging, how- 
 ever, most commonly between thirty minutes and 
 two hours. 
 
 Epilepsy is a disease which specially attracted the 
 attention of the ancient physicians ; it was termed 
 by the Greeks " the sacred disease." Plato ascribes 
 the use of the term " sacred " to the circumstances 
 of the head or brain being the part of the body 
 affected in epilepsy. Hippocrates pointed out the 
 
16 EPILEPSY. 
 
 incomprehensible nature of the malady, and believed 
 it was caused by phlegm being mixed with black bile 
 and dispersed about the courses of the head. The 
 complaint was also superstitiously ascribed by the 
 ancients to the malice of demons ; others were of 
 opinion that lunar influences produced it. 
 
 Epilepsy is an important functional affection ; 
 various exciting causes may determine an attack, 
 such as mental excitement, bodily fatigue, depriva- 
 tion of sleep. 
 
 The unhappy sufferer from fits is never safe for 
 a single moment, as he is liable to be seized at 
 any time ; it may be in a crowded street, or in 
 descending a flight of stairs, when injury would 
 be sure to occur ; numerous persons have had fits, 
 fallen in the fire, and been burned to death before 
 any help could be obtained ; others have fallen 
 into water when travelling in steamboats, and 
 been unavoidably drowned; several deaths have 
 occurred from a seizure taking place in a bath. 
 
 A person therefore who is subject to epilepsy, 
 requires to be perpetually watched ; it is a d readf ul 
 disease to witness, and if not cured is likely to end 
 in insanity ; and not unfrequently the complaint 
 will ultimately terminate in paralysis, with either 
 partial or entire loss of use in the limbs. 
 
EPILEPSY. 17 
 
 When epilepsy results from a sudden mental 
 shock, the first fit usually occurs immediately or 
 within a few hours ; but in some cases an interval 
 of days, weeks, and even months may intervene, 
 the patient mean while manifesting signs of nervous 
 disorder. 
 
 A certain number of epileptics have their 
 seizures every day, every week, every two or three 
 weeks; the recurrence of attacks evidently has 
 some relation to time, as marked by its natural 
 division into days, and periods of seven days, and 
 multiples of seven days. 
 
 "Masked Epilepsy.'' — It frequently happens 
 that the - loss of consciousness is not complete, but 
 may be partial in character ; the patient will have 
 no recollection of what has occurred during the 
 attack. He will sometimes remain away from 
 home for many hours, and when he returns will 
 be unable to give any account of himself. He 
 may do the most eccentric things possible, the 
 mind being apparently in a condition of vacuity. 
 Many of the curious cases of absent-mindedness 
 reported by various authors are undoubtedly irre- 
 gular forms of epilepsy. 
 
 The true seat of epilepsy is undoubtedly in 
 
18 EPILEPSY. 
 
 nerve-cells, and more especially those cells that 
 are located in the base of the brain ; but the 
 spinal cord has also a share in the production of 
 epileptiform convulsions. 
 
 Epileptics frequently exhibit a combination of 
 timidity and irritability, with depression of spirits. 
 The patient is often tremulous and nervous, and the 
 hand sometimes shakes. "When fits are brought on 
 by a fright, it is curious to notice that occasionally 
 the attack does not come on for many days or even 
 weeks after the occurrence ; these cases are very 
 frequent, and usually take place in highly nervous 
 persons, more particularly in children whose parents 
 have suffered from some form of nervous disorder. 
 
 There is another condition called " status epi- 
 lepticus" (etat de mal epileptique of the French), 
 in which severe attacks occur in rapid succession 
 during a day or during several successive days. 
 AYhen a series of these paroxysms occur, the mind 
 is notably impaired for a time; the patient is 
 childish for several days, but gradually recovers 
 the use of his faculties. 
 
 Epilepsy may exist for a long time before its 
 existence is ascertained, if the paroxysms occur 
 only at night. The disease is to be suspected when 
 patients complain of awaking from time to time 
 
EPILEPSY. 19 
 
 with headache, lassitude, and a wounded tongue. 
 Owing to the terrible nature of the malady, and 
 the apprehension felt by those in company with an 
 epileptic lest a paroxysm may occur, persons are 
 naturally sensitive with respect to themselves or 
 their relatives being said to have epilepsy. For 
 this reason there is sometimes a disposition to 
 conceal the nature of the attacks from the relatives 
 and friends. Epileptic paroxysms may occur at 
 all hours of the day and night ; in some patients 
 they occur only at night, and in these cases the 
 affection may have existed long before its existence 
 is ascertained. It is desirable to determine 
 whether epileptic paroxysms are connected with 
 lesions affecting the cerebro - spinal system, or 
 whether they are idiopathic. Persisting pain in 
 the head, paralysis, and disturbance of the intel- 
 lect greater than the paroxysms will account for, 
 are symptoms pointing to cerebral lesions. 
 
 Epilepsy has from time immemorial been con- 
 sidered incurable. I have studied this complaint 
 for many years, and I can unhesitatingly say that 
 the disease can be perfectly and completely cured 
 under proper treatment. I am thankful to say I 
 have cured many sad cases, after the disease had 
 existed for several years. 
 
20 EPILEPSY. 
 
 Petit Mal. — Minor Fits. — I will now consider 
 the lighter forms known as epilepsia mitior, or "petit 
 mal." In these cases the attack may be Iso unpro- 
 noimced as to escape the notice of those who may 
 happen to be present ; the patient is perhaps engaged 
 in conversation, when a momentary blank in his 
 mental process occurs ; it probably does not attract 
 attention ; if he happens to be eating at the time, 
 he will suddenly drop his knife and fork ; if 
 walking in the street, there may be a sudden 
 loss of equilibrium, he staggers, but he rarely 
 falls ; the face usually becomes pale, and after 
 the attack the patient often appears restless and 
 depressed. 
 
 Epileptic attacks in which convulsions are slight 
 or wanting, constitute that form of the disease 
 which is called mild epilepsy, epilepsia mitior, or 
 epileptic vertigo: they are sometimes distinguished 
 as epileptoid attacks. It is important for the 
 physician to recognise and appreciate the sig- 
 nificance of these attacks, as they often precede 
 the development of ordinary epilepsy. These 
 kind of attacks are multiform ; on some days 
 they occur a great number of times, and the 
 patient does not appear to be conscious of their 
 occurrence. 
 
EPILEPSY. 21 
 
 There are necessarily many degrees of spasm, 
 such as a little twitching of the hands, turning up 
 of the eyes, or pallor of the face. 
 
 In very mild cases the person simply becomes 
 giddy and slightly confused in mind for a few 
 moments. In these slight cases the patient com- 
 plains of sudden and transient loss of conscious- 
 Less, followed by little spasm, and pallor of the 
 face ; in some slight seizures there may be no 
 spasm. 
 
 There are many names given by the patients 
 and their friends to slight seizures : — " sensations," 
 "turns," "spells," " thinkings," "stupidities," 
 " reveries," " forgetfulness," " giddiness," " faints," 
 "absent." 
 
 Now these slight sensations are often the sole 
 seizures for months or years before the first severe 
 fit comes on. These peculiar feelings or sensations 
 are really slight or incipient fits. Attacks of 
 epilepsy may be so slight that strangers sitting 
 opposite to a patient may observe nothing, although 
 there is absolute though transient loss of con* 
 sciousness. 
 
 Case. — The following example of "Petit Mai," or 
 incomplete epilepsy, has lately come under my notice : — 
 A boy, twelve years ot age, had been subject to fits 
 
22 EPILEPSY. 
 
 for two years. At the first they were so slight that his 
 mother thought he was " in a deep study," as he used to 
 sit as if he were thinking : this attack lasted only a few 
 seconds. 
 
 Later on in his fits he would turn up his eyes, and 
 then also there was occasional shaking of the body. 
 Before these attacks occurred he complained of a 
 strange sensation at or near the stomach, or in the 
 chest. The medicine removed all the symptoms in 
 three months. 
 
 This variety of epilepsy, called by the French " le 
 petit mal," in which there is no evident spasm; the 
 patient loses consciousness for two or three or more 
 seconds, and may, after that period, resume his usual 
 employment, perfectly unaware that anything abnormal 
 has occurred; sometimes there is pallor of counten- 
 ance, and this may be succeeded by slight flushing. 
 These slight attacks are called by the patient "famts." 
 
 It often happens that these " faints " are preceded 
 and accompanied by giddiness, the individual thinking 
 he is about to fall, and perhaps exhibiting some ten- 
 dency to do so. He staggers, and grasps some object 
 for support, or his legs sink under him, or he slips 
 forward on to his side. 
 
 ^Etiology, or Causation of Epilepsy.— 
 Among the predisposing causes of epilepsy, here- 
 ditary tendency stands first. It lias, however, been 
 customary to consider the existence of other 
 nervous affections in parents, or progenitors, as 
 
« 
 
 EPILErSY. 
 
 evidence of an inherited predisposition to some 
 form of neurosis. While the possibility of the 
 transmission of the disease to offspring should not 
 be ignored, it is to be borne in mind as a fact 
 which may be of inexpressible comfort to many 
 persons, that an epileptic parentage by no means 
 entails this or any other disease on descendants, 
 either proximate or remote. It has been thought 
 by some physicians that the nervous and sanguine 
 temperaments predispose to the development of 
 this disease. I am prepared to state most decidedly 
 that the attacks are much more frequent when- 
 ever there is a sudden change of weather, Persons 
 not infrequently are able to judge by experience, 
 from certain indefinite sensations, that they will ere 
 long have a paroxysm. There is no doubt that 
 passion will bring on an attack in an individual 
 subject to this affection. This idea was evidently 
 floating in the mind of Shakspeare. When Iago 
 works Othello into such a nassionate ras;e that he 
 falls insensible, Cassio asks what is the matter, and 
 Iago replies, " My lord is fallen into an epilepsy ; 
 this is his second fit, he had one yesterday." 
 
 Libidinous excess and aspermatism have been 
 considered one of the principal exciting causes of 
 epilepsy, as the disease often, appears after great 
 
24 EPILEPSY. 
 
 excesses have been indulged in. Habits of detec- 
 tion will undoubtedly produce a certain instability 
 of the system which predisposes to the produc- 
 tion of the affection. There is apparently an 
 absolutely and relatively large percentage of 
 epileptics who have been syphilitic ; their number 
 is notably larger than a few years ago was gene- 
 rally suspected. The precise relation which syphilis 
 bears to a subsequent epilepsy is not known ; 
 probably it acts only as a debilitating, disposing 
 factor, like many other agencies ; but possibly 
 in a certain number of cases syphilis may be the 
 direct cause of epilepsy. Alcohol taken in excess 
 appears to act on the cerebral centres ; it impairs 
 and depresses the functional power ; and I have 
 no doubt that intemperance or excessive smoking 
 may act as an exciting cause ; also fright, grief, 
 anxiety, blows on the head, strong mental emo- 
 tion, worms (especially the tape-worm), disorders 
 of digestion, or derangement of the liver, all these 
 may enter into the etiology of the disease. 
 
 The sight of another person in a fit will some- 
 times produce one in a person witnessing it. The 
 actual cause of an attack is a sudden rush of blood 
 co the brain ; or an increased flow of blood to the 
 spinal cord may induce a seizure. Fits are often 
 
epilefjsy. 25 
 
 brought on by indigestion and a disordered state 
 of the stomach and nerves ; they sometimes arise 
 from an impure state of the blood. 
 
 Excessive intellectual fatigue, the passionate 
 emotions, especially grief, are often the starting 
 point of attacks of epilepsy ; long or deep mental 
 suffering appears to predispose to the complaint ; 
 excessive fatigue produces exhaustion and acts in 
 the same way. 
 
 Excesses of any kind cause fatigue and wear 
 of nervous substance, and this is one of the most 
 powerful causes of nerve derangement, and un- 
 doubtedly predisposes to diseases of the nervous 
 system. Excessive delicacy of feeling, ardour of 
 affection, vivacity of imagination, precociousness 
 of intellect, all these are but too frequently fore- 
 runners of epilepsy. 
 
 Invalids in whom there is any family history of 
 nervous derangements, paralysis, or apoplexy, or 
 gout, must keep a strict account of their expenditure 
 to the heathen deities (Bacchus or Venus), and they 
 must do their best endeavours to lessen such expen- 
 diture, and to keep it within very moderate limits. 
 
 Suppressed gout may predispose to, and be one 
 of the immediate exciting causes of epilepsy, so also 
 may irregular or excessive emotions, also certain 
 other chronic disorders of the nervous system. 
 
26 
 
 TREATMENT OF EPILEPSY. 
 
 Heed not the twaddling of ignorance, hut listen 
 to the voice of judgment and experience. 
 
 Few higher duties can devolve on the medical 
 man than to make obscure diseases his special 
 study, and bring them and his patient to a favour- 
 able termination. It should always be the aim 
 of the physician to cure the disease as rapidly and 
 effectually as possible; every known means 
 calculated in any way to relieve the disorder 
 should be brought to bear upon the case. 
 
 The general tendency of epilepsy, if left to 
 nature, is certainly to proceed from bad to worse, 
 and there is no disease from which a sufferer more 
 desires to be freed, or which is more certainly 
 curable. 
 
 The idea that a remedy exists for every disease 
 to which human beings are subject is one which 
 must always be fascinating. We regard diseases as 
 so many enemies, and naturally persuade ourselves 
 that Providence has placed within our reach cer- 
 tain agencies by which they may be subdued. 
 
TREATMENT OF EPILEPSY. 27 
 
 Perhaps there is no subject in the whole range 
 of medicine which is more attractive or less under- 
 stood than epilepsy, the treatment for the most 
 part has hitherto been vague and unsatisfactory, 
 but modern medicine has thrown a flood of light 
 upon its modes and causes, and has thus contri- 
 buted to a revelation of knowledge which has 
 rendered the treatment much more certain than 
 it used to be. Efficient treatment is the very foun- 
 dation of our art, the alpha as well as the omega. 
 
 To treat this disease with success, it is neces- 
 sary to ascertain the circumstances under which it 
 becomes developed in each particular case ; but 
 each case requires to be made a special study, 
 consideiing that many organs are concerned in the 
 disordered working of the system. 
 
 The special medicines I prepare are a real 
 vital antidote, really stopping the development of 
 the attacks and absolutely curing the disease. 
 When once the patient is well, the medicine must 
 not be left off suddenly, but very gradually ; this is 
 an essential condition for a permanent cure. 
 
 Case. — The following letter was sent me by a lady 
 residing in the West of England : — " I have just heard 
 of a remarkable cure of epilepsy that you have performed 
 in the case of a young gentleman, and I therefore wish 
 
28 TREATMENT OF EPILKPSY. 
 
 to present to you the case of my daughter. She is 
 twenty-two years of age, rather tall, complexion dark, 
 black eyes, dark wavy hair, very bright and intelligent, 
 and perceptions very keen. Sbe was always considered 
 healthy until four years ago. The first symptoms I 
 noticed were as follows: — Her eyes would become fixed, 
 with a dull vacant expression, and she would remain 
 motionless whatever she might be doing, and this would 
 continue for a minute or two. She would be taken in 
 this way every few days. After these symptoms had 
 lasted for some time, she was suddenly seized with the 
 first severe fit, accompanied by convulsions — this kind 
 of attack lasts about three minutes — she first turns her 
 head on one side, the body is rigid, teeth set, her eyes 
 flash, the face turns purple, she foams at the mouth, and 
 makes a peculiar noise in her throat. After a fit of this 
 kind her head aches for some hours. She has a bad 
 attack about once a week on an average, but sometimes 
 the interval will be longer, and then I notice the next 
 paroxysm will be much more severe. Sometimes the 
 attacks come on in the night." 
 
 After due consideration, I recommended this young 
 lady to take my remedies and she rapidly began to 
 improve ; she entirely recovered her bright, animated 
 look, she slept well and gained strength daily. The 
 epileptic attacks speedily began to decline, and shortly 
 left her altogether. Her general health was completely 
 restored, her memory returned, and she was pronounced 
 cured. 
 
 Extract from a letter received some time after : — " I 
 am pleased to say that my daughter has not had another 
 attack since I last wrote to you, and now three years 
 
TREATMENT OF EPILEPSY. 20 
 
 have elapsed, we consider her perfectly cured. In 
 accordance with the wish of ray grateful and beloved 
 daughter, I have recommended many patients to you, and 
 they have all derived great benefit from your treatment. 
 " It will be a source of undoubted satisfaction to you 
 to know that your great skill and careful attention has 
 succeeded in curing my darling child of a most dreadful 
 affliction, and you have restored her to health and 
 happiness." 
 
 Case. — This lady, set. 28, sought my advice and assis- 
 tance : she has been subject to epilepsy for thirteen years, 
 and for the last three weeks has had twenty-one attacks 
 of this kind. Her intellect had become much impaired, 
 the memory bad, and her condition was sad and dis- 
 tressing to witness. She commenced the treatment I 
 advised, and improved the first week ; and since that 
 period has never had another attack. This was con- 
 sidered a hopeless case, as all known remedies had been 
 tried ; the cure, however, was perfect ; her memory 
 is now restored and her faculties regained ; she is so 
 altered for the better that her friends hardly know her. 
 After the first week of treatment she speedily improved, 
 and still continues in excellent health and spirits. She 
 followed my directions with the greatest regularity, 
 and took her medicines punctually to the minute. 
 
 Case. — This gentleman consulted me by letter ; he 
 writes as follows : — " Some time ago I sent for a copy of 
 your work on Epilepsy, and I am afraid I am suffering 
 from the severe form of the disease as described by you= 
 The fits occur the first thing in the morning, the same 
 as are called by you ' matutinal epilepsy ' ; there is no 
 
30 TREATMENT OF EPILEPSY. 
 
 warning, and sometimes many fits occur in a week, at 
 other times one or two in a month. The attacks are 
 followed by a severe headache ; I then go to sleep and 
 usually wake up perfectly well." Under treatment the 
 fits ceased, and he went back to his employment and 
 has since continued free from attacks. 
 
 In this case the affection was aggravated by excess, 
 "he has loved not wisely, but too well." Epilepsy is 
 often produced from this cause. 
 
 Great advantages may be obtained in the 
 treatment of epilepsy by the judicious association 
 of remedies, which when employed alone are more 
 or less antagonistic to each other ; when given in 
 combination, their good effects are increased in a 
 remarkable manner; the curative properties of the 
 remedies appear to be increased, and new and 
 useful properties may result by the influence of one 
 upon the other. 
 
 The treatment of epilepsy has so strikingly 
 improved, and the results are so much more satis- 
 factory than they once were, that no case, however 
 severe or of long standing, can be pronounced 
 beyond the aid of appropriate remedies. 
 
 Case. — This patient, an English officer, wrote to me 
 from Scotland: — " I am desirous to consult you about my 
 health. I am thirty-one years of age, fair complexion, 
 excitable temperament. 
 
 " I have been subject to epileptic fits for three years ; 
 
TREATMENT OF EPILEPSY. 31 
 
 the attacks occur sometimes once a week, and occa- 
 sionally I have had two fits in one week. They com- 
 mence with a slight trembling of the hands, I then lose 
 my senses, and am convulsed; when I come to, I feel 
 bewildered and lost for about an hour afterwards; my 
 memory is bad; I often feel great weariness; I have 
 occasional slight attacks of giddiness. 
 
 " I have just been informed of a cure you have per- 
 formed in a case somewhat similar to mine, and I there- 
 fore wish to have your advice and assistance." 
 
 This gentleman was directed to take the necessary 
 remedies, and received instructions respecting diet, 
 exercise, &c. The medicine produced a favourable 
 result, and he was completely cured, and has since con- 
 tinued welL 
 
 Case. — This patient consulted me under the following 
 circumstances : — An English lady, the wife of a Member 
 of Parliament, sought my advice. She had suffered 
 from Epilepsy since the birth of her second child, which 
 occurred five years ago. She had previously enjoyed 
 excellent health. 
 
 This lady was seized with an attack just as she was 
 going off to sleep, or just before awaking in the morn- 
 ing; they occurred about once in three weeks, but 
 sometimes oftener. She was nervous and excitable, and 
 easily depressed, and occasionally very irritable. Blue 
 eyes, light hair and complexion, memory impaired. 
 She said her appetite was enormous, but food turned 
 acid on her stomach, and she had a bad taste in her 
 mouth. She had suffered from convulsions when a child. 
 She was the mother of five children, all healthy. In this 
 case there was some hereditary predisposition. 
 
32 TREATMENT OF EPILEPSY. 
 
 She was recommended to take the medicine twice 
 during the day, and also one dose at bed time. 
 
 The remedy was speedily successful in removing the 
 attacks. She was quite cured, and has continued free 
 from the disease ever since. 
 
 Case. — The following example is an interesting and 
 instructive one; it illustrates a chronic form of epilepsy: — 
 Mr. was desirous of placing himself under my treat- 
 ment, as an eminent provincial physician had advised 
 him to do so. The patient, set. 39, was tall, dark haired, 
 and thin ; he had suffered from indigestion and stray 
 attacks of deranged iiver. He began to suffer from 
 " fits " a few years ago ; they occurred at irregular 
 intervals, the attacks being severe with tongue-biting 
 and convulsions ; he also had frequent " minor attacks/' 
 or, as he called them, " spells," " faints," or " turns." 
 In one of these slight attacks he would turn pale 
 and drop anything that was in his hand; he had a 
 slight quivering of the eyelid ; this minor attack lasted 
 only a few seconds, but left him in rather a confused 
 state. No fit occurred after commencing my treatment 
 lie is now married and still free from attacks. 
 
 Case. — Both forms of epilepsy combined (coexistence 
 of le Grand Mai with le Petit Mai). A gentleman con- 
 sulted me for epilepsy, in which both varieties of the 
 disease occurred ; some attacks were of the fully- 
 developed form, others were " miniature fits," but the 
 slight seizures predominated. Sometimes the lighter 
 forms of a very transitory nature would occur two or 
 three times during the day, and tnen there would be an 
 interval of some days. The severe attacks occurred at 
 
TREATMENT OF EPILEPSY. 33 
 
 irregular intervals, and these were usually preceded by 
 an " aura or warning-," and this generally proceeded 
 from the stomach, but occasionally from other parts, 
 such as the leg or the arm ; and then severe paroxysms 
 often occurred in the night or early morning. The 
 disease arose from congestion at the base of the brain, 
 with spasms of the small blood vessels, and was cured 
 by medicines that diminish the congestion of that 
 organ and lessen the diameter of the blood vessels. 
 
 It is only quite recently that a true and lasting 
 progress has been made in the treatment of 
 epilepsy, and a flood of light has been thrown on 
 one of the most obscure subjects in nature, and 
 the foundation of rational methods of treatment 
 on rational and scientific principles has been fol- 
 lowed by inestimable advantages to mankind. 
 
 It conduces greatly to an alleviation of the 
 unhappy condition of epileptics for them to parti- 
 cipate so far as practicable in the interests and 
 social enjoyments of life. 
 
 When paroxysms occur during the night, the 
 patient should sleep in a bed with raised sides to 
 prevent injury from being thrown upon the floor 
 by the convulsive movements. 
 
 Case. — This gentleman, a barrister, came under my 
 observation through the kindness of his medical attei - 
 dant, who advised him to place himself under my care • 
 
 JB 
 
34 TREATMENT OF EPILEPSY, 
 
 he had been troubled with epileptiform seizures for 
 some length of time. He was 27 years of age, and had 
 been subject to " fits " for six years; he had been 
 under medical treatment, but of no avail. The fit 
 comes on without a minute's warning, it draws the 
 right hand and his mouth aside, the eyes are turned 
 up, hands clenched, and he shivers very much ; when 
 he has a bad one he bites his tongue and foams at the 
 mouth, and at times makes a choking sound in the 
 Miroat, has a bad taste in his mouth, and a pain across 
 the temples, with giddiness ; he is very irritable at 
 times, and cannot bear the least fatigue, and his memory 
 is bad. 
 
 The fits have been worse the two last times at the 
 full moon. 
 
 The patient was cured by careful treatment. 
 
 This gentleman was endowed with great intellectual 
 powers before he was seized with epilepsy. He despaired 
 of a cure. His memory has siuce wonderfully improved. 
 The disease was caused by derangement of the nervous 
 centres. 
 
 A diversity of remedies have been advocated 
 as effecting a cure of this disease, and the physician 
 is to exercise judgment in adapting them severally 
 to individual cases, and in employing them succes- 
 sively in the same case. 
 
 The hygienic management of the patient is 
 important, bodily exercise should be regular, but 
 not excessive : the food should be nutritious, but 
 
TREATMENT OF EPILEPSY. 35 
 
 neither exciting nor indigestible. The importance 
 of avoiding every alimentary substance calculated 
 to cause gastric or intestinal irritation cannot be 
 over-estimated. I have frequently seen paroxysms 
 directly caused by nuts, dried fruits, pastry, heavy 
 or badly baked bread, confectionery, excess in the 
 use of spirits or beer. Over-heated or ill- 
 ventilated rooms should be avoided, the clothing 
 should be warm in winter and cool in summer. 
 The mind should not be over-tasked, and the emo- 
 tions must not be unduly excited. 
 
 If the presence of a tape worm is suspected, 
 enquiries must be directed to ascertain whether or 
 not one is present ; if so, appropriate treatment 
 must be employed to dislodge it. 
 
 Patients with chronic maladies, and especially 
 those affecting the nervous system, should have 
 patience with the physician, and must, if they are 
 to get well, submit to a definite course of treat- 
 ment resting upon well ascertained principles, but 
 requiring, perhaps, considerable time and steady 
 perseverance. 
 
 There is another peculiar variety of this disease 
 
 called the "Salaam Epilepsy," which consists of 
 
 moving the head and body alternately backward 
 
 and forward. 
 
 B 2 
 
36 TREATMENT OF EriLEPSr 
 
 Case. — This is an example of the salaam epilepsy. 
 A fair, delicate looking boy, fourteen years of age, came 
 under my care, suffering from this rare kind of nervous 
 derangement, in which the patient makes a low bow or 
 salaam ; but he had also occasionally experienced a 
 severe fit accompanied by convulsions. 
 
 He had taken a variety of medicines, but with no 
 effect, the disease still continued to increase. He was 
 obliged to give up study, and was taken from school. 
 
 A course of treatment was advised for him with 
 most beneficial results. 
 
 Case. — This gentleman consulted me by letter : he 
 writes as follows : — " I am desirous of consulting you 
 about my health. I have been subject to fits for several 
 years. I am twenty-three years of age, and single, 
 dark eyes and complexion, and very excitable. 
 
 " The fits occur at all times, mostly in the evening ; 
 they last about twenty minutes ; I make a rattling noise 
 in the throat, and often bite my tongue; the limbs 
 and body are very much convulsed. 
 
 " I am quite lost at times, and I feel it most on the 
 top of my head. 
 
 " I have the fits once or twice a week; I therefore 
 wish to have your advice." 
 
 This patient had been subject from an early period of 
 his life to epilepsy of varying degrees of frequency and 
 severity. Many years back the fits appeared to occur 
 less often, and were somewhat diminished in violence. 
 The patient was instructed to take my specially pre- 
 pared medicine twice during the day, and another dose 
 at bed time. I afterwards heard from hiui that he had 
 
TREATMENT OF EPILEPSY. 37 
 
 been entirely free from attacks for two years. I there- 
 fore consider him perfectly cured. 
 
 Case. — The following letter was sent me by a gentle- 
 man residing in the North ; he writes : — " I am subject 
 to fits, and have been to several doctors, and taken a 
 great deal of physic, but it has not done me any good. 
 I have been recommended to write to you, so I will try 
 and state my case. 
 
 " I am twenty-one years of age, brown eyes, com- 
 plexion a little pallid, rather a nervous temperament, 
 and single. 
 
 " The fits came on when I was about fourteen, 
 without the slightest warning ; they usually last about 
 six or seven minutes, though sometimes longer. The 
 average time between them is about two months, but I 
 have been so long as fom* or five months, and as short 
 a time as a week. 
 
 *' The fit comes on without any warning whatever, 
 and generally in the morning before breakfast. I bite 
 my tongue, am much. convulsed, and remain lost and 
 bewildered for several hours after. 
 
 " A curious thing with me is, that nearly every morn- 
 ing, just after getting up, and sometimes during the 
 day, I get what appears to be a very short fit, it cannot 
 last, more than a second, as I just fall on my knees or 
 back, and am up again in an instant ; otherwise my 
 health, appetite, &c, is very good. I lead a healthy, 
 out-of-door life in the country, with plenty of exercise. 
 1 get several of these short fits in the morning. 
 
 " If you will give me your advice I shall be mucb 
 obliged." 
 
38 TREATMENT OF EPILEPSY. 
 
 This young man speedily recovered, the attacks 
 gradually left him, and he was completely cured. 
 
 The disease in this case arose from a deterioration of 
 nerve power, with brain weakness. 
 
 Case. — The failure of nerve power was here a most 
 conspicuous symptom. The following letter was sent 
 me by a gentleman residing in Scotland: — "Having 
 perused your book on Epilepsy, I feel I should like to 
 consult you as to my illness, and shall be glad to know 
 if I can do so by correspondence. Mine is a case oi 
 epilepsy, and both forms as you describe appear to 
 be combined. I have been an excessive drinker and 
 a heavy smoker; I have also had a great deal of 
 anxiety ; and these have no doubt tended to bring on 
 this complaint. I am seized with a severe attack once 
 in two or three weeks, and ' faintings' very frequently, 
 sometimes several in a week. My memory is bad, and 
 I feel weak and depressed." The fits immediately 
 ceased under the influence of the remedies, and have 
 not since recurred. 
 
 The complaint in this case was brought on by dissi- 
 pation and other bad habits, which had weakened his 
 nervous system and predisposed him to nerve derange- 
 ments. 
 
 Anyone who examines all his cases thoroughly 
 will recognise the delicate shades in epilepsy, 
 variations which are exhibited in other diseases 
 presenting more pronounced and better defined 
 symptoms ; consequently there are evidences of 
 
TREATMENT OF EPILEPSY. .89 
 
 pathological action, which are not always 
 grouped alike, and therefore all cases are not to 
 be treated in the same manner. I ascribe the 
 success I have had in the management of this 
 disease to the recognition of these differences. 
 Many epilepsies have their starting-point from the 
 organs of digestion, and are undoubtedly produced 
 by derangement of the liver and indigestion. 
 These patients suffer from headache or giddiness 
 and various other symptoms, indicating that the 
 nervous system is out of condition. 
 
 Case. — This patient, set. 7, is a well marked example 
 of an epileptoid character. His mother writes : — 
 ** My little boy is strangely affected with something 
 resembling that strange and dreadful sickness 
 Epilepsy. 
 
 "It is not very noticeable, but appears to be growing 
 on him. In walking he stands suddenly, apparantly 
 unconsciously, for about a minute, and if sitting he 
 takes it quite as often, and for about the same length of 
 time, never exceeding a minute. 
 
 " When first he was observed, he only appeared to be 
 in a deep abstracted thought, but now if he is holding 
 anything in his hand, one might take it and he would 
 not know who took it, or miss it till after he recovered 
 consciousness." 
 
 This patient rapidly improved under my plan cf 
 treatment; nothing w r as clearer than that my remedies 
 
 r. 
 
40 TREATMENT OF EPILEPSY. 
 
 at once took hold of the disease, and finally freed the 
 system from it altogether. 
 
 Case. — A young gentleman, an architect, of healthy 
 appearance, with a good personal and family history, 
 applied to me for advice. He had been subject to 
 epileptic fits for sixteen years ; the attacks now take 
 place about once in ten days or a fortnight, at one time 
 they were more frequent ; he was of a nervous tempera- 
 ment; his general health Avas pretty good. He some- 
 times complained of a feeling of numbness in his right 
 side and leg. He commenced treatment immediately : 
 and improved in a week after he began the medicine, and 
 from that time he never had another attack. As he 
 was determined to be permanently cured, I often heard 
 from him ; he continued to take the remedy for some 
 months. This is a very important case, as the fits had 
 continued for so many years ; yet the medicine at once 
 took effect and produced a perfect cure. 
 
 Case. — This patient came under my observation 
 
 some time ago. Mary C , get. 17, was brought to 
 
 me for my opinion of her case. The account given me 
 by her mother was that she had suffered from fits for 
 the past three years. The attacks recurred about every 
 two or three weeks. In the fit, without any warning, 
 she lost her senses, bit her tongue, and was much con- 
 vulsed, remaining lost and bewildered for several hours 
 afterwards. I told her mother that this was a most 
 favourable case for treatment, and that my medicines 
 would shortly cure her without any chance of tailure. 
 The remedies were success! ul in immediately removing 
 
TREATMENT OF EPILEPSY. 41 
 
 tlie fits. I saw her occasionally, and advised her to, 
 continue the treatment, so as to make the cure complete \ 
 I heard from her some months after, saying she was 
 quite free from fits and perfectly well. 
 
 Attacks of epilepsy frequently arise from some 
 slight congestion at the base of the brain, and 
 from a sudden rush of blood to that part, con- 
 sequently my plan of treatment (in those cases) 
 consists chiefly of advising remedies that act on 
 the capillary blood-vessels, and which, therefore, 
 prevent the blood from flowing to the brain in 
 undue quantities. 
 
 An important part of the rational treatment 
 consists in enforcing observance, in all respects, of 
 the laws of health. Disorders of the digestive 
 system, morbid disturbance anywhere in the 
 economy, should receive appropriate treatment, as 
 they may in some way be concerned in the develop- 
 ment or perpetuation of the malady. Overtaxing 
 of mind or body, sedentary habits, the facts with 
 regard to mental and moral influences, or the abuse 
 of alcoholic stimulants, the immoderate use of 
 tobacco, are all to be enquired into. It will be 
 aecessary to consider the many details which this 
 part of the treatment involves. Under the use 
 of my special remedies the fits will immediately 
 
42 TKEATMENT OF EPILEPSY. 
 
 become less severe and less frequent, and finally; 
 when the system is restored to a healthy state, 
 they will disappear altogether, and the patient will 
 be permanently cured. 
 
 Case. — This will illustrate a serious example of 
 epilepsy. — Major Fits. A lady writes : — " I wish to pre- 
 sent to you the ease of my daughter, aged 22 years, of 
 middle height, fair complexion and hair, bright and 
 intelligent up to 20. The first symptoms I noticed, her 
 eyes became fixed with a dull vacant expression, and 
 she would remain motionless, and this would continue 
 for a few minutes. 
 
 "Twelve months last May she was seized with the 
 first fit, and the complaint has increased up to the 
 present time. From Saturday 7 p.m. to Sunday 7 p.m. 
 she has had eight fits, accompanied with convulsions, 
 which last four or five minutes. She throws her head 
 on one side, and the body becomes rigid, teeth set, eyes 
 fixed, face turns purple, foams at the mouth, and makes 
 a peculiar noise in her throat. 
 
 " After a fit of this kind she sleeps, and they return 
 again in her sleep ; she gets them rather worse by 
 night than by day; and the only warning she seems to 
 have is a fluttering in the inside, but I detect it by her 
 peevish ways. She is very nervous and irritable, with 
 loss of memory; but previous to these fits she was 
 strong and healthy. 
 
 " I shall feel thankful if you will let me know if you 
 think you can do anything for my daughter." 
 
 This young lady took the Remedies regularly accord- 
 
TREATMENT OF EPILEPSY. 43 
 
 ing to my directions. The beneficial effects of the 
 medicine were soon seen. She speedily improved in 
 health, the seizures soon became lighter and less fre- 
 quent, and finally left her altogether. I have since 
 heard that she has remained entirely free from attacks. 
 The disease in this case arose from weakness of the 
 brain. 
 
 Case. — The following is of much practical interest. 
 
 Mrs. W writes : — " Having fortunately seen one 01 
 
 your patients who has been cured of Epileptic Fits, I 
 would esteem it a great favour your kiudly considering 
 the case of my son, who is subject to them since he has 
 been in India. 
 
 "An explanation of the symptoms I have noticed 
 previous to the tit coming on may possibly assist you to 
 arrive at the cause. 
 
 "I first noticed the countenance flushed, with a 
 vacant look in the eyes. If you speak to him he will 
 answer you, but seems powerless to move, remaining so 
 for a minute or two, when all at once he looks up, and 
 seems to be following an object round the ceiling, and 
 turns his head round as far to the left as possible, and 
 would then fall down if no one was near to catch him. 
 His mouth is drawn slightly round to the left, and his 
 arms and legs work a little for the sjDace of two or three 
 minutes, when he vomits- and becomes better. 
 
 " The convulsion is so slight that 1 can hold him 
 myself without assistance. After he has vomited he 
 goes to sleep for two or three hours, and when he 
 awakes he is as well as ever, witn the exception of a 
 slight headache. 
 
44 TREATMENT OF EPILEPSY. 
 
 * There has been one, two. and three months between 
 each fit hitherto. Appetite and general health good, 
 and I have noticed for some days previous to the fit 
 coming on he is very irritable and sleepy. He will be 
 18 years of age next month, height 5 feet 7J inches, and 
 32 inches round the chest ; weight, 9 stone 7 lbs. 
 
 " He is my fourth child, and the only one of the family 
 suffering from anything of the kind, either on the father's 
 or my own side, therefore I am wholly unable to account 
 for them. Trusting you will, by your kind advice, be 
 able to assist me in this great trouble, for which I shall 
 ever be thankful." 
 
 A course of treatment effected a cure in a few 
 months. 
 
 During a fit the patient ought to be laid on a 
 large bed or on the floor; air is to be freely 
 admitted around him; his head is to be raised 
 and his neckcloth loosened ; a piece of cork or 
 india-rubber should, if possible, be introduced 
 between the teeth to prevent injury to the tongue. 
 
 In the interval between the attacks we must 
 endeavour to improve the general health, and 
 especially to give tone and firmness to the nervous 
 system. The diet must be nutritious and carefully 
 regulated ; patients taking my remedies will receive 
 explicit directions as to the nature of the food 
 desirable to be taken at each meal. 
 
 Many epileptics eat largely and voraciously ; 
 
TREATMENT OF EPILEPSY. 45 
 
 they do not masticate their food properly, and 
 often choose the most indigestible things that they 
 can obtain. They then often suffer from indiges- 
 tion, attended by a sense of fulness or distension, 
 with much flatulence. Persons suffering from 
 epilepsy should live by rule, and be temperate in 
 all things. They should rise early and take regular 
 exercise in the open air, keeping the head cool 
 and the extremities warm ; all mental excitement 
 should be avoided. 
 
 An individual who has been attacked with 
 epilepsy should, if possible, take partial mental 
 rest ; he should take things easy, or, as the Irish- 
 man says, "If you can't take things aisy, take 
 them as aisy as you can." 
 
 Case. — This is worthy of perusal as exhibiting the 
 disease in a severe form: — An Irish gentleman, set. 37, 
 had suffered from fits since childhood — they were 
 brought on by a fall; the attacks have latterly been 
 very frequent, he had often so many as six or seven 
 every week, sometimes in the night. This was a serious 
 case ; his digestion was bad, his breath fetid, the bowels 
 constipated ; and these symptoms had lasted for some 
 time. He at once began the specific treatment I recom- 
 mended, which he continued with great regularity. 
 After the first ten days, he was perfectly free from fits, 
 and has never had any seizure since. I therefore think 
 this case may certainly be pronounced cured, as two 
 
46 TREATMENT OF EPILEPSY 
 
 years have elapsed and no fit has occurred. A more 
 satisfactory case I never attended, as the serious 
 symptoms immediately yielded to the medicine I 
 employed, and the patient is now in good health. 
 
 Case. — This is a typical example of epileptiform 
 attacks. A lady writes : — " Having heard of a young 
 lady who was cured by your medicine, I am desirous to 
 consult you about my daughter. She has been troubled 
 with fits for three years. There is something dark 
 comes across her left eye, her head and eyes turn to the 
 left side ; sometimes she will go round once or twice 
 and then fall ; it is sometimes so slight that it will not 
 continue for a second, and never longer than two 
 minutes. She is frequently troubled with sickness and 
 headache after a severe attack, which occurs once a 
 week or fortnight. There is scarcely a day passes 
 without a slight attack ; we think she is troubled with 
 worms. She is thirteen years of age, fan complexion, 
 and blue eyes. 
 
 " If you think you can do anything for her, please 
 write and let me know." 
 
 Suitable remedies were prescribed with most bene- 
 ficial results. 
 
 Case. — Mr. writes to me from the south of 
 
 England : — " I have a peculiar feeling occasionally 
 which I can hardly describe to you. It is such a strange 
 sensation in my chest and a tightness in my throat as 
 though I am going to be choked, and a feeling on the 
 cop oi my netta as though I had a heavy weight on it, 
 and I feel very nervous —the least sound startles me. 
 
THEA.TMENT OF EPILEPSY. 47 
 
 " When it comes on I see things swimming before my 
 eyes, and when I come to myself 1 am in a cold, clammy 
 perspiration, and such a trembling for some time after. 
 I think it proceeds from the weakness of my heart, as I 
 find the palpitation so mnch more at the time of the 
 attacks. When I am able to attend to business a little 
 I find myself much better, for it employs my mind ; 
 when doing nothing I feel myself so low. 
 
 "I think I have given you the particulars as Dear as 
 possible. Will you please give me your opinion of my 
 case." 
 
 This patient required very careful treatment, as he 
 suffered from functional derangement of the nervous 
 system ; but by fully following out my plan, he speedily 
 obtained relief, and ultimately was entirely restored to 
 health, and is now able to enjoy the society of his 
 relatives and friends. 
 
 These cases present excellent illustrations of 
 the greatly increased or rapidly acquired strength 
 which is experienced under my combined treat- 
 ment, This sudden restoration of strength has 
 often created astonishment in the minds of rela- 
 tives and of the patients themselves, who were 
 previously suffering from considerable debility. It 
 is, however, much more frequent to find epilepsy 
 in those who are in other respects quite healthy, 
 and some epileptics are remarkable for their Her- 
 culean frame and strength. Injuries to the head 
 and sunstroke are frequently followed by epilepsy, 
 
48 TREATMENT OF EPILEPSY. 
 
 and in these cases both forms of the disease may 
 co-exist at the same time. When the affection 
 arises from this cause the memory is very liable 
 to be affected, especially with regard to recent 
 events. Headache and giddiness are the two 
 symptoms most frequently complained of, and 
 sometimes the patient becomes gloomy, irritable, 
 and distrustful. 
 
 Apoplexy is one of the events which is fre- 
 quently dreaded by epileptics and their friends ; 
 and sometimes the epileptic paroxysm is followed 
 by profound coma and a general appearance of 
 apoplexy. Paralysis is another nervous pheno- 
 menon constantly haunting the minds of some 
 patients and their friends, and sometimes in 
 severe forms of epilepsy there is some ground 
 for the apprehension, for tumours and softening 
 of the brain are frequently productive of 
 paralysis. 
 
 As we advance in life our experience naturally 
 increases ; then the mental horizon expands, and 
 much more is seen in medicine, as in everything 
 else, than in the earlier part of life. 
 
 The real physician is the one who cures. After 
 twenty-five years' experience in the treatment of 
 epilepsy, I conceive it to be my duty to bring pro- 
 
TREATMENT OF EPILEPSY. 49 
 
 minently before the public what I believe to be the 
 correct principles of treatment. 
 
 I am prepared to prove, beyond all fear of con- 
 tradiction, that I have cured the most inveterate 
 cases of epilepsy, after every known remedy has 
 been tried. This terrible disorder has never been 
 properly studied in all its various bearings ; it has, 
 indeed, been the opprobrium of medicine. After 
 studying this sad disorder for many years, 1 have 
 been enabled to prepare remedies which are almost 
 infallible. They have cured numerous sufferers ; 
 and, if used according to my instructions, will 
 immediately relieve, and, in a reasonable length of 
 time, permanently cure the most intractable case 
 that can exist. 
 
 It is of the utmost importance that all internal 
 remedies should be prepared with the greatest 
 nicety and care, and also that the ingredients 
 should be of absolute purity and of the finest 
 quality, consequently my remedies are always 
 prepared by myself, and all preparations are 
 thoroughly tested before being used. I consider 
 it of great advantage to a sufferer from disease to 
 be certain that his medicines are of superior quality 
 and carefully amalgamated ; I have therefore for 
 many years past departed from the usual rule of 
 
50 TREATMENT OF EPILEPSY. 
 
 physicians, and instead of giving the patient a 
 prescription, I supply him with appropriate reme- 
 dies, of the purity of which I am certain. It is 
 only hy a careful discrimination alone of the many 
 peculiarities of a case, and a judicious combination 
 of remedial means, that a successful issue can he 
 obtained. 
 
 After prolonged study and extensive experi- 
 mental research, I have been enabled to discover 
 certain remedies for all forms of epilepsy and fits ; 
 they are prepared exclusively by myself, with the 
 greatest possible care, in different forms, to meet 
 the peculiarities of each individual case, ^o two 
 patients can be treated exactly alike ; every case 
 must receive separate attention, and great discrimi- 
 nation is necessary on the part of the physician to 
 guide him as to the administration of the remedies 
 required. This, experience and practice alone can 
 give, as when a medical man makes a speciality of 
 any class of disease, he soon acquires very great 
 facility in his treatment. The valuable medicines 
 I prepare especially for the treatment of epilepsy 
 will cure the most inveterate cases, even when the 
 fits have lasted for years. Eone need therefore 
 despair. After years of careful study I have 
 arrived at the conclusion that these remedies form 
 
TREATMENT OF EPILEPSY. 51 
 
 the most valuable contributions that modern 
 science has made to the treatment of epilepsy. 
 
 The success which has attended the adminis- 
 tration of my remedies, I believe to be due not 
 only to the peculiar form in which they are pre- 
 pared, but also to the unremitting care taken in 
 the skilful manipulation which is required. 
 
 I have for twenty-five years past endeavoured 
 to bring my remedies within the reach of all, and 
 as some persons desire to try a small quantity of 
 medicine to begin with, I shall continue to supply 
 single bottles as I have hitherto done. 
 
 The Special Medicines for Epilepsy are all the 
 same price, 5s. . per bottle. — (Post free, 5s. 6d.) 
 
 A case containing three bottles, 13s. 6d. — 
 (Post free, .145. 6d.) 
 
 A case of six bottles, 26s. — (Post free, 
 27s. ()d.) 
 
 The medicine will be securely packed and 
 accompanied with full directions for use. 
 
 Parcel Post facilities are now so perfect that 
 medicines can be daily and safely transmitted to 
 any part of the Kingdom at a very small cost. 
 
 Post Office or Postal Orders should be made 
 payable at the General Post Office, London, to 
 
52 TREATMENT OF EPILEPSY. 
 
 the name of S. Berry Niblett, and should be 
 crossed ZZZZI & Co. 
 
 Letters containing gold or notes should always 
 be registered, to ensure their safe arrival. Cheques 
 to be crossed. 
 
 I make no charge for consultation, either per- 
 sonally or by letter, to patients desirous of taking 
 my remedies, and invalids are invited to call and 
 have an interview with me on the usual days. 
 
 For the convenience of Invalids residing at a 
 distance, and unable to consult the Author per- 
 sonally, a form of questions has been prepared, 
 which should be rilled up by the patient and 
 returned to me accompanied with a Cheque or Post 
 Office Order for any quantity of medicine that 
 may be desired. This form will be forwarded on 
 application, with any other particulars required- 
 All letters for consultation, or orders for medi- 
 cine must be addressed to Dr. S. B. Niblett, 
 Burwood House, 11, Burwood Place, Hyde Park, 
 London. 
 
 Medicines can be safely sent to any part of the 
 world, securely packed in extra strong cases, accom- 
 panied with full directions for use. 
 
63 
 
 SENSATIONS AND FAINTS. 
 (Prodromata.) 
 
 Minor Fits. — These conditions consist of a 
 temporary and sudden loss of consciousness, for two 
 or more seconds, after which the patient may resume 
 his employment, perfectly unaware that anything 
 abnormal has occurred. The sufferer may exhibit 
 no loss of equilibrium, or he may lean slightly 
 forward or to one side. 
 
 Sometimes there is pallor of countenance, and 
 the pallor may be succeeded by slight flushing. 
 If the attack is more severe than usual, he may be 
 confused, or may exhibit some delusion ; or he will 
 be depressed in spirits and dull of apprehension ; 
 and he may remain in this condition for an hour 
 or two ; gradually, however, he recovers, and 
 regains his usual health. These slight attacks are 
 called by the French "le petit mal." 
 
 In very mild cases the person simply becomes 
 giddy and slightly confused in mind for a few 
 moments. In these slight cases the patient com- 
 
54 SENSATIONS AND FAINTS. 
 
 plains of sudden and transient loss of consciousnesSj 
 followed by little spasm, and pallor of the face ; 
 in some slight seizures there may be no spasm. 
 
 There are many names given by the patients 
 and their friends to slight seizures : — "Sensations/' 
 "turns/' "spells/' " thinkings/' " stupidities/' "re- 
 veries/' a forgetf illness/' "giddiness/' "'faints/' 
 "absent." 
 
 Now these slight sensations are often the sole 
 seizures for months or years before the first severe 
 fit comes on. These feelings or sensations are 
 really slight or incipient fits. These peculiar mild 
 attacks of epilepsy may be so slight that strangers 
 sitting opposite to a patient may observe nothing, 
 although there is absolute, though transient, loss 
 of consciousness. Mental emotion will produce 
 one of these seizures in persons predisposed to 
 them, so also will undue fatigue. 
 
 A child may be seized with one of these attack* 
 in the middle of its play; it will stop for a few 
 moments, and then resume its former occupation 
 there having been neither convulsions nor stagger- 
 ing ; simply a sudden but complete blank, lasting 
 a few seconds. Such a seizure in an adult might 
 be preceded by giddiness, so that he would be glad 
 to hold some object during the attack. 
 
SENSATIONS AND FAINTS. 55 
 
 A young lady, aged 14 years, presented the 
 following features : — 
 
 Almost daily, often during breakfast, she sud- 
 denly manifested a changed expression of counte- 
 nance, appearing as if frightened, sometimes 
 uttered some exclair ition, as if surprised, and her 
 consciousness was lost for a few seconds. Some- 
 times the face was distorted. She never had any 
 convulsive movements of me limbs. These "sensa- 
 tions " had troubled her for many months. Appro- 
 priate treatment entirely removed these symptoms, 
 and I was afterwards informed that she never had 
 any return of them. 
 
 The sensations in this patient were evi- 
 dences of a functional nervous derangement ; 
 under the pressure of any mental excitement 
 they were increased both in frequency and 
 duration. 
 
 I will give here another example. A young 
 man had been for some months in disordered health, 
 suffering from palpitation and mental depression. 
 He described paroxysms of frequent occurrence, in 
 which he felt a flash, as he termed it, originating 
 sometimes in the chest, sometimes in the stomach, 
 and sometimes in one of the lower extremities, 
 rising upward, giving rise to a sense of suffocation, 
 
56 SENSATIONS AND FAINTS. 
 
 and, on reaching the head, followed by momentary 
 confusion of mind. 
 
 In some of these attacks he felt stiffness of the 
 jaws and of the forehead. The attacks were irre- 
 gular, hut had occurred more or less every week 
 for some time. After a few months' treatment, 
 this patient recovered his former health, and no 
 longer had the attacks before described. 
 
 In this case there was evidence of nervous 
 asthenia, and the treatment was especially directed 
 towards the nervous derangement. It is not un- 
 common to meet with persons who have overtaxed 
 the nervous system for many consecutive years. 
 
57 
 
 PAINTS. 
 
 (Proclromata.) 
 
 A sense of faintness sometimes occurs, a sort of 
 indescribable sensation of vagueness ; this is often 
 followed by temporary loss of consciousness, or a 
 feeling of choking. It is sometimes described as a 
 "rising up through the chest" to the throat and head; 
 it feels occasionally as if blood were rushing to the 
 head, with a sense of pressure on the brain. 
 
 There may also be some slight twitchings of 
 the muscles of the face, succeeded by a dazed 
 feeling, after which the patient will exclaim, "He 
 is all right again ! " This complete blank will only 
 last a few seconds : this is called "partial epilepsy." 
 Faintness is the principal symptom, accompanied 
 with a sinking sensation or trembling, or a sense 
 of coldness or nausea. Often the patient turns 
 giddy, but does not lose consciousness; these 
 feelings are described as attacks of "faints." 
 These distressing conditions are often caused by 
 fright or anxiety, or by some cause of excitement, 
 or by a sudden rush of blood to the brain. These 
 attacks are not dangerous, although if they occur 
 repeatedly they sometimes impair the memory, 
 and show that the nervous influence is diminished. 
 
58 FAINTS. 
 
 Occasionally the patient sinks to the ground insen- 
 sible and exhausted, and remains so for a short 
 time, and then recovers, frequently with a slight 
 headache. 
 
 Case. — The following is a characteristic example ot 
 part'al epilepsy : — A lady from Edinburgh came under 
 ray care ; she had suffered from epilepsy for many years, 
 but latterly is subject to what is termed by herself and 
 friends "slight attacks." of the following kind: — Some- 
 times merely a momentary oblivion, and nothing beyond 
 that can be seen ; when speaking she will stop for a 
 second or two, and appear evidently " lost," her coun- 
 tenance losing all expression. At other times her face 
 turns pale, she smacks her lips two or three times, makes 
 efforts at deglutition, turns her eyes about, the face 
 flushes, and she goes on with what she was saying 
 before. In other attacks there is some slight distortion 
 of the countenance. After the first period of the paroxysm 
 is over she can answer questions, and often speaks quite 
 rationally, but there is a strangeness in her manner for 
 two or three minutes; and she almost universally forgets 
 what has been said to her. 
 
 These attacks were of the kind called by the French 
 "le petit mal: " she took the Medicine twice during the 
 day, and also one dose at bed-time, and her diet was 
 regulated according to my instructions. This case 
 rapidly improved, the " faints " disappeared, and I have 
 lately heard from her, and she assures me she is per- 
 fectly well. 
 
59 
 
 DR. NIBLETT'S LIVER PILLS. 
 
 A medicinal concentration, prepared exclusively 
 from the extracts of foreign roots and barks, com- 
 bined with rare gums and distillations. The 
 express use of this pill is to remove bilious and 
 liver complaints, to purify the blood, strengthen 
 and invigorate the nerves, restore the tone of the 
 stomach and bowels, exhilarate the mind, improve 
 the digestion, cleanse the skin and complexion. 
 
 Persons who suffer from liver disorders, indi- 
 gestion, giddiness, or nervous complaints, should 
 always keep these pills by them, — they are, beyond 
 ail doubt, a blood purifier of the very best kind. 
 
 These pills do not contain one particle of 
 mercury or calomel, or any deleterious ingredients 
 whatever. 
 
 Persons who lead a sedentary life frequently 
 suffer from biliousness; the skin gets greasy and 
 opaque, the countenance sometimes becomes puffy 
 and bloated, or pale and thin, the lower eyelid 
 especially sallow and discoloured ; the nose is fre- 
 quently spotted with black dots. Persons who 
 suffer from costiveness are frequently low spirited, 
 and have pains in the head, back, and limbs ; they 
 are often very nervous and irritable, from the 
 effete materials beino: retained in the blood 
 
60 LIVER PILLS. 
 
 The Liver Pills are a certain remedy for cos- 
 tiveness, and act most beneficially on the blood, 
 purifying it from all bad humours; they will cleanse 
 the complexion, raise the spirits, improve the 
 appetite, and strengthen the functions of digestion. 
 If the bowels do not perform their proper functions 
 daily, numerous evils must sooner or later inevi- 
 tably result. The liver will become disordered, 
 the action of the heart will be interfered with, 
 headache and bilious attacks will follow, the 
 kidneys will not act properly, and the whole 
 system will be deranged ; the blood will become 
 charged with effete matters, the skin will be 
 muddy, and the nerves weakened ; cutaneous 
 eruptions of various kinds will be induced, pimples 
 and blotches will come out. All these distressing 
 conditions are speedily cured by the use of the 
 Liver Pills ; they should be taken so as to produce 
 one action of the bowels daily. 
 
 Dr. Niblett's Liver Pills are sold in bottles, 
 price 25. 9d. each; post free for thirty-five 
 stamps. Also in larger bottles, double size, 
 4s. 6d. each ; if by post twopence extra. Direc- 
 tions for use will accompany each bottle. All 
 communications to be addressed to 11, Bur wood 
 Place, Hyde Park, London. 
 
61 
 
 CHOREA OR ST. VITUS'S DANCE. 
 
 [Dancing or Jumping.) 
 
 This disease generally sets in with slight con- 
 vulsive movements of the face or one of the 
 lower extremities, which gradually extend and in- 
 crease in severity until they embrace one side of 
 the body or the whole frame. This affection has 
 been quaintly designated " insanity of the muscles." 
 in consequence of the jerking, tremulous action of 
 the voluntary muscles, especially those of the face 
 and limbs. If the leg is affected it is not lifted as 
 usual, but is dragged along as if it were paralysed. 
 In attempting to raise anything to the mouth the 
 sufferer often jerks it over the head, or swallows it 
 hastily with ludicrous grimaces. 
 
 This affection generally comes on gradually ; 
 the child is observed to drop things, or to be unable 
 to hold its book or thread the needle, the speech 
 is also imperfect. The disease is most common in 
 3 T oung persons, particularly in young girls between 
 the age of six and sixteen ; it may be either of a 
 mild or severe type. The patient finds it impos- 
 sible to keep quiet, whilst there is a constant rest- 
 lessness of the hands and arms, and even of the 
 legs. One half of the body is generally more 
 
62 ST. VITU^'S DANCE. 
 
 affected than the other. As the disease increases, 
 the twistings and contortions of the features become 
 more constant and distressing : she cannot even sit 
 still, she writhes about, she picks her dress, and 
 scrapes the floor with her feet. If she tries to 
 walk she advances in a jumping manner, by fits 
 and starts, dragging her leg rather than lifting it, 
 and alternately halting and hopping. 
 
 Chorea usually occurs in very nervous children, 
 and is frequently caused by fright, or sometimes a 
 fall or blow appears to induce it. Adults occa- 
 sionally suffer from this derangement, but not so 
 often as children ; in adults it is caused by strong 
 mental emotion, but the essence of the disease is 
 impairment of nervous power, and this impairment 
 manifests itself in different ways, according to the 
 nerves especially affected. This affection is usually 
 very exhausting to the sufferer, and a good 
 nourishing diet will be recmirecl, and sometimes a 
 small allowance of claret or half a glass of sherry 
 will be necessary ; exercise in the fresh air is to be 
 freely allowed, while amusement or occupation does 
 good, yet mental excitement ought to be guarded 
 against. This complaint usually yields readily to 
 skilful treatment. 
 
G3 
 
 SPECIFIC AFFECTIONS OF THE BRAIN. 
 
 {Secondary or Tertiary Manifestations.) 
 
 Major or minor fits may be caused by the 
 poison of syphilis in the system, even if the 
 original disease occurred twenty or thirty years 
 before : so also may idiopathic epilepsy be 
 produced from this cause. The patient presents 
 a peculiar cachectic appearance, there is some 
 enfeeblement of the intellect, memory appears 
 to be blunted, he will be irritable and peevish 
 without appreciable cause, severe headache will 
 come on often at night, he may have epileptic fits 
 with convulsions, or only very slight attacks, such 
 as temporary loss of consciousness, lasting only a 
 short time. He will probably have secondary 
 symptoms, such as skin diseases of a syphilitic 
 nature, of a copper or ham colour, or mucous 
 tubercles, sore tongue, loss of hair, pain in the 
 bones of the shins, or other parts, and also a sore or 
 ulcerated throat. If most of these symptoms are 
 present, there can be no doubt as to the nature of 
 
64 SPECIFIC AFFECTIONS OF THE BRAIN. 
 
 the case, especially if the patient admits having 
 had syphilis, although that may have occurred 
 many years since. 
 
 Constitutional syphilis will produce the symp- 
 toms before enumerated, and various other brain 
 troubles, such as caries of a cranial bone, or altera- 
 tion of the arteries of the encephalon, or it may 
 he a gummy arteritis, and that syphilitic arteritis 
 will often be the cause of thrombosis and softening 
 of the tissue of the encephalon. We must always 
 look for cutaneous manifestations if the symptoms 
 lead to the belief that the brain or its mem- 
 branes are the subject of syphilitic inflammation 
 or softening, or a gummata. 
 
 Cerebral syphilis is of a very grave character, 
 more especially if the individual is attacked with 
 paralysis of any muscles or groups of muscles, or if 
 he is weakened by excesses of any kind, or has 
 indulged unduly in alcoholic stimulants. There is 
 no doubt this disease does frequently produce 
 epilepsy, although the syphilitic epilepsy may only 
 be manifested under the form of the "petit mal," 
 or minor fits. 
 
 Headache is regarded generally as an essentia] 
 symptom of this disease, and is often combined 
 with sleeplessness. Syphilitic deafness is not un- 
 
SPECIFIC AFFECTIONS OF THE BRAIN. 65 
 
 frequently met with, it often proves intractable 
 unless the treatment is undertaken at an early 
 stage. Syphilitic epilepsy demands the utmost 
 care, but if subjected to proper treatment it is not 
 an obstinate affection. 
 
 This serious complaint may be brought on by 
 bad specific treatment of the original disease, by 
 emotional disturbances, nervous affections, excesses 
 of all kinds, and anything that weakens the ner- 
 vous system. 
 
 Excesses of any kind tend to produce nervous 
 exhaustion. I have seen cases of epilepsy that 
 might be attributed to this cause. Dissipation 
 lowers the nervous energy and predisposes to 
 disease. 
 
66 
 
 SPECIFIC AFFECTIONS OF THE SPINAL CORD. 
 
 (Gummata — Sclerosis) 
 
 Nervous affections and epileptiform attacks 
 come on at an advanced period of the disease, 
 and in persons who suffer from syphilitic cachexia. 
 The characteristic symptoms are pains in the spine, 
 or radiating to the limbs, formication, creeping 
 feelings, numbness, then rigidity of the muscles 
 comes on, and is succeeded by contractions and 
 painful cramp; these symptoms gradually become 
 aggravated, and eventually end in paralysis, which 
 occurs first in the lower extremities, and advances 
 rapidly. If the genito- urinary organs are involved, 
 the matter becomes serious. Often skin affections 
 supervene. In other cases the bladder becomes 
 affected with a certain degree of weakness, which 
 is manifested by incontinence, or, perhaps, by 
 retention of urine. 
 
 In these cases the symptoms are often rapidly 
 developed, and a specific treatment instituted 
 opportunely, if carefully selected, will check the 
 farther advance of the disease. 
 
07 
 
 NEURASTHENIA CEREBRALIS. 
 
 (Functional Weakness of the Brain.) 
 (Cerebral Paresis.) 
 
 Epilepsy is often brought on by functional de- 
 rangements of the brain and the symptoms will 
 vary considerably. Many will complain of numb- 
 ness and tingling, with sensations of " pins and 
 needles"; others will complain of a tenderness of 
 the scalp, or a feeling of weight in the head, or 
 shooting pains in the muscles and joints, weakness 
 of the limbs, noises in the ears, black specks floating 
 before the eyes, muscse volitantes, palpitation, sleep- 
 lessness, the patient becomes fidgetty, the voice 
 is feeble or trembling, he forgets words he wants to 
 use, his heart becomes irritable, and he suffers from 
 nervous dyspepsia, he often flushes and complains of 
 cold hands and feet, with chills passing down the 
 spine, he arises in the morning unrefreshed from 
 sleep, and frequently with a dull headache, and 
 sometimes he developes a morbid craving for 
 
 stimulants Some individuals will sutler from that 
 
 C 2 
 
68 NEURASTHENIA CEREBRALIS. 
 
 remarkable emotion called gynephobia (a special 
 fear of women), or perhaps to a less extent from 
 anthrophobia (fear of men and of society generally). 
 This complaint is caused by exhaustion of the 
 nervous system, excesses of various kinds, emotional 
 disturbance, troubles, and anxieties; if not pro- 
 perly treated it will probably end in paralysis. Thi? 
 chronic nervous affection will often cause great 
 mental depression. 
 
 A person suffering from neurasthenia should 
 take a long holiday, but should not over-exert 
 himself, sea air and warm sea- water baths are 
 useful, two or three glasses of light wine may be 
 taken for dinner. 
 
69 
 
 NEURASTHENIA SPINALIS. 
 
 {Spinal Irritation.) 
 
 This is a functional weakness of the spinal cord, 
 and will often predispose to epilepsy. The patient 
 will complain of backache, general loss of power, 
 nervous irritability, exhaustion on slight exertion, 
 feeling of heat and cold passing up the spine, ting- 
 ling sensations, formication, palpitation of the 
 heart, faceache, pain in the side, hiccough, great 
 weakness of the limbs almost amounting to a slight 
 form of paralysis, stiffness and pain in the muscles, 
 and sometimes bladder troubles, and the sufferer is 
 in constant dread of some serious affection of the 
 spine occurring. He or she will perhaps suffer from 
 that peculiar abnormal emotion called claustropho- 
 bia (fear of being alone in narrow and closed 
 spaces), or it may be from angoraphobia (fear of 
 open spaces). Spinal irritation must be distin- 
 guishedfrom myelitis and from hyperemia, as quite a 
 different mode of treatment will be required. Change 
 of air to the sea will be beneficial, or mountain air 
 suits some cases better ; warm salt-water baths 
 are sometimes to be recommended. I have used 
 with great success salicine in this affection, it is use- 
 ful in those forms of weakness depending on wasting 
 
70 NEURASTHENIA SPINALIS. 
 
 of the spinal cord; it strengthens the spinal nerves 
 and restores power to the muscles, it is one of the 
 most valuable remedies in functional spinal diseases. 
 The essential symptom of spinal irritation is 
 tenderness at some one or more points of the spinal 
 column, and this tenderness is increased by pres- 
 sure. Sometimes the skin is so tender at these 
 points that the pressure of the clothing is sufficient 
 to cause the wearer great discomfort : in other 
 cases there are shooting pains, which radiate from 
 the tender spot to the chest, neck, and shoulders. 
 
 Case. — This is one of irritation of the cervical region 
 
 of the spinal cord. Mrs. , consulted me for spinal 
 
 tenderness of the upper part of the spine and great 
 weakness, almost amounting to paralysis, of the lower 
 extremities. The disease had come on gradually, she 
 was pale and ansemic, even slight exercise increased the 
 pain. She also complained of indigestion and palpitation 
 of the heart, and at various times suffered severely from 
 neuralgia. 
 
 My object was to improve the nutrition of the 
 cord and spinal nerves. Under appropriate treat- 
 ment she improved so rapidly in every respect that 
 in three weeks she was able to walk with a cane, 
 and in a few weeks more was well, being in as good 
 health, according to her own report, as she had 
 ever enjoyed in her life. 
 
n 
 
 VERTIGO OR GIDDINESS. 
 
 [Meniere 's Disease.) 
 This affection consists of a transitory sense of whirl- 
 ing round, or of falling. Surrounding objects appear 
 to be in motion. The sufferer loses his balance for 
 a minute or two, but often recovers himself with- 
 out dropping, provided he can grasp some firm 
 support ; or the attack may assume a different form: 
 the patient feels as if he were moving ; the kind 
 of motion which is most commonly felt to be pre- 
 sent is that of falling or floating away. He wall 
 sometimes say he feels as if he were spinning 
 round, or that the room appeared to him as if 
 moving. In more severe attacks he staggers, and 
 grasps some object for support, or his legs sink 
 under him, or he slips forward on to his side. 
 
 An individual is said to be " giddy " when he 
 perceives the objects about him to be in a state of 
 motion ; when he sees the walls of his room move 
 round, or feels the ground give way, or the seat 
 sink, as he goes to walk or to sit down. Some- 
 times giddiness is accompanied with nausea, and 
 is increased with every attempt to move. 
 
 When giddiness is connected with stomach 
 disorder it sometimes commences with dimness of 
 
72 GIDDINESS. 
 
 vision ; the patient sees specks floating before his 
 eyes, objects appear to revolve around him, double 
 vision occurs, he staggers, and sometimes he is 
 unable to stand. Giddiness is most prevalent in 
 advanced life; when it occurs frequently it shows 
 there is some disturbance of the nervous system ; 
 but it often arises from weakness of the circulation 
 in the brain. It may be due to some poison in the 
 blood, or it will arise from depressed vital power. 
 If the bowels are in a constipated condition, a 
 suitable aperient must be prescribed, to be taken 
 as occasion requires, as it will be necessary to 
 promote the action of the liver and bowels. 
 
 This disease often betokens great weakness, or 
 it may be due to an impure state of the blood, or 
 to a morbid condition of the nervous system. It 
 may be induced by some affection of the liver or 
 kidneys, or more frequently of the heart. Disease 
 or weakness of the heart will cause vertigo, or 
 " swimming in the head ; " and frequently head- 
 ache, with great nervous irritability. 
 
 A restorative plan of treatment will usually be 
 indicated, with a good nourishing diet ; it will also 
 be necessary to attend to the condition of the 
 liver, so that it secretes healthy bile. 
 
 Giddiness will often recur if the constitution 
 
GIDDINESS. 73 
 
 gets impaired, or the nervous system becomes 
 weakened. The diet may always be nourishing 
 and sufficient in quantity to satisfy the patient's 
 demands. Sherry and soda-water, or seltzer-water, 
 with a little brandy in it ; or claret, mixed with 
 water, may be taken for dinner. White fish, 
 mutton, beef, chicken, and game, together with 
 fresh vegetables, bread and butter, and light pud- 
 dings ; these are all unobjectionable articles of diet. 
 On the contrary, the patient must avoid strong ale, 
 raw spirits, sugar, pastry, most salt meats, and indi- 
 gestible articles of diet, particularly nuts and walnuts. 
 
 Example. — A clergyman writes as follows : — 
 
 "I have been subject to giddiness in my head foi 
 two or three years, which is now becoming much worse. 
 1 have just bad a severe attack, and had to grasp some- 
 thing for support, and found myself screaming for help. 
 
 "When I awoke this morning the room and every- 
 thing appeared in rapid motion, and that is a frequent 
 occurrence, so much so that I feel afraid to go out. I 
 am single, aged 33, rather nervous, very bilious, pale 
 and sallow complexion. 
 
 "I have suffered from giddiness since the age of 
 16. I may add that I have always been delicate, but 
 never had to give up my duties. I have been very 
 cheerful and in good spirits ; I also live very regularly, 
 and do not take wine, spirits, or beer. I have nearly 
 always a singing noise in my left ear." 
 
74 GIDDINESS. 
 
 About a month after, this patient called to 
 thank me for what I had done for him ; he after- 
 wards wrote to say he had been wonderfully well, 
 in fact better than he had ever anticipated. 
 
 In this case the affection was brought on by 
 nerve derangement. By careful treatment, the 
 giddiness was removed, and the patient restored 
 to a sphere of usefulness. 
 
 The Special Medicines for Giddiness or Faints 
 are all the same price, 55. per bottle. — (Post free, 
 55. 6d.) 
 
 A case containing three bottles, 135. 6d. — 
 (Post free, 145. 6d.) 
 
 A case of six bottles, 265. — (Post free, 
 275. 6d.) 
 
 The medicine will be securely packed and 
 accompanied with full directions for use. 
 
 Medicines can be safely sent to any part of 
 the world, securely packed in extra strong cases, 
 together with full instructions as regards diet, &c. 
 
 All communications to be addressed to Dr. 
 Niblett, 11, Burwood Place, Hyde Park. London. 
 
75 
 
 OBSERVATIONS ON DIET. 
 
 For any general rule of diet, none can be more 
 definite than the rule of moderation ; the patient 
 may eat as much as he has good reason to believe 
 he can easily digest. He must avoid all things 
 hard, dry, tough, very salt, very sweet. Melted 
 butter, meat pies, and fat meats must especially be 
 avoided. The invalid should be warned to be 
 very moderate with fermented drinks, with salted 
 meats, with pickles and vinegar ; he should 
 take very little sugar, as all these articles are 
 injurious. 
 
 In drink the rule of moderation must be yet 
 more rigid. Light wines are more wholesome 
 than the strong. The patient may take one or 
 two glasses of good claret, or a glass or two of 
 so and sherry for dinner if it appears to agree with 
 him ; if not, a bottle of soda-water or seltzer- water 
 with a table-spoonful of brandy in it. 
 
 Provided the food is of a wholesome character, 
 the appetite is the best guide in the selection of 
 
76 OBSERVATIONS ON DIET. 
 
 a diet. Good roast or boiled meat, bread, pota- 
 toes, green vegetables, and farinaceous puddings 
 made with milk, together with stewed fruits, may 
 be taken with advantage. 
 
 Among the different kinds of meat there are 
 great differences; lamb and mutton are easier 
 digested than beef, and meat that has been kept 
 until it is tender is more easily digested than meat 
 freshly killed. 
 
 Most cooked vegetables, also bread, farinacea, 
 potatoes, rice, &c, are soon digested. 
 
 It should be noticed that pain and oppression 
 during the digestion of food are signs of imperfect 
 digestion ; and if beef or pork be taken by a weak 
 stomach it will refuse to perform its functions 
 properly, and a severe attack of indigestion will be 
 the result. The patient will suffer from headache, 
 flatulence,, pain in the stomach, w T ant of sleep, 
 loaded tongue, and other sjmptoms of disordered 
 digestion. Large quantities of beer or wine will 
 often disturb digestion by producing congestion of 
 the liver and stomach. The invalid should not 
 exceed one or two glasses of wine for dinner, or 
 one glass of bitter ale. 
 
 The hours of meals should be established and 
 adhered to with the strictest regularity. The 
 
OBSERVATIONS ON DIET. 77 
 
 intervals between meals should be at least four 
 hours. 
 
 The influence of the mind on the development 
 of disease must not be lost sight of; any mental 
 disturbance tending to depress the nervous system 
 is certain to be followed by injurious consequences, 
 and therefore, all such influences should be care- 
 fully avoided, and the tranquillity of the mind as 
 much as possible ensured. Late hours should be 
 shunned, and the mind employed with pleasant 
 thoughts and occupations. 
 
 The following diet-table may be recommended 
 to most invalids, but it will of course have to be 
 varied according to season : — 
 
 Breakfast : A large cup of black tea with half 
 milk, or, in preference, a breakfast- cupful or two of 
 cocoa prepared from cocoa nibs. Sole or whiting, 
 or the lean of an underdone mutton chop, or a 
 new-laid egg lightly boiled about three minutes 
 and a half, or home-fed bacon, cold chicken, or 
 game. Stale bread and a little fresh butter, or 
 dry toast. 
 
 Dinner : Codfish, sole, whiting, smelts, turbot, 
 or brill, mutton, venison, chicken, grouse, partridge, 
 hare, pheasant, sweetbread, roast leg of lamb, or 
 roast beef. Stale bread, cauliflower, asparagus, 
 
78 OBSERVATIONS ON DIET. 
 
 vegetable marrow, French beans, floury potato, or 
 sea-kale. These should be varied from day to day, 
 and occasionally with the addition of fruit or 
 farinaceous puddings. Beverage : Half a tumbler 
 of claret, burgundy, or carlowitz, taken with half a 
 pint of water, or about one table-spoonful ot whisky 
 or cognac brandy in a tumbler of cold water. In 
 some cases a glass of good bitter ale will assist 
 digestion, or if it disagrees, one or two glasses of 
 good dry sherry may be taken. A few grapes, an 
 orange, a baked apple, or perhaps strawberries 
 after dinner. 
 
 Tea : Plain bread and butter, or dry toast , 
 one egg may be taken if desired, two small 
 cups of cocoa prepared from nibs, tea, or milk 
 and water. 
 
 Supper (not later than 9 p.m.) : Some white 
 fish or a little cold meat, or some cold chicken 
 or game. Beverage : one claret glass of light 
 wine, or one table-spoonful of whisky or cognac 
 brandy with half-a-pint of cold water. 
 
 Avoid rich soups, sauces, nuts, pickles, spices, 
 salted, smoked, dried, potted, or otherwise pre- 
 served meats, veal, pork, dried fish, lobster, salmon, 
 pies, pastry, or new bread, cheese, jams, raw 
 vegetables, dried fruits, malt liquors, effervescing 
 
OBSERVATIONS ON DIET. 79 
 
 wines, liqueurs, cyder, and all stimulants, except 
 with food. 
 
 Avoid rapid eating, which is one of the most 
 frequent causes of indigestion. The result of rapid 
 eating without thorough mastication is : first, that 
 the food is not sufficiently mixed w r ith the saliva, 
 which is poured into the mouth during the 
 process of mastication, and which is an im- 
 portant aid to digestion ; and, second, that the 
 food is swallowed in large masses which are 
 difficult of digestion. 
 
 Exercise is most important, as inactivity tends 
 powerfully to engender a state of system leading 
 to diseas-e. Exercise to he useful should be 
 moderate and regular; if excessive at any one 
 time, it may produce injury by exciting the action 
 of the heart and accelerating the flow of blood in 
 the arteries. In all cases the amount of exercise 
 must be carefully apportioned to the age and 
 strength of the patient. 
 
80 
 
 ESSENTIAL REMARKS. 
 
 It is of the utmost importance that all internal 
 remedies should be prepared with the greatest nicety 
 and care, and also that the ingredients should be 
 of absolute purity and of the finest quality, con- 
 sequently my remedies are always prepared by 
 myself, and all preparations are thoroughly tested 
 before being used. I consider it of great advantage 
 to a sufferer from disease to be certain that his 
 medicines are of superior quality and carefully 
 amalgamated ; I have, therefore, for many years 
 past departed from the usual rule of physicians, and 
 instead of giving the patient a prescription, I supply 
 him with appropriate remedies, of the purity of 
 which I am certain. It is only by a careful 
 discrimination alone of the many peculiarities 
 of a case, and a judicious combination of remedial 
 means, that a successful issue can be obtained. 
 
 The success which has attended the adminis- 
 tration of my remedies, I believe to be clue not 
 only to the peculiar form in which they are 
 prepared, but also to the unremitting care taken 
 in the skilful manipulation which is required. 
 
 Harrison and sons, printers in ordinary to her majesty, sr. martins lane. 
 
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