Epilepsy : its symptoms, treatment, and relation to other chronic convulsive diseases / by J. Russell Reynolds.

  • Reynolds J. Russell (John Russell), Sir, 1828-1896.
Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: Epilepsy : its symptoms, treatment, and relation to other chronic convulsive diseases / by J. Russell Reynolds. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    68/434 (page 32)
    EPILEPSY. avec les convulsions.* But to such statements it must be replied, that cases occur not infrequently in which no such convulsion or even transient and local spasm can be positively observed, and yet the whole character of such cases and their ultimate development is such as to leave no doubt of their epileptic character. (See Case IX.) While, however, excluding from the definition of epilepsy a symptom which is not shown to be unive]^aUy present, it should be stated, that there are grounds for believing that in epilepsy loss of consciousness is invariably associated mth, and dependent upon contraction, the result of a motor impulse; but that this impulse may be confined to the contractile fibres of the cerebral vessels, t The element of spasm, therefore, is not denied, but affirmed to be one that is essential to the existence of epilepsy; but it is asserted that this element does not necessarily occur in muscles which are exposed to observation. Epilepsy may then be defined to be a chronic disease charac- terised by the occasional and temporary existence of loss of con- sciousness, tvith or without evident muscular contraction. Epilepsy should be regarded as an idiopathic disease, i. e. as a morbus per se, distinct from eccentric convulsions, from toxasmic spasms, from the convulsions attendant upon organic lesion of the cerebro-spinal centre, and, in fact, from every other known and appreciable malady. The special organic condition upon which it depends may be induced in various ways, but it may occur primarily; and, in the vast majority of cases of epilepsy proper in the human subject, there is no evidence to show that the disease is other than idiopathic and primary.^ In 1855 I made the remark that, if we can succeed in distributing all the cases hitherto known as epilepsy among the several classes of better defined diseases, we ought to reject the term epilepsy from our nosology: but if we cannot accomplisli this distribution, and are compelled to recognise the existence of many, or even of a few, cases distinct from any more general condition of systemic or local disease, then we must employ the * Recherches et Observations siir I'Epilepsie, p. 36. t Vide Chap. V., Pathology. X For the sense in wliich these terms are used, and the reasons why they are applied to epilepsy, the reader is referred to Chapters I. and V.