Epilepsy and other chronic convulsive diseases : their causes, symptoms and treatment / by Sir William R. Gowers.

  • Gowers, W. R. (William Richard), 1845-1915.
Date:
1901
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Licence: In copyright

Credit: Epilepsy and other chronic convulsive diseases : their causes, symptoms and treatment / by Sir William R. Gowers. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    victiou that it obtains in all. We see it in the activity of the spinal cord which maintains muscular tone, and this must be accompanied by a similar continuous activity of the cerebral centres, of which there is indeed abundant evidence. Thus a condition of stability is maintained, and yet readiness for the energetic liberation of nerve force when a stimulus is re- ceived. In epilepsy, however, the equilibrium is apparently unstable, and a sudden release of energy occurs apart from a normal stimulus, in what we term spontaneous discharge. The tendency to it must depend on some slight difference in the molecular constitution of the nerve structure, inherited or acquired. When we consider the energetic release of force in the motor centres, which the mere sight of an alarming object will instantly induce in any animal, it is intelligible that a trilling change in elementary constitution may involve the liability to apparenth spontaneous action. The activity thus suddenly developed in epilepsy is more- over abnormal in form. The combination of cerebral centres involved differs from that which is active in normal conditions, and the form in which the nerve energy is released is also unlike that which occurs in health. But the difference varies in degree ; the more intense the discharge, the greater is its difference from that of health. It is greater also in some centres than in others. '^Phe most conspicuous deviation is seen in the discharge in the motor structures, manifested by the spasmodic muscular contractions, tonic and clonic, which are, as a rule, unlike any that are seen in health. When the discharge begins in a sensory centre, the process may differ but little from normal action, judging from its effect on con- sciousness. It produces a sensation which often resembles that which might be experienced in health from an adequate stimulus. It is important to note, at the outset, these features of the epileptic discharge; an abnormal form of activity is associated with undue readiness to act. Both must be as- cribed to nutritional changes, which permit the molecules to break up too readily and to escape in a more random man- ner than in health. It may be a congenital imperfection of nutrition, or induced by abnormal influences to which