Notes on Epilepsy, and its Pathological Consequences

Abstract

Although a certain number of those who are subject to epilepsy may pass through life without displaying any sensible diminution in mental capacity or power, it is nevertheless true that in a vast majority of the sufferers from this disease the mind is rapidly and seriously damaged by the recurrence of the seizures which are characteristic of it. Epilepsy, indeed, is one of the most prolific causes of insanity in this country, and fills our lunatic asylums with patients of a dangerous and intractable class. It would not, perhaps, be going too far to say that it invariably exerts a prejudicial influence on the minds of those who are afflicted by it, and that the statements which have been made to the contrary have arisen out of imperfect observation. Unfortunately, we have as yet no test types by which to gauge the scope and accuracy of the ‘mind's eye,’ and hence serious impairment in its range and precision of action may readily exist without detection. Apprehension may be dimmed, judgment confused, and memory shortened, while no suspicion of mental failure has occurred to the patient or his friends. Then, again, modifications of disposition and temper are apt to be attributed to outward circumstances rather than inward derangements, so that when essentially morbid in origin they may fail to be recognised as such. Hence it is, I think, that epilepsy has often been credited with a blamelessness to which it has no just pretension. Its evil effects have not been found out, or have been traced to some other source, and it has been concluded that epilepsy may co-exist throughout life with perfect intellectual and moral integrity. Nay, some authors have gone further than this, and have written of epilepsy as if it were a thing to be desired, and, like the goitre of the Roman ladies, added a new charm to its victims. Falret says that epileptics sometimes evince real intellectual activity, and a rapid circulation of ideas, which corresponds to a certain degree of cerebral excitement. A roll of eminent epileptics has been drawn up, including the names of Cæsar, Mahomet, Napoleon, and Molière, and a connection has even been suggested between fits and genius. Dr. Morel has referred to a marvellous quickness of conception and imaginative intensity as distinctive of the epileptic condition in some persons. Surely, however, such qualities are not to be regarded as the fruits of epilepsy, but rather as characteristic growths of that kind of soil in which the pernicious plant is most likely to take root and flourish. Surely the fact—if it is one—that some great men have suffered from epilepsy in peculiar forms does not establish any causal relation between epilepsy and greatness, for how much greater might they not have been but for epileptic limitations? And surely the wild whirl of epileptic excitement is not to be confounded with the well-ordered evolutions of genuine intellectual activity. The experience of those who have seen most of epilepsy, will, I believe, confirm the assertion that no good thing can come out of it, and that it entails a blight and a blemish upon the mind of everyone who is affected by it. It robs the brain of its cunning; it strips the mind of its ornaments, of its garments of delicacy and gracefulness, and reduces it to savage rudeness and unrestrained movement. And then it wraps round it its own strong web of disease, fold after fold, layer after layer, more and more confining it, and becoming at last its inevitable cerement. Esquirol has ably summed up the effects of epilepsy on a man's physical and psychical nature. He has shown that it shortens life, deranges nutrition, that it degrades the mental faculties, and that it undermines rectitude of character, and disposes to suicide, violence, falsehood, venery, and onanism.