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when we realize that convulsions are far nearer normal than the stormy nature of their presence would lead us to believe.

But we will not wonder so much at this if we go just a step further, and briefly study the mechanism of the fit itself. We assume that all manifestations witnessed during a convulsion appear as a result of a sudden liberation of nerve force somewhere in the brain. It is not often that a seizure occurs without involving, sooner or later, the motor cells of the cortex of the brain ; and, as a rule, these cells constitute the seat of the discharging lesion more frequently than any other. We go a little further, and are led to believe that the discharge in the motor cells of the cortex takes place as the result of defective inhibitory action on the part of the sensory cells underlying the cortical layers. Just why these sensory cells partially or wholly lose control periodically over the action of the motor cells above has not been explained; but, like the stigmata of degeneration, the forces of inhibition may have suffered from lack of completion in the original creation.

The epileptic, therefore, is not only often congenitally weak, but is peculiarly liable to acquire a very generally marked condition of feeble health. All this being true, the need of the highest possible degree of physical health that can be attained through proper and continuous exercise and means of development is all the more forcibly demanded; and, in seeking to bring this about, we should not for a moment forget the one fact important above all others in developmental training in the restoration of health. And that is that the very exercise that strengthens and develops the muscles of the arms and legs, or, indeed, any other part of the body, will just as surely strengthen and develop the areas or centres in the brain that control these outlying parts.

Theoretically and without any violence to the teachings of physiology, we should be able, under proper given conditions, to take a young and healthy body, and train it up to the highest possible standard of physical health.

We need only to remember that with the young nervous system anything is possible, and that, roughly speaking, the plasticity of the nerve-cells declines in proportion to their age. It is this fact that makes early education so important.

The system of developmental training, the training that carries with it co-equally all parts and functions of the body, and that brings with it perfect physical health, is so elaborate in its construction that it can be only touched on in this paper. Its first

principle lies in the recognition of co-equal development. The rest is a matter of method and detail. Co-equal development means that all of the functions and special sense faculties of the body shall share, in proportionate degree, in the processes of education and development. Muscular development should go hand in hand, and keep equal pace with the growth and expansion of the brain; and the brain should not be forced to work under forced draught while the muscular system is permitted to atrophy through habitual inaction. Inaction means atrophy, and atrophy is closely allied to disease.

Many vocations call for the habitual use of a given set of muscles or for brain-work along sharply circumscribed lines; and the individual called on to do such work will in time be overdeveloped, as far as health is concerned, in one direction and suffer from lack of development in another. The tendencies of the times are toward specialisms; and the laws of progress demand not only the survival of the fittest, but the fullest development of specialized faculties. But it is not healthy, and the wreckage of health that follows the practice is becoming greater all the while.

When we come to the employment of means for the promotion of health for the epileptic, we do not need to use any system different from that we would use to strengthen and develop a normal individual. But with the epileptic we must begin earlier in point of age, work harder, and in the end be satisfied to have accomplished less.

And by no means should we fall into the disastrous error of taking a fatalistic view of the case ; for, in spite of all his deficiencies, his abnormally low standard of physical health, his ingrained inertia, his too frequently perverted moral sense, I know of no class of sick or defective dependents for whom more can be done than for the epileptic.

Under proper measures, almost miraculous changes can be made in his condition, and that, too, through influences devoted solely to building him up physically. As to the best methods of doing this I can only briefly indicate in this paper, but I hope brevity will not contract the expansive horizon of the lesson it teaches.

Recognizing to the fullest extent the great value of a high grade of physical health for the development and cure of the epileptic, I declare to this Association that it is my belief that the solution of the problem will be found to be largely solved when we come to recognize to the fullest extent the great value of industrial education for this class.

Hidden in the mazes of its great diversity of forms, all of which contain the possibilities of physiological and moral regeneration, lie, almost wholly to this time unrevealed, potential influences destined to work untold good, under proper seeking and cultivation by the dependent and delinquent classes.

The principle of labor was given prominence above all others, when the now famous colony for epileptics at Bielefeld, Germany, was founded thirty years ago, and it has been kept foremost on the list of remedial agents to this day. We recognize its value at the Craig Colony for epileptics, because we have fully tested it and in no instance found it wanting. As yet our system of industrial education is incomplete; indeed, far from perfect; but it is growing, and it is our aim to extend it for both sexes, as far as it is possible to go.

We have found that labor, properly and systematically performed, is a moral and regenerative agent of untold value. And why? Simply because it brings about a physiological and healthy growth of the entire organism.

We believe in labor, the kind that quickens the pulse and brightens the eye, that sends currents of pure blood sweeping throughout the entire vascular system ; the kind that brings normal fatigue and induces sweet sleep; the labor that has a place in the world of economics, and the kind that eventually conquers all things, even the perverted tendencies of a degenerate ancestry. The value of systematic labor for the epileptic is but little appreciated. It has curative powers not lacking for proof.

I would not be understood as saying that work will cure all cases of epilepsy, for nothing could be more absurd than such a statement. But I make the assertion, and can demonstrate it to the entire satisfaction of the most sceptical, that the healthy physiological activity necessary in systematic labor acts as a normal avenue of escape for the accumulated energy that would otherwise expend itself in a convulsion.

I could cite a score of cases in support of this assertion,- cases in which the connection between fits and no work and no fits and work is so patent as to leave possible but one deduction.

V. S., male, age 26, was admitted to the Colony Feb. 5, 1896. He had been an epileptic for eighteen years. Twice previously he had been discharged from State hospitals as incurable, hopeless. For five years prior to his admission to the Colony he averaged from three to five seizures a day. During his first

month at the Colony he had 110 seizures; during the second, 98 seizures; during the third, 3 seizures ; during the fourth, o seizures; during the fifth, i seizure, and that was brought on through excitement caused by his going away from the Colony over night; and for fifteen months now he has not had a seizure. He has learned the printer's trade at the Colony, and is now doing most of the printing required by the Colony. When admitted, he was emaciated and weak, and had to be supported to his meals by two persons.

We got him out of doors for a little exercise daily, and he had a generous diet of proper food. When potato-planting commenced, and just as soon as he could get about, he was put in the field with a bag of potatoes over his shoulder, and required to work an increasing length of time each day. He had medicines, of course ; but they had no more effect on him than they had during the previous years of his disease.

There was only one reason why he improved under the new form of treatment. He was made to acquire, through labor, better physical health; and, when that came, the vulnerable points for attack on the part of his epilepsy were destroyed and the attacks ceased.

While this single case is reported, I might report fully a score where the value of labor has been none the less marked.

For the cure, development, and reform of the dependent and delinquent classes, I believe we must first elevate the standard of physical health of these classes; and this, I believe, can best be done through the medium of the wide diversity of industrial training that seems so full of promise, both from the standpoint of economy and from that yet more valuable, the physical and moral regeneration of an ever-increasing class.

3. THE HOME CARE OF EPILEPTIC CHILDREN.

BY EVERETT FLOOD, M.D., SUPERINTENDENT OF THE HOSPITAL

COTTAGES FOR CHILDREN, BALDWINVILLE, Mass.

[Read Wednesday morning. ]

I have departed a little from the plan of discussing influences within institution walls alone. The statistics offered are not exact, as the data now collecting are as yet immature ; but inquiry and observation have so far substantiated the deductions reached.

For treatment little more is done than to offer advice upon certain points, some portions well founded upon experience, and some of a more theoretical nature. The first question arising is the one as to what sort of spasmodic action shall be classed as epileptic.

Sufficient authorities agree that “convulsions in infancy are intimately connected with the epileptic diathesis" to make it warrantable for me to assume this position, especially as my own experience leads me to fully believe that epilepsy is more likely to occur in after years where the infant or child has been subject to convulsions.

In a very large number of cases the convulsions cease after appearing a limited number of times and during a very short period of the individual's early life. This happens in most cases without being due to medical treatment. It happens in some very poor and ignorant families, where the home care is of the most unintelligent kind; but it happens oftener in families where the child is surrounded with approximately hygienic conditions.

The occurrence of spasms or fits or convulsions in a given child in a family, while it is the cause of immediate commotion, really occasions very little apprehension in the ordinary family as to the future of the child. So many are solitary attacks that the parents always conclude that this one will be so.

About one in twelve children in several towns in Maine and Massachusetts have one or more fits in infancy or childhood from some cause undetermined.

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