(From Epilepsia 3558 to seize, invade, or oppress). The epilepsy; Abas, morbus caducus, in-terlunius, magnus, and attonitus morbus, analepsia; by Paracelsus, catalentia; by the Portuguese, cobrello; by Hippocrates, eclampsis, falling sickness; heracleios, the great or herculean disease, from its violence and intractability; the sacred or divine disease, because it was supposed owing to the divine influence; morbus infantilis and puerilis, as happening most frequently to infants and children; comiste, and comitialis morbus, since people were frequently seized with it whilst in the comitia.

Dr. Cullen places this genus of disease in the class neurcses, and order spasmi. He defines it a convulsion of the muscles, attended with a loss of sense, terminating in a state of insensibility, and seeming sleep. He distinguishes three species:

1. Epilepsia cerebralis, when it arises suddenly without any manifest cause; no except sometimes a giddiness or loss of sight.

2. Epilepsia sympathica, when it arise without any manifest cause; but is preceded by a particular sensation, called aura epileptica, from some part of the body rising upwards to the head.

3. Epilepsia occasionalis, when from manifest irritation, and ceases on the removal of that morbid cause.

An epilepsy is a violent, involuntary, or convulsive contraction of the muscular parts of the whole body, attended with an abolition of sense, owing generally to some irritation in the common sensorinm, producing insensibility, and consequently irregular actio: the cause is in the brain itself, it is called an idiopathic epilepsy; when in other parts, symptomatic.

The idiopathic epilepsy is remotely occasioned by external violence; by bony protuberances arising internally in the basis of the skull, in the lateral falciform sinuses; from an obstruction of the jugular veins; from polypous concretions; the passions of the mind; an ill conformation of the brain, etc.

A symptomatic epilepsy is produced by cachectic and hypochondriac habits; flatulencies proceeding from the stomach and bowels; spasms of the intestines; irregular secretions and excretions; the acrid matter of eruptive and other diseases conveyed to the brain; gout;; that are violent and attended with spasms; stones passing through the ureters; worms; poisons, etc.

The diagnostics vary in different people: some are suddenly seized; others have a train of symptoms foreboding the attack, such as weariness, an oppressive pain in the head, interrupted sleep, a languid pulse, a ' pale countenance, stupor and drowsiness, an unusual dread and terror, a ringing in the ears, palpitation of the heart, inflation of the precordia, disturbed respiration, rumbling in the bowels, a discharge of fetid stools, coldness in the joints, and a copious discharge of urine. A cold vapour is sometimes perceived gradually ascending from the extremities to the brain. Whether these symptoms precede the attack, or are absent, the fit approaches suddenly, and as it were unexpectedly; the patient falls down; the thumbs are firmly fixed on the palms of the hands; the eyes are distorted, and the white part only appears; all sensation, both internal and external, is lost; a froth is forced through the closed lips, with a hissing noise; the tongue is often lacerated by the teeth; and the limbs are agitated with the most violent convulsive motions. In some, the distortions and gesticulations are ridiculous and distressing; in others, instead of convulsive motion, there is highly rigid spasm in all the members, by which they are so fixed that no force can move them. The seed is occasionally ejected, and sometimes the urine is discharged to a considerable distance, and this, as well as the discharges by stool, are involuntary. At length these symptoms remit; the patient seems to have a sort of respite at intervals, but the eyelids remain immovable; the teeth grind upon each other, the tongue hangs out of the mouth. When the paroxysm ceases, the patient is entirely ignorant of every thing that happened during it; he rolls on the ground; his countenance appears sad; he begins to yawn, and stretches himself with a kind of violent effort; he rises and walks slowly, seems uneasy, and the veins of his forehead appear distended. The recollection returns very slowly, and the symptoms which preceded the fit sometimes continue after it. The returns, in many instances, are regularly periodical; more frequently irregular and uncertain. By a frequent recurrence of this disorder the patient grows dejected; is indolent; subject to a vertigo and a trembling if he looks upward; is irritable, and quickly agitated.

The epilepsy should be distinguished from the apoplexy, convulsions, and hysterics. In apoplexy there are no convulsions; the breath is drawn with a stertor, and the pulse is unusually slow and laborious. If convulsions and hysterics are confounded with epilepsy, the inconvenience is not very great. The remedies do not materially differ; and those reputed epilepsies, attended with, and in part owing to, flatulencies in the stomach, are more nearly allied to hysteria. We may add also, that the epilepsies attended with stupor rather than convulsions, do not essentially differ from apoplexy.

Hereditary epilepsy is rarely cured; and when the disorder is chronical or habitual, success is scarcely to be expected. When the approach of puberty, the eruption of the menses, or the first delivery, does not remove an epilepsy in woman, an hereditary cause may be suspected, and a cure is not to be expected. When caused by frights, they are so rarely cured as to afford but little hope; for, when the patient seems recovered, trifles occasion a relapse. When the fit approaches during sleep, the danger is greater. Hippocrates asserts, that boys are relieved from this disorder about their seventh, fourteenth, or seventeenth year. There are hopes of cure when the case is not inveterate or hereditary, when the cause is in the primae viae, too great irritability, or some disorder translated to the brain. In all spasmodic diseases, the disease often continues from custom alone, after the original cause has long ceased to act; so that much depends upon breaking the habit. If several successive attacks can be prevented, it may never return. No medicine will so certainly prevent an epileptic fit, as a vomit given an hour before the attack. But this can only be employed when the disease is regularly periodical, as its approach is known by previous symptoms. In the epilepsia nocturna, a dose of ipecacuanha may be given at bed time.