It is also one of the most eminently characteristic, and at the same time terrible to witness, when it occurs in its severer forms. The fits are most varied as to occurrence; occasionally an individual has suffered from one paroxysm, and one only, the disease never again returning; in other cases, years have intervened. Frequently the interval is one of months, but again, daily fits, or even two or three times a day, are the rule in the worst cases.
The attack of epilepsy is for the most part sudden: the individual in the midst of some accustomed occupation, or whilst holding active communion with persons around, suddenly utters a loud cry and, if unsupported, falls to the ground; the eyes are staring or rolling, the head - or rather chin - is drawn towards the shoulders, the colour becomes dark or livid, the veins of the face are thrown into convulsive movement, there is froth on the mouth, whilst a chocking noise is often made in the throat. The limbs are also more or less convulsed, and the excretions are often expelled involuntarily. The tongue very often suffers from being bitten and the teeth have even been fractured during the fit.
Gradually these convulsive movements diminish, and the person awakes to consciousness with a heavy stupid look, or falls into a deep lethargic sleep which continues for some hours; but even when this is roused from there often remains slight temporary suspension of the activity of the mental functions.
The most troublesome class of epileptics are those who have become insane or insane individuals who show signs of epilepsy. In such patients the criminal propensities are strongly marked and they are often extremely dangerous about the period of an epileptic attack, being urged on to deeds of violence by a hardly controllable impulse.
At all times they are unreliable and as they may show little signs of aberration during the intervals between attacks they may be allowed to go abroad. It is to this class that many of the purposeless murders we hear of are due.
- Taken from Practical Medicine by Alexander Silver MA MD, published in 1874 by Henry Renshaw of London.