This disease attacks the patient by fits or paroxysms, which, after a certain time, go off, leaving him most commonly in his usual state; but sometimes a considerable degree of stupor and weakness remain behind, particularly where the disease has had frequent returns. It is oftener met with among children than grown persons, and girls seem more subject to its attacks than boys. Its returns are periodical, and its paroxysms commence more frequently in the night than in the day, being somewhat connected with sleep. When the disease first develops itself, the intervals between the paroxysms are usually long, probably two or three months, but as it becomes rooted in the system they return with greater frequency, until at length scarcely a day passes without an attack. It may be considered as an hereditary disease, and although the parents of the patient may not have been afflicted with actual Epilepsy, still they will often be found to suffer from other maladies of the same class, such as palsy, idiotism, or mania. It is a disease sometimes counterfeited in order to extort charity, or excite commiseration, and is also frequently simulated by soldiers and sailors, with the view of obtaining their discharge. For the detection of such impositions, it is usually recommended to apply a lighted candle near the eyes, as in the true Epileptic fit the pupil is perfectly insensible to light; but this method of detection does not always prove satisfactory. In all such cases, therefore, the introduction of some dry pungent snuff into the nostrils, blown through a quill, will be found more certain and useful. In the true Epileptic fit it will produce no effect whatever, whereas, in that which is feigned, violent sneezing will soon be brought on.

The only disease with which Epilepsy can be confounded is Hysteria, and from this it may readily be distinguished by the foaming at the mouth, gnashing of the teeth, blackness of the countenance, etc, together with the speedy termination of the fit in sleep, and the absence of the usual symptoms of Hysteria, such as palpitations of the heart, involuntary laughing or weeping, etc.

The causes which give rise to Epilepsy are blows, wounds, fractures, and other injuries done to the head, by external violence, together with fulness of the vessels of the head, lodgments of water in the brain, tumours, concretions, polypi, and a deformity in the shape of the bones in some interior part of the skull. Epilepsy has also been known to arise from an affection of the spinal marrow; violent affections of the nervous system, sudden frights, fits of passion, great emotions of the mind, frequent intoxications, acute pains in any part, worms in the stomach or intestines, teething, the suppression of some long accustomed evacuation, such as the drying up of an issue or old sore, too great emptiness or fulness, and poisons received into the body, are causes which likewise produce Epilepsy. Sometimes it is hereditary, and at others, it depends upon a predisposition arising from a too great activity of the organ of sense, occasioned by either fulness or a state of debility.

An attack of Epilepsy is now and then preceded by a heavy pain in the head, dimness of sight, noise in the ears, palpitations, flatulency in the stomach and intestines, weariness, and a slight degree of stupor, and in a few cases, there prevails a sense of something like a cold vapour rising up to the head; but it more generally happens that the patient falls down suddenly without much previous notice; his eyes are distorted or inverted, so that only the whites of them can be seen; his fingers are closely clenched; his limbs and the trunk of his body, particularly on one side, are much agitated; the teeth gnash against each other; he foams at the mouth and thrusts out the tongue, which often suffers great injury from being caught between the teeth; he loses all sense of feeling, and not unfrequently passes both urine and faeces involuntarily. The breathing is irregular and laborious, and the pulse, for the most part, is small and contracted.

After a continuance of the convulsions for some time, they abate gradually, and the patient continues for a short period in a state of insensibility and motionless, as if in a profound sleep; but, on coming to himself, feels very languid and exhausted; retains not the smallest recollection of what has passed during the fit, and complains of a degree of stupor and sense of oppression in the head.

Epilepsy, when of long continuance, is apt to produce much injury to the constitution; the memory fails, the mental faculties become gradually more and more impaired, and there is a vacant stare in the countenance that makes a strong impression on the beholder. Sooner or later it generally produces some other form of a diseased state of the brain, either water on the brain, apoplexy, palsy, mania, or idiotism, but occasionally it terminates fatally without bringing on any other disease, particularly among children.

When Epilepsy proceeds either from tumours, polypi, concretions, or a deformity in the bones of the skull, the case is hopeless. When it arises from an hereditary disposition, or comes on after the age of puberty, or where the fits return frequently and have become habitual, or are of long duration, it will be very difficult to effect a cure; but when it attacks at an early age, and is occasioned by worms or any accidental causes, it may, in general, be removed. In some cases it has been entirely carried off by the occurrence of an intermittent fever, or by the appearance of the menses, or of an eruption on the skin.

Epilepsy has also been known to disappear suddenly about the age of puberty, where it has attacked children of five or six years old, and where no treatment has had any effect. The number of fits is always increased by parturition, and by every other thing which has a tendency to debilitate the system.