Nothnagel thinks it possible or even probable that in those cases in which the division of nerves is followed by epilepsy, a neuritis ascendens—an inflammation passing along the nerves in a central direction—is the cause of the changes suggested by him in the epileptic centre. All our knowledge of bacteria and of the pathological processes induced by them, seems to indicate that such a neuritis ascendens, as is assumed by Nothnagel, would render important support to the hypothesis that the artificial epilepsy is due to infection. But when we further consider that the offspring of artificially epileptic animals may themselves become epileptic, although in most cases they suffer from a variety of other nervous diseases (in consequence of trophic paralysis), I hardly see how the facts can be rendered intelligible except by supposing that in these cases of what I may call traumatic epilepsy, we are dealing with an infectious disease caused by microbes which find their nutritive medium in the nervous tissues, and which bring about the transmission of the disease to the offspring by penetrating the ovum or the spermatozoon. Obersteiner found that the offspring were more frequently diseased when the mother was epileptic, rather than the father. This is readily intelligible when we remember that the ovum contains an immensely larger amount of substance than the spermatozoon, and can therefore be more frequently infected by microbes and can contain a greater number of them. Of course, I do not mean to assert that epilepsy always depends upon infection, or upon the presence of microbes in the nervous tissues. Westphal produced epilepsy in guinea-pigs by striking them once or twice sharply upon the head: the epileptic attack took place immediately and was afterwards repeated. It is obvious that the presence of microbes can have nothing to do with such an attack, but the shock alone must have caused morphological and functional changes in the centres of the pons and medulla oblongata, identical with those produced by microbes in the other cases. Nothnagel also distinctly expresses the opinion that epilepsy ‘does not depend upon one uniform and invariable histological change, but that the symptoms which constitute the disease may in all probability be caused by various anatomical alterations, provided that they take place in parts of the pons and medulla which are morphologically and physiologically equivalent[223].’ Just as a sensory nerve produces the sensation of pain under various stimuli, such as pressure, inflammation, infection with the poison of malaria, etc., so various stimuli might cause the nervous centres concerned to develope the convulsive attack which, together with its after-effects, we call epilepsy. In Westphal’s case, such a stimulus would be given by a powerful mechanical shock, in Brown-Séquard’s experiments, by the penetration of microbes.