In considering peripheral irritation of the pudic nerve as a cause of this disease, we must, I think, consider mental emotion, which occupies the highest rank in causes of epilepsy, in conjunction with that second in the list,—eccentric irritation. I would, therefore, classify the cause of epilepsy depending on such irritation as both eccentric and centric. The former, inasmuch as it produces exhaustion, and, by deranging the nutrition of the nervous tissue, generates abnormal excitability; the latter, for that it is a physical excitant which is not only “a mere provocative of the paroxysms, the convulsions being supposed to ensue as the reflex results of irritation, but that it actually _sets up_ in the nervous centres that state of excitability which is the essence of the disorder.” Further still, looking on epilepsy as a direct sequel of hysteria, when it is produced by excitation of the pudic nerve, the patients are, in an eminent degree, predisposed to the disease. Women are also more naturally prone to epilepsy from mental emotion than men; “Emotional disturbance being assigned,” says Dr. Reynolds, “as the cause of their attacks in so many as 36 per cent., whereas in the male sex there were only 13 per cent. who referred their diseases to that cause.” It would be out of place in a work of this nature to detail at length the symptoms of these attacks. Whether they are truly epileptic will be seen as the cases are related. I have been very careful to separate those which seemed to be of an hysterical or epileptoid nature; and have had the advantage of being able to show the greater number of them to many eminent members of the medical profession, who have witnessed my practice in the London Surgical Home. CASE XXXIV. EPILEPTIC FITS—TWELVE YEARS’ DURATION—OPERATION—CURE. S. F., æt. 41, single; admitted into the London Surgical Home Dec. 16, 1861. _History._—Was always ailing, and hysterical for many years. Catamenia appeared early, and always rather profuse. For the last twelve years has suffered from epileptic fits; recurring frequently every week or fortnight, and lately as often as every day. Has constant headaches; is losing memory and all power of concentrating her ideas. Has no premonition of seizure; falls down; is unconscious; has frequently bitten her tongue; and “froths” at the mouth. Says she has had several attacks of hæmatemesis. She was a dressmaker, and had so frequently, on her way to or from business, fallen in the streets, that she had been carried into almost every hospital in London, and a large number of open surgeries. _On examination_ there was found every indication of irritation about the vulva, and also a small polypus of the os uteri, which latter was large and patulous. Dec. 19. Usual operation of excision; polypus uteri also removed.