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

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

Licence: Public Domain Mark

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

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

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    exciting cause, as a rule, bears no more causal relation to the disease than does a spark to the explosion of the gun- powder on which it falls. The real cause of the explosion is the chemical tension of the constituents of the gun- powder, the existence of which is revealed by the action of the spark. The real cause of the disease is the morbid state of the nervous system, the existence of which is only revealed by the effect of the immediate excitant of the first fit. Nevertheless, since the occurrence of one fit undoubtedly facilitates the occurrence of others, we must regard the excitant of the first fit as, to some extent, the cause of the other fits, i.e. of the whole developed disease. Without that cause, the disease might have remained for ever latent. The study of these causes presents peculiar difficulty. The statements made by patients have, of necessity, to be received with caution, and the facts to be carefully inves- tigated. An occurrence so striking as a fit is naturally assumed to be due to some cause at least discoverable, and so is often attributed to a remote and improbable ante- cedent. Of 1,150 cases in which this point was noted, a reasonable cause for the first fit was given in 428, or 37 per cent., and in the remainder no probable cause could be ascertained. From this series the cases distinctly originating in dentition convulsions are excluded. Relation to Sex.—An exciting cause is met with in males much more frequently than in females: in 44 per cent, of men (235 out of 537 cases), and in only 31 per cent, of women (193 out of 616 cases)—a difference be- tween the sexes of 13 per cent. This can scarcely be accounted for by greater exposure to exciting causes, since some of these act more on the female sex; it seems to indicate a greater predisposition on the part of women. Relation to Age.—If we examine the proportion of cases in which an exciting cause can be traced in the different periods of life, we find that under ten it is nearly the same for both sexes (males 41, females 40 per cent.) From ten to twenty there is a great difference between the sexes