In the intervals of the attack, the general health of the patient is one of the most important points to be attended to. The strictest hygienic and dietetic rules should be observed, and all such causes as have been referred to as favouring the development of the disease should, as far as possible, be avoided. In the case of children, parents must be made to realize that epilepsy is a chronic disease, and that therefore the seizures must not be allowed to interfere unnecessarily with the child’s training. The patient must be treated as such only during the attack; between times, though being carefully watched, must be made to follow a child’s normal pursuits, and no distinction must be made from other children. The same applies to adults: it is far better for them to have some definite occupation, preferably one that keeps them in the open air. If such patients become irritable, then they should be placed under supervision. As regards those who cannot be looked after at home, colonies on a self-supporting basis have been tried, and where the supervision has been intelligent the success has been proved, a fairly high level of health and happiness being attained.
The various bromides are the only medical drugs that have produced any beneficial results. They require to be given in large doses which are carefully regulated for every individual patient, as the quantities required vary enormously. Children take far larger doses in proportion than adults. They are best given in a very diluted form, and after meals, to diminish the chances of gastric disturbance. Belladonna seems also to have some influence on the disease, and forms a useful addition; arsenic should also be prescribed at times, both as a tonic, and for the sake of the improvement it effects in those patients who develop a tendency to acne, which is one of the troublesome results of bromism. The administration of the bromides should be maintained until three years after the cessation of the fits. The occurrence of gastric pain, palpitations and loss of the palate reflex are indications to stop, or to decrease the quantity of the drug. In very severe cases opium may be required.
Surgical treatment for epilepsy is yet in its infancy, and it is too early to judge of its results. This does not apply, however, to cases of Jacksonian epilepsy, where a very large number have been operated on with marked benefit. Here the lesion of the brain is, in a very large percentage of the patients, caused by pressure from outside, from the presence of a tumour or a depressed fracture; the removal of the one, or the elevation of the other is the obvious procedure, and it is usually followed by the complete disappearance of the seizures.
EPILOGUE. The appendix or supplement to a literary work, and in particular to a drama in verse, is called an epilogue, from ἐπίλογος, the name given by the Greeks to the peroration of a speech. As we read in Shakespeare’s Midsummer Night’s Dream, the epilogue was generally treated as the apology for a play; it was a final appeal made to encourage the good-nature of the audiences, and to deprecate attack. The epilogue should form no part of the work to which it is attached, but should be independent of it; it should be treated as a sort of commentary. Sometimes it adds further information with regard to what has been left imperfectly concluded in the work itself. For instance, in the case of a play, the epilogue will occasionally tell us what became of the characters after the action closed; but this is irregular and unusual, and the epilogue is usually no more than a graceful way of dismissing the audience. Among the ancients the form was not cultivated, further than that the leader of the chorus or the last speaker advanced and said “Vos valete, et plaudite, cives”—“Good-bye, citizens, and we hope you are pleased.” Sometimes this formula was reduced to the one word, “Plaudite!” The epilogue as a literary species is almost entirely confined to England, and it does not occur in the earliest English plays. It is rare in Shakespeare, but Ben Jonson made it a particular feature of his drama, and may almost be said to have invented the tradition of its regular use. He employed the epilogue for two purposes, either to assert the merit of the play or to deprecate censure of its defects. In the former case, as in Cynthia’s Revels (1600), the actor went off, and immediately came on again saying:—
| “Gentles, be’t known to you, since I went in I am turned rhymer, and do thus begin:— The author (jealous how your sense doth take His travails) hath enjoined me to make Some short and ceremonious epilogue,”— |
and then explained to the audience what an extremely interesting play it had been. In the second case, when the author was less confident, his epilogue took a humbler form, as in the comedy of Volpone (1605), where the actor said:—
| “The seasoning of a play is the applause. Now, as the Fox be punished by the laws, He yet doth hope, there is no suffering due For any fact which he hath done ’gainst you. If there be, censure him; here he doubtful stands: If not, fare jovially and clap your hands.” |
Beaumont and Fletcher used the epilogue sparingly, but after their day it came more and more into vogue, and the form was almost invariably that which Ben Jonson had brought into fashion, namely, the short complete piece in heroic couplets. The hey-day of the epilogue, however, was the Restoration, and from 1660 to the decline of the drama in the reign of Queen Anne scarcely a play, serious or comic, was produced on the London stage without a prologue and an epilogue. These were almost always in verse, even if the play itself was in the roughest prose, and they were intended to impart a certain literary finish to the piece. These Restoration epilogues were often very elaborate essays or satires, and were by no means confined to the subject of the preceding play. They dealt with fashions, or politics, or criticism. The prologues and epilogues of Dryden are often brilliantly finished exercises in literary polemic. It became the custom for playwrights to ask their friends to write these poems for them, and the publishers would even come to a prominent poet and ask him to supply one for a fee. It gives us an idea of the seriousness with which the epilogue was treated that Dryden originally published his valuable “Defence of the Epilogue; or An Essay on the Dramatic Poetry of the Last Age” (1672) as a defence of the epilogue which he had written for The Conquest of Granada. In France the custom of reciting dramatic epilogues has never prevailed. French criticism gives the name to such adieux to the public, at the close of a non-dramatic work, as are reserved by La Fontaine for certain critical points in the “Fables.”
(E. G.)