The medicinal agents employed have been mainly such as are sedative, or tonic to the nervous system. Valerian was long extolled as a valuable remedy (Gohier, Delafond, Delwart), and this has been improved upon more lately by substituting valerianate of zinc. Belladonna and its alkaloid atropia have been strongly advocated (Tisserant, Bernard, Williams, Friedberger) and it has the recommendation that it causes vaso-motor contraction and tends to lessen cerebral congestion. Hyoscine or duboisine may be used as a substitute. Cyanide of iron has been lauded by Jourdier and Tabourin, as far superior to valerian. Of late years the nerve tonics, zinc compounds (oxide, sulphate, chloride) and silver salts (nitrate) and arsenic have been used, often with excellent results. Borax strongly recommended for man (1 to 1¾ drachm daily) by Pastena is worthy of a trial for dogs. It is given largely diluted in syrup to avoid gastric irritation.
Of all agents employed up to the present the bromides still claim a foremost place. They should be given in a large dose, on an empty stomach and at such a time as to occupy the system at the hour when the seizure is expected to recur. Thus for morning attacks the dose may be given at night, while for night attacks it may be given in the afternoon. Müller uses sodium bromide in the dog as least liable to disturb the stomach, while Peterson, for man, advises the potassium salt for the same reason. For man, McLane Hamilton advocates a combination of the sodium and ammonium salts, Eulenberg adds the potassium compound, while Berkley uses strontium bromide, and Bourneville camphor monobromide.
Given at night in full dose (30 grs. for dog) the bromides tend to secure a quiet sleep, with brain rest and recuperation. If beneficial they should be repeated daily until a cure or other sign of bromism appears. This may be somewhat checked by arsenic or chloral hydrate.
Wesley Mills finds potassium iodide useful in some dogs when bromides fail. Bromohydrate is advocated by Müller. Flechsig and others have had excellent results in man from the opium bromide treatment. Full doses of opium are given three times a day for six weeks, when they are replaced by full doses of bromides four times a day.
Improvement should be shown in the shortening of the convulsions and the lengthening of the intervals between them. Should the bromides fail in this, resort may be had to other treatment.
Toulouse, Clark and others find that privation of salt, in man, allows the bromine salt to replace the chlorine one in the tissues, and the hydrobromic acid the hydrochloric in the gastric juice, and in this way the bromine can be introduced safely in larger amount into the tissues and is longer retained, though given in half the doses.
A most important element in the treatment is a vegetable diet with or without milk, to obviate excessive production of uric acid. Anything which will disagree and produce gastric or intestinal fermentations with toxins must be carefully guarded against and these will differ in different individuals.
Stallions and other excitable males, and females may often be cured by castration. Patients should be very carefully guarded against all sources of excitement, reports of guns, sight of locomotives or automobiles, waving flags, instrumental music, sudden exposure to sunshine or other bright light, reflection from water, snow, or ice, the contrast of dark shadows, as of trees, alternating with bright light, etc. Dogs, becoming excited at a show, may have a convulsion if not removed, and much more so in presence of another dog in a fit.
A surgical operation often places the disease in abeyance for many months, but, unless in the case of the removal of a diseased organ which has acted as a factor, this is not permanent. Hence in man transient benefit has been secured from operations on the eyes, the brain, the testicles, the ovaries, etc. In local (Jacksonian) epilepsy, which can be traced to a definite cortical area in the brain, the trephining of the skull and the excision of the cortex at that point, has given temporary relief, with a local palsy, but too often the irritation from the resulting cicatrix has in time aroused the disorder anew. Even independently of the removal of the cortex, the trephining has been successfully resorted to, by savage as well as civilized peoples, securing a temporary relief. Though not in practice in veterinary medicine it seems as if this were even more applicable than in man. It would be fully justified if it preserved for a year or more an animal in usefulness which must otherwise be destroyed, even if the disease should return at the end of this time.
Plunge or douche baths (60° to 70° F.) and rubbing dry will often tone up the nervous system, and a course of bitters, or iron, or both, may prove valuable. An outdoor life and moderate muscular exercise are important.