A Statistical Inquiry Into the Nature and Treatment of EpilepsyBennett, Alexander Hughes
Science
A Statistical Inquiry Into the Nature and Treatment of Epilepsy
Bennett, Alexander Hughes
Epilepsy
ADMINISTRATION OF THE BROMIDES
IN EPILEPSY.[D]
The present inquiry is the result of an experience of 300 cases of
epilepsy treated by myself with the bromides of potassium and ammonium.
In all of these the clinical facts, as well as the progress of the
malady, were carefully studied and recorded. The effects of the
administration of these remedies on epileptic seizures I have already
investigated and demonstrated in a somewhat elaborate series of
observations.[E] Further experience has confirmed the correctness of the
general propositions then arrived at, so that they need not again be
elaborated in detail.
At present it is proposed to direct attention to the effects of the
prolonged administration of large doses of the bromides, and to attempt
to ascertain if, while arresting or diminishing the frequency and
severity of the paroxysmal symptoms, they beneficially influence the
disease itself, or in any way injuriously modify the constitution of the
patient. On this subject much difference of opinion and misconception
prevail. It is well known that the injudicious use of the drugs leads to
certain physiological phenomena which are comprised under the term
"bromism." It is also generally believed that the physical and mental
depression resulting from their prolonged toxic effects constitutes a
condition worse than the malady for which they are exhibited. One of the
objects of this article is to question the accuracy of this assertion,
a true apprehension of which is the more important when we reflect how
universal is this method of treatment, and the deterrent effect it
exercises upon epileptic attacks. The task, like other therapeutic
inquiries--especially those connected with chronic disease--is a
difficult one, there being innumerable pitfalls of error between us and
a sound scientific conclusion. These, however, may, I believe, in great
measure be surmounted by the accumulation of facts laboriously and
accurately recorded, by the intelligent study of their details, and the
impartial and logical deductions which may be drawn from the data
supplied. The value of a therapeutic inquiry depends, not upon the
opinions and undigested experience of individuals, or by the narration
of isolated cases, but upon the indisputable proofs resulting from the
unbiassed analysis of a large series of accurately observed and
unselected examples. The solution of the problem, if complex in all
clinical affections, is especially so in epilepsy. Although the symptoms
of this disease have been recognised from the earliest ages, our
knowledge of its essential nature is as yet shrouded in mystery. The
etiology and pathology are practically undetermined. The phenomena are
not only due to a varied series of morbid conditions, but may assume a
multitude of forms and degrees of severity, which may be, on the one
hand, of the briefest duration, or, on the other, of a life-long
permanence. The symptoms may comprise not only a diversity of physical
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