CASE XL. EPILEPTIC FITS—TWO YEARS AND A HALF DURATION—OPERATION—RELIEF. S. Z., æt. 16, single; admitted into the London Surgical Home October 20, 1865. _History._—Was strong and well until two and a half years ago, when she had an epileptic fit in the middle of the night. Can assign no cause for the attack. For a long time had a fit once a month, but latterly once a week. The catamenia appeared six months before the first fit, and have always been regular. There is no exacerbation at menstrual epoch. Complains of great irritation of pudendals for three years. Nov. 2. Since admission this patient has been watched: she has had two fits, both of a genuine epileptic character. Mr. Brown this day performed his usual operation. She went on well till the 10th, when she had a slight fit; there being irresistible irritation, the hands were restrained. A lotion of bromide of ammonium was ordered to be applied to the wound, and 20 grains of the bromide to be given in water three times daily. She convalesced well, and had no more attacks till the 29th, when, her hands having been released only a few minutes previously, she had a fit, and the nurse found one hand on the wound. She was conscious during the attack, which was not so violent as before treatment. Dec. 2. Discharged relieved. If this patient could be under control for a few months, she would probably be cured. CASE XLI. EPILEPTIC FITS, WITH DEMENTIA—THIRTY YEARS’ DURATION—OPERATION—CURE. M. F., æt. 44, single; admitted into the London Surgical Home December 8, 1865. _History._—Epileptic fits first attacked her when she was about 14, at which age she menstruated. For the first few years there was a long interval between each, but they gradually became more frequent and violent. Latterly she has had several during the week of each menstrual period, and as a rule none in the interval. Catamenia have been tolerably regular in appearance, but rather profuse. Is tall, pale, and thin; has a dull and somewhat vacant expression; is very eccentric in her manners and conversation; is frequently observed, both day and night, by the nurses to practise injurious habits, to which she acknowledges for the last thirty years. The fits are genuine epileptic. _On examination_, there is evidence of very long-continued peripheral irritation, and also a fissure of rectum. Dec. 12. The usual operation on clitoris and rectum. Dec. 13. In the absence of nurse, removed the dressing, and immediately had a fit. To have opium 1 grain, with ¼ grain of extract of belladonna, every six hours. Under this treatment the patient improved daily, became cheerful, rational, tractable, and much more sensible in her conversation. She passed two menstrual epochs, but without a fit, and she was discharged perfectly cured.