|1. The Gardener, with the aid of such patients as can be taken out for that purpose, shall have the care of the orchard, garden, and grounds around the Asylum and Physician's house; he shall have charge of the cultivation of the vegetables, fru... Read more of Gardener at Insane Asylum.ca|| Informational|
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Source: Papers On Health
The first sign of such an illness is a brief and slight
attack of "absence." We notice once or twice that the person "loses
himself" for a few moments, but recovers so speedily that we scarcely
are sure whether anything of importance has occurred. He is perfectly
unaware that he has so "lost himself" or been "absent" at all. That
part of the brain on the activity of which consciousness depends has
been for the moment inactive.
There is another symptom--that is, the "falling" which gives one of its
titles to this malady. It is called "the falling sickness." There is a
peculiarity in the falling of one who is affected in this way. In some
cases consciousness partially remains, but the balancing power of the
brain is lost. A patient in this case sees the ground rise till it
strikes him violently on the forehead. We remember a friend telling us
that he was walking along a railway, when all at once the rail seemed
to rise and strike him in the face: he had fallen on the rail, and
seriously wounded himself. The same thing occurs to the person who has
taken enough alcohol to deprive him for the time of brain action for
the usual balancing of his body. Just as there is a certain part of the
brain which gives men consciousness, so is there a part which gives
muscular control, such as we use in balancing the body, and there is a
stream of vital action flowing from the nerve sources by which both are
supplied. If this stream is diverted from these organs, "absence" and
"falling" are the natural and necessary result.
There are many cases in which there are only "absence" and "falling,"
but in others, symptoms much more alarming appear. The next of these
which we notice introduces us to a totally distinct element in our
explanation. It is found in the "screaming" that follows instantly on
unconsciousness, and precedes the "falling" generally. The sufferer is
entirely unaware of all that occurs with him, and screams by no
voluntary act on his part. The symptom is purely bodily, and expresses
no thought or feeling, good or bad, though it is similar to the scream
of terror, and makes the same impression on the uninformed hearer. The
muscles are used in the scream of epilepsy, just as the muscles of
ordinary movement are used in St. Vitus' Dance, but there is nothing of
the mind whatever in the movement. The organ of the mind is unsupplied
with vital action, but the organs of voice are over-supplied. It is
beyond doubt this over-supply which shows itself in the scream, for
there is nothing else to account for it.
The same thing is true of the movements of the jaw that are so terribly
strong, and so sorely wound the tongue, in the case of those suffering
in this way. The jaws open and shut with great force, and without the
mind regulating their movement. All the motor nerves are convulsed with
strong action, and the muscles they supply are wrought to the utmost,
while all consciousness and control are entirely suspended. There is
such an overwhelming supply of activity to the mere muscular system
that the sources of that supply are soon exhausted, and the motion
ceases for a time. Consciousness does not at once return fully, but the
convulsions cease, and something like a sleep follows before the brain
has its needed supply.
How is it that vital action seizes these mere motor nerves and leaves
the brain? There is a symptom in cases of epilepsy which tends to throw
some light on this question. It is seen in the extreme activity of the
brain, indicated by the incessant talking of the patient before a
series of convulsions come on, when taken along with the extreme
depression and silence that follow such a series. During whole nights,
even, the sufferer will talk, till every organ is exhausted; then comes
a series of violent convulsions, then a season of perfect silence and
This explanation of the disease points to the remedy. That which will
nurse the brain, and at the same time lessen nervous force in the
system, will tend to cure the evil. Strong fomentations round the lower
part of the body may be used. Soap in fine LATHER (see) should be
made to cover the skin at bedtime, and washed off with weak ACETIC ACID
(see) in the morning. Easily digested food should be taken, and all
so-called stimulants strictly avoided. We should endeavour to secure
the soothing of the spinal system of nerves. This is done in a degree
that is incredible to those who have not actually witnessed it by a
persevering use of the cold treatment of the back. The best time is
early in the morning, after the patient has had a good night's sleep.
For a whole hour spinal treatment should then be used. We have no faith
in any royal road to success in such a cure, but we have faith in
common sense and right good work. Taking three towels, and putting two
of them in cold water, the "operator" is ready to begin. It will be
well first to rub the patient's back gently with a little warm olive
oil. This will obviate all danger of shock or shiver when the cold
cloth is placed on the skin. Then wring out one of the cold towels
thoroughly, so as to have it damp and not dripping; fold it lengthways
eight ply. Put the one over the other, place both on the centre of the
patient's back as he is sitting up in bed to receive them, keeping the
damp towel next the skin. Adjust these cloths nicely, make the patient
lie down upon them, and cover him snugly up with the bedclothes. So
long as the feeling is nice, let well alone. When the towel becomes
hot, wring out the second, and change it on the back. Carry this out
for a full hour, and if the patient is disposed to go to sleep again,
encourage him to do so.
Continued for weeks every morning this humble treatment, without any
addition, has an incredibly soothing effect on an excitable system. But
it will be well to add to it some nursing of the head and feet, so that
every encouragement may be given to a diffusion of nerve action over
the body. At night, before going to bed, the feet and legs should be
bathed in hot water for a quarter of an hour, dried, rubbed gently with
warm olive oil, and a pair of soft cotton stockings drawn on. While the
patient is being treated, every possible wearing and irritation of the
brain must be avoided, and when lying on the cold towel, the head
should be soothingly rubbed by a gentle hand. If an actual violent
attack comes on, loose all tight clothes, place a piece of cork between
the patient's teeth to prevent biting the tongue, give plenty of fresh
air, and keep the patient in a recumbent position.
Everything should be done, by training, to increase the patient's
self-control, and all stimulants should be avoided as most injurious.
See Head, Rubbing the.
It is important that those liable to these attacks should be kept
employed. Nothing is so harmful as idleness. Everything tending to good
health is of value, but the essentials of the treatment are found in
soothing the spine as above, and stimulating the brain by the head
rubbing. Unless in cases in which the very structure of the system has
been, so to speak, altered by long-continued disease of this sort, we
should look for good results from such treatment as this. Even in the
worst cases it would be possible to mitigate the severity of the
A difference in the focus of the eyes often causes a strain on the
brain in the effort to adjust them. This sometimes causes epilepsy, and
we have known many cases cured by the use of spectacles made to correct
this inequality. In all cases of this disease, therefore, an optician
should be consulted, to see if there is any defect in the eyes.
Other illnesses are sometimes mistaken for epilepsy: for example, the
liver and kidneys in a defective state and impurities passing in the
blood to the brain, will explain certain forms of that which passes as
epilepsy. It is often easy to cure attacks of this nature by merely
bringing the liver and kidneys into working order. If there is a
yellowness of the skin, or other signs of the blood failing to be
purified in a natural way, then that should first be dealt with, and
the fits will often be removed as soon as good action is established in
the purifying organs. But in all cases in which there is anything like
real "fits," it will be found of great importance to study the
over-and-under-actions of the nerve system as by far the most essential
elements in the disease. See Jaundice.