2 London Med. Gazette, 1851, xlviii. 534-540.
3 Am. Journ. of the Med. Sciences, 1870, N. S. lix. 278.
In rare cases the administration of anæsthetics is followed by epilepsy, and Gowers alludes to a case in which convulsions were due to the inhalation of nitrous oxide gas.
Concussion of the brain as the result of railroad injury or falls may give rise to a progressive epilepsy which is usually of serious character.
Reflex causes play a prominent part in many instances, though I am inclined to think that their importance has been greatly exaggerated. This is especially true of so-called uterine epilepsy. It cannot be doubted that difficult menstruation, ovarian neuralgia, etc. are found in connection with epilepsy, but whether as a cause or effect it is not always possible to say. The fact that in some women we find accès at periods identical with menstruation would point to a very close relationship. Carstens4 reports a case due undoubtedly to stenosis of the cervix; Cohen,5 an example in which there was a uterine fibroid; and others have spoken of erosion of the cervix, etc. as possible explanation of the seizure.
4 Detroit Lancet (8), 1880, N. S. iii. 153.
5 Wochenschrift f. d. ges. Heilkunde, Berlin, 1839, vii. 648, 673.
The toxic forms of epilepsy hardly need discussion in this article. Metallic poisoning, which gives rise to a veritable plumbic encephalopathy, is rather the cause of a symptomatic than generic epilepsy. Curious cases of epilepsies which have followed the use of oil of tansy (Mitchell6), ergot, absinthe (Magnan7), and various drugs show that occasionally their mode of origin may explain the convulsive seizure. Alcoholic epilepsy I do not regard as being the rare affection some authors consider it. In cases of prolonged saturation, where perhaps there are no other symptoms of chronic alcoholism, I have found it perhaps associated with the trance state (cataleptoid) or appearing in the psychic form.
6 Cincinnati Lancet and Clinic, 1881, N. S. vi. 479.
7 Recherches sur les Centres nerveux, Paris, 1876.