ANTONIUS GUAINERIUS ON EPILEPSY* By WILLIAM G. LENNOX, M.D.

BOSTON

nfortu nately , infor- chamberlain, Andrea de Birago. The mation about Antonius Gu- work on pests and poisons was com- ainerius (Antonio Guaineri) posed about 1440, since in that year a is very scanty. We know copy was made by Nicolaus Ofhuys of that he lectured in the UniversityAmsterdam. of There is a suggestion of his UPavia near the beginning of the fifteenth interest in politics in the fact that in his century. As with many historical frag- preface to his tract on pests he appeals ments, certain small details have been to the duke of Milan to save “our perfectly preserved, whereas the facts Liguria.” usually important, such as dates of birth These medical writings give no in- and death, honors and nonprofessional formation about Guainerius as a man. activities, are absent. For example, One of his fifteenth century manuscripts Maiocchi (1) states that he lectured has the name of Theodori Guaynerii de at the University in the early after- Papia on the fly leaf and on the reverse noon in the year 1412-13, receiving for the statement that the work was com- this a total of one hundred and twenty posed by Antonius Guaynerius de florins. Thirty-six years later, in 1448, Papia, “my ancester” (genitor meus). he gave the lecture in medicine in the Therefore we may conclude that An- late afternoon, the salary having risen tonius was a family man. to three hundred florins with a prospect Neuburger (2) places the death of of receiving twenty-five more in the Guainerius about 1445, Sudhoff (3) in following year. In the same year a meet- 1440. Neither of these dates is com- ing was held at his house in Pavia for patible with the previous quotation the purpose of protesting against the from Maiocchi that Guainerius taught admission of a foreigner to the College in 1448. Since he was teaching thirty- of Arts and Medicine. Some time be- six years previously, he must not have tween the years 1413 and 1448, Gu- died young. ainerius must have taught at Chieri Thorndike (4), from whom these bio- and he apparently resided in Savoy and graphical notes have been taken, gives Liguria. At any rate, some of his medi- a list of the editions and manuscripts of cal works were addressed to Antonio the works of Guainerius. The A. C. Magliani of Chieri, who was physician Streeter Collection at the New York to the duke of Savoy. He sent his Academy of Medicine contains the edi- treatise on fevers to Magliani from tions of Pavia printed in 1481 and of Chambéry. Other treatises were ad- Venice printed in 1500. At the British dressed to Filippo Maria, who was the Museum there is the edition of Pavia of duke of Milan, and one to the ducal 1488. This is the same as that of 1481, * From the department of Neurology, Harvard Medical School, Boston, Massachusetts, aided by a grant from the Milton Fund of Harvard University. except that the name of the editor is lieves him somewhat more credulous different. In addition to the collected and superstitious than other medieval works, many of the chapters have been writers. Neuburger regards Guainerius’ printed separately; the one on fevers at writings on the pathology of the nerv- Naples in 1474, and the antidotarium ous system and on gynecology as his in 1472. In addition to the printed most valuable contributions. works, various manuscripts are to be The chapter on epilepsy contains found in some of the great libraries. nothing not found in writings which The Vatican Library contains four. antedated it by hundreds of years. It is, The edition of 1500, unlike that of however, characterized by clarity and a 1481, has numbered leaves and consists minimum of (to us) meaningless hu- of 141 pages. Following are the titles mors. The discussion of organotherapy, of the sections: diseases of the head, or at any rate the parts of animals suita- pleurisy, stomach complaints, intestinal ble for treatment of seizures, is unusu- disorders, diseases of women, diseases of ally well organized. Faithful to Galen, the joints, calculus, on pests, fevers, on the human skull is recommended but the baths of Montferrat, antidotarium. prescriptions for the most part consist The section “De egritudinibus capi- of harmless herbs. Anthony in this chap- tis” consists of 27 folio pages. The chap- ter refers to only seven authorities, ter on epilepsy occurs in this. The trans- Galen, Rhazes, Avicenna, Hippocrates, lation which follows was taken from Serapion, Mesue and Thessalus. Amu- the 1488 edition. This translation is the lets and charms are recommended, but work of Father Adrian P. English, O. P., without much conviction. His practice Professor of History at Providence Col- of giving an odd number of pills, of lege. Mr. James F. Ballard, director of fighting poison with poison, and his the Boston Medical Library, was of practical psychotherapy illuminate med- great assistance. icine as practiced in the Dark Ages. Thorndike viewed the medical writ- ings of Guainerius against his own in- Anth ony Guai neri us terest in magic and the development of Opera Medica. Pavia, Carchavo, 1488. medicine as an experimental science. Tract 7, Epilepsy . In 8 Chapters He believes Guainerius has an attitude Chapter 1. what epi leps y is . its of independence towards earlier writers and gives his own interpretation of what CAUSES. WHERE IT OCCURS the ancients meant. He quotes widely Only as correlatives do sleep and wak- from authorities such as Arnold of Vil- ing appear to have an affinity with each lanova, Simon of Genoa, Taddeo Al- other. Wherefore many would think it cerotti of Florence, Gerard of Cremona, reasonable that after the ailments which Albertus Magnus and Avicenna. He occur in sleep or from sleep, they speaks highly of two of his teachers who should set waking, which was done. But were in the University of Pavia at the between coma, incubus, and epilepsy, in beginning of the fifteenth century. He their causes and cures, I find a much was obviously a religious man and fre- closer connection than between sleep quently interrupts his medical dis- and waking. For this reason I have de- course to address Christ and the Virgin. voted the present tract to epilepsy. He has faith in the relics of saints and Later I shall treat of waking, in its in the virtue of gems. Thorndike be- proper place. Epilepsy is a disease very much dis- that in his paroxysms he always saw cussed everywhere, for it dwells among wonderful things, which he most ar- all nations, and more familiarly than dently desired to set down in writing, they would like; wherefore it is known for he hoped they would certainly come by various names, epilepsy, hieranoson, in the future.3 Wherefore the ancients divination, Hercules’ disease, or herac- called this disease “divination.” lea pedicon, the comitial disease, the It is also called “Hercules’ disease,” lunatic disease, and the mother of chil- because it was the ailment of the great dren. It is called epilepsy from “epi,” Hercules, and he suffered from it, as above, and “lesis,” lesion, as an injury the poets tell us. And because this dis- of the upper parts, that is, the head.1 ease very often attacks children, it was Wherefore some hold that epilepsy is called pedicon by some, from the Greek named from the oppressing of the mind paidos, the Latin puer, boy. Or, as and sensation, and when these are im- seemed better to others, from the dis- peded, the body is hindered in its op- ordered movements of the feet (pedes), erations. For this reason also, some call which commonly accompany this dis- it “hieranoson.” Older authors inter- ease. It is called the “comitial disease” preted this as the “sacred disease,” for, from comitia, assembly. Comitia were since they placed the activities of the assemblies of the Roman populace in soul more in the brain than in any other the Campus Martius on the first day of member, they called the brain the January for the purpose of electing “temple of the soul.” And since tem- magistrates for the year. If this disease ples are commonly sacred, they called attacked any one there, the assembly the brain a “sacred” place, wherefore was adjourned to another day. And so they called the disease “hieranoson.”2 it was called the “comitial disease.” It It is called by some “divination,” as the is also called the “falling disease,” be- wise Serapion says, because they thought cause whomever it attacks it causes to the cause came from the devil. But, with fall. It is called the “lunatic disease,” all respect to Serapion, that was not the because it advances according to the meaning; rather, it was called “divina- various phases of the moon. And it is tion” because in epilepsy, in which called the “mother of children” because there is violent occlusion, all the ex- it attacks children more often than all ternal senses were so bound that they others. All that has been said bears on were impeded from almost all opera- that disease called epilepsy by the tions. Whence, the rational soul, not authors. So much for the name. being otherwise impeded, remained, so Now we must investigate what epi- to speak, in its purely natural state, in lepsy is. Whence Galen, in his “On which, it sometimes happens that the Internal Diseases,” chapter 4, and in the soul apprehends future things; and little work, “On Helps for Breathing,” when the paroxysm is removed, very also Avicenna, Canon 1, Fen 3, in the often patients predict future events. appropriate chapter, and very many Whence the uneducated masses, not other authors agree in this, that the knowing the cause, thought this was disease comes chiefly in the fore part of done by the power of the devil, and for the head, although other parts of the this reason some of the ancient authors brain are said to be involved because of called it “divination.” I myself have their connection. Otherwise all who seen a certain choleric youth who said suffer this disease would remember their paroxysm.4 But the opposite hap- not all members are thus deprived. pens in many cases. It comes therefore, From what has been said it is evident to a good mind from a vapor, humor, that vapor, windiness or humors par- or wind; for, windiness either being ticipating in a certain poison are the generated in the brain, or coming immediate cause of epilepsy. Galen, thither from elsewhere, if there is Rliazes, and Avicenna, confirming this joined to it some poisonous quality, opinion, think that epilepsy cannot strikes the brain; whereupon, the brain come save from some intervening windi- perceiving the injury contracts. At this ness. They prove this by dissected sheep contraction, the things which spring who have suffered this disease, for in from the brain, namely the nerves, con- their heads there is always found a poi- tract also, and when the nerves are sonous humidity if they are dissected at drawn back toward their source, a spasm the time when the paroxysm strikes is produced.5 In this spasm or contrac- them. But for a fuller explanation we tion of the nerves, there comes an oc- must pass to an examination of the clusion in the breath-passages. On this causes of particular epilepsy. account the breath is unable to pass to These causes can be both intrinsic the various members, they are deprived and extrinsic. Some of the extrinsic of sensation and motion; and so the causes occur inevitably, some not. Those patient falls. But if the disease comes which occur inevitably are six non- from humors, there is first caused an oc- natural things, such as excessive air, clusion which prevents the passage of coldness, great fear, unduly prolonged the sensory and motor impulses to the sleep, excessive rest, excessive repletion various members; then comes the con- with, or improper taking of, food and traction or spasm, for when these hu- drink.6 mors are received in the folds of the Those things which can avoidably brain, the latter distend sidewise and occur are, briefly, everything surpassing contract lengthwise; wherefore they are sensibility, and able to destroy the perforce contracted. Out of this grows sense, such as things of a horrible aspect, the spasm. things whirled about and the like; ter- From this it is clear that in the first rifying sounds, as of thunder; foul at- case the spasm comes first, then the oc- mosphere, or the smelling of such clusion; in the second case the occlusion things as have the property of inducing comes first, then the spasm. Yet in epi- epilepsy, such as the smell of garlic, the lepsy there is never a total occlusion, for horn of a she-goat, fumes of certain then all members would lack both sen- fungi, and many other things. Many sation and motion, but that is the op- things which can be tasted and touched posite of what we observe. produce the same effect. From the foregoing it is manifest As to the intrinsic causes, they can what epilepsy is, namely a disease of come indifferently from any humor; the brain, coming from humidity, more frequently from phlegm, least vapors, or windiness, all of them par- often from choler. By reason of the place taking of a certain poison; at the advent wherein they come, they receive a three- of their cause it is contracted upon it- fold name. When epilepsy comes from self, and an occlusion from sensation a cause existing in the brain it is epi- and motion is made along the paths of lepsy; from a cause in the stomach, ana- the sensory and motor spirits, although lepsy; from other members, catalepsy. Whence Galen says, “On Internal Dis- however, in which the paroxysms so eases,” Book 3, chapter 7, that a certain agree with those of epilepsy, that one vapor arose from the big toe of a body can hardly distinguish them, such as who, when the vapor reached his brain, lethargy, coma, apoplexy, stupor, syn- fell into a paroxysm, the cause of which cope, and hysteria. It remains for us to was the vapor’s being resolved by poi- see the difference between them and sonous matter. In some members there epilepsy. Lethargy and coma differ from often occurs an occlusion, the cause of epilepsy because in them there is no which was transpiration. No breath can spasm, where in epilepsy there is a reach that humor, wherefore it is cor- spasm. If a lethargic or comatic be rupted and putrefies, and from it a watched, and permitted to sleep, he falls vapor being then elevated, ascends to again into a deep sleep, but an epileptic, the brain along those passages by which never. Also, in epilepsy there comes a the breath reaches the members; and foam at the mouth, but not in lethargy striking the brain with that poison, in- or coma. duces epilepsy. And so epilepsy can Apoplexy differs from epilepsy be- occur in any member in which a cor- cause in the former sensation and mo- rupt, and especially a poisonous, humor tion are entirely taken away, but not in is found, such as putrefied phlegm. And epilepsy. Therefore some authors call from this fact, that worms are in the apoplexy a violent epilepsy. I have seen intestines or elsewhere, other worms certain epileptics die whose last parox- are generated. And from corrupted ysm was one of apoplexy. Epilepsy is semen in both women and men epi- also a paroxysmal disease, but not apo- lepsy often occurs. I believe this hap- plexy. pened more often in Galen’s day You may distinguish epilepsy from than in ours, because the women syncope because an epileptic has a liv- and men of our day take as great care ing voice, whereas a syncopetic has a as possible not to fall into this danger dead voice. Also, syncope does not come by wearing a hair-shirt, by sleeping on suddenly, epilepsy always does. Epilepsy the bare ground, by eating rough herbs, differs from hysteria because an hysteric and so much do they [....] that they very often bends at the knees, but an never fear to incur this danger. But do epileptic does not. An hysteric, although not trust too much in such repressions, he cannot respond, yet understands, and because as a general rule it is better for after the paroxysm remembers every- such seed to germinate in nature’s fields thing that happened during it. You, than to allow it to become corrupted. who desire to practice this art with Pregnant women, because they retain honor, keep these things in mind, and corrupted matter, incur epilepsy, and thus you will easily come into knowl- their labor over, they are delivered from edge. it. Now it remains to describe the signs of the paroxysm of epilepsy, which are Chapter 2. sig ns indi cati ng epilep sy that most frequently the paroxysm Now we treat of the signs, which are comes suddenly, the patient loses sensa- of two kinds, indicative and prognostic. tion and reason, he is tortured, he Of the indicative signs, some are taken twitches in spasm, he foams at the from the paroxysm, some from the pe- mouth; sometimes he urinates, defe- riod of quiet. There are many diseases, cates, and sometimes suffers a pollu- tion. When all or many of these signs that rarely happens. For, choler opens appear, do not doubt that the man is because of its heat, and occludes by its suffering epilepsy. But because it can subtlety; it penetrates easily and closes come from some member or humor, the passage for the breath. For these indifferently, as has been said, we must reasons epilepsy rarely comes from first understand the signs of the offend- choler, but if the cause should be there, ing humor, second, the member in the signs described will indicate the fact which this disease is seated. This can to you. best be done during the time of quiet. Thus the signs of the simple humors If phlegm should be the cause, as hap- which can induce epilepsy have been pens most often, the paroxysm will be described. But if the humors be mixed lengthy, the foam coarse and white; but up, then the signs also will be mixed. you must also consider his age, com- For it happens, both in diseases which plexion, preceding routine, the season have been mentioned, and in those still of the year, and such things; if these to be described, that it is easier for those attest phlegm, then you will be certain. who desire, to describe the signs of the You will be all the more certain if the offending humor than to study them, urine be weak in color, thick like lique- wheretofore I pass them over quickly. fied glass, and a sediment remains; if Now the place whence epilepsy comes the pulse be weak and irregular, and is to be investigated. If it comes from after the paroxysm the patient remains the head, the patient often suffers heavi- as if stupefied. But if the foam tends to ness in the head, vertigo, scotoma, be yellow, and there is a ruddiness in darkening of vision, and other diseases. his face, the saliva in his mouth be- In this case he does not feel in advance comes sweet, the veins in his forehead the coming of the disease. If it comes fill up, his urine is coarse and ruddy, from the stomach, he suffers pain, pulse full, and his age, preceding rou- nausea, and other ailments of the stom- tine, etc. conduce to blood, and if, with ach. Before he is attacked by the parox- this, after the paroxysm the sick man ysm, he feels a disturbance in the stom- remains with a certain foolish grin, you ach, with which it frequently happens will have no doubt that the cause is that he comes down during the parox- blood. If the foam be moderate, the pa- ysm. If the disease be from the womb, tient livid in countenance, the urine the woman very frequently complains thin and clear, the pulse strong, and of pain in the womb, and sometimes with all this his age, complexion, pre- urinates. If it be from the spleen, the ceding routine, etc. agree, and after the patient often feels pain in the right side, paroxysm he remains melancholic, then and if it be from the liver, other ail- it is certain that the disease comes from ments of the liver have preceded. If it melancholy. When the paroxysm is be from the bowels, pains there often slight, the foam yellow, his face, age, have gone before, and the patient often complexion, preceding diet, and the defecates during the paroxsym. If it be like argue for choler, and if the urine from worms, signs of the worms will be tends to a certain fiery color, the pulse present. All of these things will be evi- is rapid and strong, along with which, dent to you in their proper place. If it during the period of quiet the sick man be from the kidneys, disease of these remains contentious and maniacal, such will have preceded, and during the epilepsy comes from choler, although paroxysm the patient suffers a pollu- tion. From all of the foregoing it is clear sick man falls, foams at the mouth, the how easily you can discover, during the paroxysm seizes him frequently, and it period of quiet, both the seat and the is prolonged. After it, he is timid, half- cause of the epilepsy. dead, and remains very sad. He remem- bers nothing about falling into the Chapter 3. pro gn os tic si gns of epi - paroxysm, and is not ashamed. Moder- lep sy , THAT IS, THOSE WHICH AN- ate epilepsy has some resemblance to NOUNCE FUTURE EPILEPSY. THE this second type. But epilepsy, however OUTCOME OF THE PAROXYSM light, is cured only with difficulty. Something must now be said about In order that you may know how to the prognostic signs of epilepsy. Those predict anything, you must know cer- which, on the part of the head, indicate tain things. And first, the place; for that a coming epilepsy are various sleeps, which occurs in the brain is more diffi- especially if there is a sound of water cult to cure than that which occurs in during sleep; if drowsiness, scotoma, any other member. Yet if the patient’s incubus, heaviness of the head, darken- head has appeared white, it is a good ing of the eyes, yellowness or greenness sign, and possibly curable. With respect of the veins of the tongue or the like in- to his age, the older he is the more diffi- duce somnolence, they threaten future cult is the cure. Wherefore, after the epilepsy. From the stomach, if one ac- twenty-fifth year epilepsy which comes customed to suffer epilepsy feels a trem- from a defect in the brain is very rarely bling or shaking in the orifice of the cured, as Hippocrates said. And if one stomach, and particularly when he is a takes a cure in youth, it is more easily youth, fear future epilepsy. If, along done than in old age. But if one be epi- with these, scotoma or vertigo seize leptic from infancy, and has passed his him, that is itself a paroxysm. As for twenty-fifth year still with epilepsy, he other members, when you see that the is never cured. Also, if women are epi- patient has an ailing member, then, if leptic before the first menstruation, and you can, assist the sick man, for epilepsy are not cured by the first discharge, is near. If the epileptics suffer hemor- afterwards they will never be cured. rhoids or (excessive) menstrual flow, This can be gathered from the sense of and these are retained longer than the Aphorism in Particula 3 (N.B.—of usual, epilepsy will come in a short Galen’s “Tegni”) “Pueris plurime pas- time. All of these things mentioned in- siones, etc.” The same thing can be dicate a future cause. said about the difficulty of the cure in But other prognostications remain. regard to complexion, season of the To explain them, it must be recognized year, climate, and the like. The more that epilepsy is three-fold, light, vio- these things approach to a state of hot- lent, and moderate. Light epilepsy is ness, other things being equal, the more that which is felt in advance, which does easily does the patient receive a cure. not compel the sick man to fall; he does In regard to the cause and matter not foam at the mouth, and the parox- which comes from humors, as well as ysm holds him but a short time, because from windiness or vapors, the cure is it comes rarely. After it is over, the pa- more difficult; and with respect to hu- tient is joyful and remembers every- mors, the most difficult is that which thing. Violent epilepsy, on the contrary, comes from phlegm. In some of the is that which is not felt in advance; the items mentioned, other things are equally to be considered. With respect vent the ascent of vapors, and as far as to the paroxysm, when a minor disease possible, to draw the matter down- is present, epilepsy is that much the wards. Therefore perform vigorous rub- weaker, for it indicates a greater occlu- bings or painful ligatures on the ex- sion and greater lesion. If a trembling tremities, on the buttocks; under the occurs, and the paroxysm is prolonged, knee make a slight incision with a it quickly kills the patient. Likewise, if cupping-glass; and call the patient in a the patient suddenly falls with a loud loud voice by his own name. If the outcry, if his members are tortured, his paroxysm cannot be broken by these mouth foams, if he urinates and defe- means, or if it is too long, as was that cates, he will rarely come out of that of the youth who was held by a parox- paroxysm. Also, children who contract ysm for seven hours, immediately apply epilepsy while still in the womb very this clister: R mallos, blitis, chamomile, rarely escape, either because they were stiche, lesser centaurea, of each, 1 conceived from infected blood, or be- minim; polypody, cardamom, each 1/9 cause of the constellation, or because oz; common oil, 3 oz; a little salt, and they have acquired this tendency in the make the clyster. After this has been womb through the eating of garlic or discharged, hold fresh rue, rubbed be- something else. But those on whose tween the hands, at the patient’s nos- heads or jaws or nose scabs or ulcers are trils, or inject its juice into the nostrils. formed, from which many mucus dis- Place a wooden peg between his teeth; charges run, with watery discharges then with fumes of balsam rub his from the mouth, seldom incur epilepsy. palate, his nostrils, and the veins puls- Violent epilepsy which comes from ing at his temples. These things usually phlegm existing in the body often ends drive away the paroxysm at once, and in paralysis. If it comes from some retard it greatly, as I have learned by coarse humor, like melancholy, the pa- experience. If you do not have any tient becomes melancholic. Since many balsam, rub his palate and tongue with are cured before their twenty-fifth year, mithridate, or theriaca, or juice of rue. after that only some, if you would be If, after these things, the patient is un- prepared to know whether a patient is able to rise, provoke a vigorous sneezing wholly cured, rub fresh garlic between with pepper, white hellebore, or some- your hands, then hold it for a time to thing else; but never do this at the out- the patient’s nose; or suffumigate the set, lest from that violent motion, the epileptic with fumes from a goat’s horn; matter escape upward. Some say that if or place the dust of the horn in the pa- you utter three times into the ear of the tient’s nostrils, or let him smell a goat’s patient “Gaspar bears the myrrh, Mel- liver. If the epileptic does not fall on chior the frankincense, Balthasar the account of any of them, he will be gold,” the epileptic will arise immedi- wholly cured.7 ately. Or say thrice, “Let us pray. In- structed by Thy saving precepts” etc., Chapter 4. on the cur e of the with the whole Lord’s Prayer. PAROXYSM OF EPILEPSY Coming to sacred medicines, some The cure of epilepsy is two-fold; one say that if blood be extracted from the regards the paroxysm, the other the ear, and the patient anointed with it, period of quiet. If a paroxysm comes to he will soon arise from the paroxysm. an epileptic, let it be your aim to pre- If he remains stupid for a long time, three drams of the blood should be receive it, and, other things being equal, given to him to drink, and afterwards the better result is attained than if the he will never fall. There is, however, patient did not receive it with that af- some discrepancy among authors as to fection. Hence it is that we perform so the place of extraction, because some many ceremonies in medicine. For we hold that it should be, not from the ear, offer pills in unequal number, since the but from the big toe of the right foot. ignorant think that that number is Also, when an epileptic falls, at once much more perfect than an equal num- kill a dog, and give the gall to the pa- ber; whence, many people, if they tient in any way that you can. If the should take six pills of one dram each, one who first sees the attack urinates would think them of no efficiency, be- in his own shoe and then stirs it around, cause they believe that one pill of the as if to wash it, then gives the urine to same weight would do much better the patient to drink, afterwards the pa- work than six. Therefore all diseases tient will be entirely delivered.8 Some partaking of poison are cured much bet- cut a frog through the back, extract the ter by such things than otherwise, al- gall, wrap it in a cabbage-leaf, dry it, though it is not usual for us to omit make a powder, and with good wine some ceremonies.9 If I shall henceforth they give it to the patient; if he is not describe anything in this little work of cured the first time, they do the same mine after the manner of an old woman, thing when the paroxysm is coming on. do not, on that account, regard them Some men, thinking themselves to be as written by me, for even if, perchance, wise, wonder that the disease can be bewitchings should appear, yet nothing removed by the things described. Know, is set down without a reason which I however, that no poison is driven away shall give you from natural principles by cold or dryness or moisture alone; when there is need. Since this is the you must find in the repellent some function of a philosopher, it would be hidden counter-agent to the poison. pertinent to my little work to make it Since, therefore, epilepsy is produced by known. reason of something poisonous, the Chapter 5. on obs erv in g the ro utin e thing which expels it must possess some quality opposed to the poison, and OF THE SIX NON-NATURAL THINGS IN THE this can reside in the gall of a frog, the CURE OF EPILEPSY blood of a dog, or the urine of a man, In the preceding chapter I have made or something else. known to you what is to be done in a Many properties are present in paroxysm. It now remains to describe things, which as yet remain unknown to what should be done during the period us. But you will say, why put the first of quiet and what things root out a urine in [. . . .] why adduce these curable epilepsy, or at least mitigate ceremonies, viz., that the first one to the ravages of incurable epilepsy. The witness the attack should do this; why most serene Hippocrates says in the should not everybody do it? The an- Aphorism “Epilenticorum uero iuveni- swer is that this is done in order that, bus etc.” that changes in age, seasons, whatever the medicine be, greater con- places and routine are of very great help fidence be placed in it. The greater the in the cure of epileptics, from which affection with which a sick man takes the the curative object in this disease is medicine, the more eagerly does nature sufficiently clear. To come to practical things, since this disease comes from unusually; every day he should take phlegm more often than from any other care to have a movement of the bowels. humor, I shall begin with the cure of If nature does not effect this, he should that, starting with the routine of six make a clyster or a common suppository, non-natural things. or otherwise assist himself with the pills Make the air hot and dry, that the I shall describe later. patient may live in air which is free As to drink and wine, it is especially from smoke, wind, clouds, dust, foul prohibited in cerebral epilepsy; in place smells, the rays of sun and moon. The of it the authors recommend water, with patient should flee from sharp sounds, which hyssop and honey may be boiled. discordant and terrifying sounds, every In this disease hyssop is very strongly loud din. He should not look on recommended by Mesue, in the proper whirling things, or dancing; or deep chapter. Know also, that as Rhazes says, things, or those of great splendor, or too during a whole year an epileptic ought obscure. He should avoid all foul not to drink plain water. But if he smells; taste nothing of great bitterness; drinks wine, it should be weak, or very avoid everything that makes a swift and light, so that its strength will not injure sharp impression when touched. He the brain. For this purpose he ought should avoid sleep in the daytime; nor always, at the end of a meal, to eat some sleep in a rheumatic room; he should prepared corianders, which he should sleep with his head partly covered. His chew well; or take a little diachylon, supper should be light, after which he but after that drink nothing. These should delay in going to bed; after sup- things prevent the ascent of the fumes, per he should never drink anything. which is the object particularly sought He should avoid fear, sadness, anger, in such a case. Therefore Rhazes and and all disturbances of soul; also coitus, some of the ancients recommend the unless he be a robust youth accustomed mixing of grains of coriander with to it; he may have intercourse lest his bread, because, he says, they prevent semen be turned into poison by being the ascent of vapors. too long retained. I recommend to him The patient should avoid all aquatic as strongly as possible moderate exercise birds, flesh of pork, cattle, and the in- at proper times, but he must take care sides of all animals save the testicles of not to walk beside rivers nor dwell in a fowl, the livers and brains of hens. The place too near rivers. Rubbings before flesh of vultures and doves is by nature he arises are suitable, and these may also valuable when eaten; also the flesh of a be done lightly after he arises and his wolf, and of a pig or sow born alone, head is shaved, but he should not use a the flesh of wild boars, all things roasted circular motion in rubbing. The same on spits, and especially eggs. Fish also, may be done with the combing, for if, particularly eels and other oily fish he because of it, some disturbance occurs should avoid. But if he eats anything in the vapors, yet because of the open- from stones or woods or water com- ing of the pores the fumes escape more monly praised among us, it should not easily, and therefore more help than be roasted, especially in nut-oil, as is hindrance follows from such an agita- commonly done at the foot of the moun- tion. The patient should always live tains or across the mountains. He should soberly; he should entirely gratify his avoid everything made from pastry or hunger, neither should he eat nor drink cheese. He should avoid all milk save horse’s milk, which is said to have cura- the herb parsley the first flower of tive properties for epilepsy. He should Spring, and mistake St. Peter’s herb for avoid garlic, onions, scallions, cabbage, it. In place of the prescribed water, take and above all parsley which, not only six ounces of the following decoction: by being eaten, but the very sight of it hyssop, 1I/2 minims; herb parsley, induces epilepsy. Of fruits, the fig is thyme, epithyme, stiche, each, 1/2 suitable, but all others are to be minim; currants, 1 oz; make the decoc- avoided, especially walnuts and hazel- tion, and add the thyme and epithyme nuts; and if he eats a pear or apple at at the end. If you wish to make a syrupus the end of a meal to repress vapors, or magistralis: I£ hyssop, 11/g minims; rue, as a laxative, it should be balanced by origan, flowers of stiche, bettony, cala- eating anise. mint, sage, thyme, herb paralesy, each Thus you have the routine of the six 1/9 minim; root of iris, root of peony, non-natural things by which the nurse aristolochia rotunda, mistletoe, each 14 is to be governed if the epileptic be a oz; seed of physalis, 2 drams; currants, suckling child. 1 oz; make the decoction with 3 lbs. of honey, and 1 quart of vinegar of squill; Chapter 6. the mann er of dig esti ng make the syrup with nux moschata; give AND EVACUATING THE MATTER OF it an aroma with a little of the seed of EPILEPSY, OF WHATEVER SORT IT BE peony. Of this take three and a half I shall speak below of the medicines ounces, and with the prescribed water which are to be given to children. Com- and decoctions mix with from one dram ing now to adults, always keep in mind to 4 scruples of compound extract of that from whatever member epilepsy colocynth of Almansor’s prescription, comes, into all things that are taken and give to the patient. Or do it this internally remember to put something way: 1^ cinnamon, 2 drams; carpobal- which pertains to the brain, and which sam, crocus, spikenard, xylobalsam, may resist the poison. But do not forget Chinese cinnamon, rue, squinancy, the provoking member. To begin with peony seed, of each, 1 scruple; root of phlegmatic matter, first get rid of it bryony, l/g oz; colocynth, stiche, of each, thus: R squilled oxymel of Democritus’ 3 drams; agaric, 2 drams; turpeth, 1 prescription, 214 oz’ syrup of hyssop, 1 dram; diagrydium, 4 scruples; aloes, 2 oz; water of the herb parsley, 4 oz; drams; make pills with syrup of hyssop. water of hyssop, 2 oz; mix, and if you The dose is from 1 dram to 4 scruples, wish, clear it twice; give it an aroma by in a form to be drunk. R agaric 2 adding nux moschata and a little of the drams; sal gemme, 2 scruples; stiche, 1^ seed of peony. Note that the herb pars- dram; pour in water of milk, adding 1 ley is extremely helpful for epilepsy. oz; of squilled oxymel; twelve hours It is the herb which is found at dawn after the infusion, express it strongly, throughout the year and is called by the and give it to drink. In place of this you unlearned “St. Peter’s herb.” Some can give half an ounce of hieragolodion apothecaries mistake for the herb pars- tempered with hot wine; it is greatly ley a certain herb whose leaves are beneficial in this case. So also is hieraga- like those of callithrix. When, at the leni, into which colocynth is injected, beginning of spring, the latter first sends the dose of which is half a dram with forth its flowers, it is called by some the wine. first flower of Spring. Whence some call If it is desired to have an appropriate solutive confection: R agaric, 3 drams; hops, of each |4 minim; currants, 14 turpeth, 11/2 drams; diagrydium, sal oz; make the decoction, and use instead gemme, each 14 scruple; stiche, peony of those prescribed above. When the seed, each 2 scruples; root of iris, 14 oz; matter is digested, remove it: Alman- white sugar 3 oz; make the confection, sor’s compound extract of colocynth, and from it give 6 drams. When the pills of lapis lazuli, each 14 dram; and matter has been evacuated, on four suc- if you wish a potion, add 2 drams of cessive days, in the morning, with the agaric; after expressing, add 1 dram of stomach empty, make this capitipur- the confection of Hamech, and make gium: R marjoram, 1 f4 minims; rue, 1 the drink. After this is done, when there minim; boil in 114 quarts of water until is a capitipurgium or gargle do as di- a third is consumed; then take four rected above. drams; of the juice of iris-root, 14 oz> If the epilepsy comes from blood, and or of the juice of blitis, 1 oz; and make age and other details agree, first com- the capitipurgium. Or do it thus: IJ mand bleeding from the saphena, then juice of blitis, 1 oz; juice of rue, 14 oz; from the basilic vein, then in the veins honey, 6 oz; heat, and when it is luke- of the tongue, not all at the same time warm, make the capitipurgium; or but at different times. If there be a great make it from marjoram alone, or the surplus of blood, in the morning bleed juice of rue, or the dust of peony-root, from the saphena, in the evening or on or from one grain of mumia with water the next day from the cephalic vein, of marjoram. and three or four days after that from Some (authors) say that wolf’s gall in- the veins of the tongue. Where there is jected into the nostrils with musk at the not a great surplus of blood, phlebot- beginning of the month cures epilepsy. omy from the cephalic vein is sufficient. Or make this gargle: 5 hyssop, mar- Where there is something to prevent joram, stiche, calamint, each 14 minim; bleeding, and there is a large quantity peony-root, 14 oz; mustard seed, 1 oz; of blood, first, order cupping-glasses cook, and make a decoction, from which over the nostrils, then on the fingers, take six ounces, with two ounces of with a slight incision. If there is no squilled oxymel, mix, and make the great abundance of blood in the fingers, gargle. Or make this mastication: R the cupping-glasses alone are enough to pirethrum, 1 dram; mustard, 114 oz> evacuate sanguinary matter. sassafras, 1 dram; mix with wax, and When choler is the cause, it should make in the form and size of a hazel- be expelled with this: simple oxymel, nut. Or these can be made with only 2 oz; squilled oxymel, 114 oz» water of pirethrum, mastich, and wax. endive, 4 oz; water of hops, 2 oz; pre- If melancholy be the cause, expel it pare it for two doses. Remember that with this: R squilled oxymel, 2 oz; the squilled oxymel prescribed in the syrup of fumitory, 114 oz; water of cure of epilepsy is that which is made bugloss, water of absinthe, water of according to the prescription of Democ- fumitory, each 2 oz; aromatize with nux ritus. When the matter is expelled, moschata and a little of the seed of give one dram of aggregative pills, or peony, and give as often as the matter an infusion of the following: spike- is carried off. Or, instead of the pre- nard, 2 grains; peony-seed, stiche, 14 scribed waters, kJ hyssop, 1 minim; dram each; pour in water of milk, add- epithyme, flower of borage, flower of ing a little white wine, and ten hours after the infusion, make a strong expres- vomiting, and afterwards wash the teeth sion; with it mix cassia or extract of with hot wine. You can do the same if manna with this decoction: tops of melancholy be the cause. Let the pa- stiche, flowers of borage, buglos, of tient take one of the pills described each, minim; tamarind, 1/^ oz; below, which should be made suffi- thyme, 1 minim; make the decoction, ciently large, two hours before dinner or and with it mix cassia or marjoram, supper every day: B cinnamon, carpo- afterwards adding one ounce of syrup balsam, cloves, aloes wood, cassia lignea, of violet, and make the drink. squinancy, crocus, xylobalsam, each, 1 On the digestives of these matters. scruple; peony-seed, 2 scruples; mace, 1 Concerning the solutives I have thus dram; stiche, ii/£ drams; agaric, 2 briefly treated, since above, in the cure drams; bryony, 3 drams; hepatic aloes, for diseases of the head from any 214 drams; make a paste with syrup of humor, you will find an abundance of stiche, from which make the pills when digestives and solutives to apply to these necessary; that paste will keep per- humors, and in this case. When there is fectly for three years; after two months need, seek help from them. But because have passed it is better than at the be- sanguinary and choleric epilepsy come ginning. These pills are suitable in mel- rarely, yes, very rarely, what has been ancholic epilepsy also; likewise, once a said about the digestion and evacua- week make two drams of theriaca or tion of the matter should suffice for you. mithridate; let the patient take them As to the complement of the cure, only at dawn, or at such time that after they those things which by their properties have been given he may sleep a little apply to every form of epilepsy, will be while. Or in place of the theriaca, give suitable. About them I shall below, two drams from the following: powder with the help of God, inform you. of peony-root, oz; powder of peony- Praise be to God. Amen. seed, 2 oz; hyssop, 1 dram; include the same amount of squilled oxymel, and Chapter y. on thos e thing s whic h , add a little theriaca to make it take TAKEN INTERNALLY, ROOT OUT ALL shape. CURABLE EPILEPSY When the patient goes to bed, let him It now remains to describe some often take one dram of sweet confection things which root out this malign of musk on alternate days, because this disease. Beginning with phlegmatic epi- cure is not accomplished save over a lepsy, according to the approved teach- long period of time. Although the pa- ing, when the phlegm has been evacu- tient may think himself already cured, ated, from time to time have the capiti- yet he should observe the routine thus purgia and gargles made as directed far described, and that still to be de- above. If the patient vomits lightly, scribed, for at least a whole year. Since once or twice a month make him vomit I have said that this disease is cured by with water of radish, and simple or poison which comes through things the squilled oxymel. Or take four ounces properties of which are not yet known of water of radish, four ounces of the to us, I have decided to mention many juice of elder, tearing off the bark from things which are suitable, both exter- above, mix, and when it is taken with nally and internally. Beginning with onions, garlic, salted fish, and other in- herbs, it was discovered by the ancients cisives of this sort at dinner, induce that many of the following are bene- ficial: mistletoe, cinquefoil, peony- matter which causes epilepsy. He adds root, peony-seed, gentian, Syrian rue, that the head of the cuckoo, when worn sparrow-wort, castor-bean, seed of the around the neck does not permit an chastity-tree, mountain laurel, borage, epileptic to fall. root of aristolochia rotunda, pirethrum, As for the parts of animals, the blood bettony-seed. caraway, physalis, penny- of the following is valuable: blood of a royal. rosemary, rue, sage, stiche, thyme, white lamb, blood of a first-born ass, of and hair-moss. Any one of these may be the weasel, wood-tortoise, leopard, and taken in powder form on an empty vulture; the blood of the lamb and ass stomach. Hair-moss is ordinarily given given with wine, the blood of the weasel with the Lord's Prayer; peony with with vinegar, that of the tortoise in any wine of the decoction of artemisia, gen- way that is desired. From the blood of tian with the juice of sage. From rue, the leopard is made a meat-pie, which marubium, and the herb parsley, juice is given to the patient to eat. The blood is extracted and given with honey; of vulture is dried and given with dust pirethrum is prepared in the manner of its liver and squilled oxymel. Of ani- of [. . . .] flavored; from borage is mal brains, the brain of a small crow is made a juice which is afterwards made helpful, the brain of the bear and the into a julep. Whichever one you give, weasel; from any one of these make a continue it for a month. From what has powder and give with vinegar. Of hearts, been said, the careful physician will be those which are suitable are the heart able to make not only powders, but also of the swallow, vulture, she-goat, wolf, syrups, decoctions, confections, and monkey, and mule. The heart of the electuaries in his own way. But of these swallow should be eaten hot; but all of I shall speak more in detail below. them are beneficial when eaten; usually Now something must be said about there is made a powder from them, and minerals. These are iris-stone; lapis this is valuable in any form. Of livers, judaicus, antimony, sea-foam, stones there are suitable the liver of the ass, found in the bellies of swallows; for the wolf, eagle, mule, and vulture. All of latter, when the moon is growing, kill these are beneficial when eaten; powder young swallows, take the red stones from them may be given in any form. which you will find in their bellies, pul- Eagle’s liver works more efficaciously verize them, and give with wine to when pulverized and given with the drink. eagle’s blood and honey. Of galls, there Of animals, those taken are worms, are the gall of the white lamb, the bear, earth-lizards, weasels, the mole, the the wolf; and these should be given cuckoo. Take any one of them you with honey. Of testicles, there are those please, allow it to dry in an oven until of the boar, goat, and rooster; these are a powder can be made, taking care that valuable when eaten, but from them it is not reduced to ashes, and give that there is usually made a powder, and the powder with wine or use it in the pa- powder from the testicles of the boar is tient’s food. I have read in a book “On given with water, that from the testicles the Properties of Animals” by Rhazes of the goat with horse’s milk, that from that the cuckoo has a valuable property the testicles of the boar with sow’s milk, in this, that it falls in epilepsy once a and that from the testicles of the rooster month. Just as rhubarb attracts choler with water and honey. to itself, so does the cuckoo attract the There are some things from animal parts which we can use only in pow- nothing will be better. I have described dered form, such as ashes of asses’ hoofs, to you many (medicinal) simples which goat-horns, the human skull. For a male are suitable for epilepsy, but from some patient, take the skull of a man, for a of them mixtures can be made which, woman, that of a woman, and the ashes in that case produce a wonderful, yes of a wood swallow; these ashes are even a divine, effect. The first of these: given with wine. Of dung, there are R powder of cuckoo, powder of swal- suitable the dung of the peacock and low, ashes of asses’ hoofs, powder of the stork; give either of them with human skull, male for a man, etc., of wine and honey. Give the urine of a each, 2 drams; bettony seed, seed of boar with horse’s milk. Of curds, there vitex agni casti, rue-seed, castor-bean, are suitable the curds of a leopard and mistletoe, seafoam, stiche, lapis iris, of of a she-goat; these are given with wine each 1 dram; peony-seed, 11/9 drams; or water to the amount of a chick-pea. peony-root, 3 drams; make the powder, From these two animals the excres- and give half a spoonful in the morn- cences which grow on their thighs are ing on an empty stomach. If you prefer also valuable. Likewise, when a horse is a confection from that powder: I£ of born, a certain star remains on its fore- the foregoing powder, 1 oz; white sugar, head, and this the mother immediately lb; dissolve the sugar in water, and licks off; you, therefore, should be right make the confection, the dose is half an on hand to gather it. Also when a horse ounce in the morning on an empty brings forth a colt, the latter in some stomach. Know that although one way or other emits through its nostrils ounce of the species to a pound of a little thing in the form of a pig’s sugar is ordinarily prescribed, still do spleen, which the mother immediately not hesitate to put two ounces to a licks. Therefore, if you wish to gather pound of sugar, because the confection it, be prepared, because unless you are will have more strength and be suffi- right on hand, the mother will imme- ciently tasty. diately devour it. From any one of Note further that peony, according to these, make a powder and give it with the testimony of Thessalus, in his “On wine to drink. Crow’s eggs are beneficial the Properties of Twelve Herbs,” grows when eaten; also a powder made from with the moon, and wanes with the the entrails of a dog, such as the liver, moon, wherefore both he and other heart, and spleen; and these should be ancient writers have learned by experi- given with wine. If these things cannot ment that when it is gathered while the be had in abundance, use them as long moon is growing, it increases the dis- as they last; but if you have an abun- eases to which it is proper, and dimin- dance of them, they should be used for ishes them when the moon wanes. From at least a whole year continuously. If which I infer that in epilepsy both the you wish to mix the dust of swallows root and the seed should be gathered with any of the foregoing, it will be when the moon is waning. What won- very beneficial. der, then, that Galen and some others If you give any of the foregoing with have sometimes found it to be bene- squilled oxymel, it will be very bene- ficial. and sometimes not at all helpful. ficial, and if you add a little water, so Another powder that is divine in this that they may be more easily taken, disease: I£ powder of human skull, 1 oz; powder of earth-worms, or swallows, honey until they are covered. Then, 6 drams; peony-seed, 14 oz; make the during the Dog Days, put them in the powder. Take the parts of swallows, sun for forty days continuously; stir one part of viscastor, cook; make a them every day with a wooden paddle. plaster with vinegar; extract water from If you wish quicker results, place the the alembic; the dose is one spoonfid vessel on hot coals, and stir continually. on an empty stomach. Give two drams of this conserve every Another exceptional confection: R morning, but it is very bitter to the juice of the herb parsley, 1 lb; juice taste. From this you can mix with your of rue, juice of marubium, 14 lb; white confections whatever you wish: I praise sugar, 114 lb; dissolve the sugar in these it very highly, and especially with those juices; cook, and when it begins to cool, that are made with honey, I have found add these powders: ashes of skull, ashes both the prescribed powders and the of asses” hoofs, of each, 6 drams; powder confections wonderfid in this disease. of swallow, powder of cuckoo, coral, But you should choose from the simples powder of lapis iris, castor-bean, of whatever suits you, make the confec- each. 1 dram; peony-root, 214 drams; tion in your own way, or extract water peony-seed, 114 drams; make the pow- from the alembic if you wish. der and mix with the sugar; make the Now I am pleased to describe certain confection in boles or the form of opi- secrets, the first of which is: take a ates. Or another way: crush fresh rue cuckoo, put its plumes with wine in an with a knife, take 1 lb of it with 2 lbs earthen jar; after sealing the jar, put it of honey, and cook. When it begins to in the oven till a powder can be made; cool, add these powders: R choice cin- when the patient goes to bed, give him namon, 2 drams; nux moschata, 3 some of the powder, to the amount of a drams; amber, 14 dram; peony-seed, chestnut, with two ounces of water. At peony-root, 114 dram each: ashes of the end of supper, set the following skull, ashes of asses’ hoofs, 14 oz- each; powder over cooked bread, soaked in powder of cuckoo, powder of swallow, wine, let the patient eat it, and drink 2 drams each; make the powder, mix nothing after it: R myrrh, mastic, with the previous prescription, and frankincense, of each 14 oz.; make the make the electuary; the dose is to the powder and use as directed above. And size of a chestnut, in the morning, on do this for thirty consecutive days, as an empty stomach. has been said. As for the purgings and Syrup of squill is greatly recom- routine, do as has been said above. An- mended in this disease by Avicenna; and other secret by which one man did won- if it pleases you to make it, place the ders: take peony-seed, gathered on a squill in a glass vessel with honey; bind waning moon, which has never touched the vessel tightly with a leather thong, the earth; pulverize them, and with and set it in the sun for four days dur- the blood of a bat make pills the size of ing the Dog Days. Then press out the peas; give the patient three pills when whole expression with syrup of honey; he goes to bed. Make another from a the dose will be one spoonful every rib of the left side of a man who has morning. Others make this from squill: been hanged, or beheaded, and give it take as many squills as you wish, crush with water to the patient every morning them with a wooden paddle, pour in for a month. Chapter 8. on app rop riated thi ng s bears the myrrh, Melchior the frankin- WHICH ARE ADDUCED FROM WITHOUT IN cense,” etc. it is said that when the in- THE CURE OF EPILEPSY scription is worn turned towards one- From without, there are many things self, it does not permit the epileptic to of assistance, such as a belt of wolf’s hide fall. These rings can be worn on the worn over the naked flesh; a belt of skin finger or about the neck. When other from the forehead of an ass, worn on the things are of no avail, some authors head; crushed rue, smelled frequently; highly recommend an actual or poten- also, thyme. Or make this apple: take tial cautery, which I also endorse. If you peony-root, powder it very finely, re- make it, keep the aperture open for a duce to the form of an apple with liquid year, and place over the conjunction storax, and let the patient smell it often. the potential cautery described in the Infants should wear it around their cure for bubonic plague. After remov- necks, so that the odor may pass to their ing the scar, let the patient wear con- nostrils. In that case some suffumiga- tinually in the aperture a pill made tions are praised, such as those made from the stem of ivy, cabbage-leaf, and the like. If you do this, it would be a from the membrane found on the foal very malign epilepsy 'which would not of an ass at birth, or peony, or blatta forsake the patient after observing the bizantia, or amber mixed with the bone prescribed routine. from the heart of a crow. There are many things which are of value when Chapter 9. on the cur e of tha t worn about the person, such as the root EPILEPSY WHICH IS CAUSED BY of pyrethrum about the neck, or peony- COMMUNION WITH OTHER MEMBERS root collected at the proper time; or take When epilepsy comes from the stom- peony-seed which has never touched the ach or some other member, with some ground, and soak it for a day and night humor offending, purge the member in the blood of a bat. When it is dried, according to need, then soothe it, which bind it in the skin of a calf or stag, and you will know how to do from the doc- let the patient wear it continually about trine set down in the proper chapters. his neck. Or have him wear an emerald Then in order turn your attention to or some other stone, or a coral, or the (other) things prescribed, but avoid swallow-stone which has never touched gargles, capitipurgings, and suffumiga- the ground; wrap it in the skin of a stag tions when the trouble does not lie in or calf, and have the patient wear it the head. That which comes from worms continually, bound on his left side. Do is cured by the cure for worms which, the same with a chelidony, but let this with the help of God, will be given in be worn under the left armpit. Certain its proper place. Infants, and even those rings are made. Take the umbilical cord somewhat older may not be able com- from a child newly born, and enclose pletely to perform all those things it in a gold ring, with an emerald on which have been mentioned, yet from top. Or do this: take the hair of a white many confections and the like they can dog, with a little peony-root and pyreth- partake, with milk, or wine or water, rum-root, enclose them in a gold ring, and wear the prescribed articles about with an emerald on top, and have the their persons, and you should be pre- ring highly polished. If you make this pared with such things that this may inscription on these rings, “Gaspar be done. Do not trust entirely to time, because those who live by the best tications, odoraments, and suffumiga- routine are by no means cured with tions according to the prescribed order. advancing age. But in order that what Let the patient continue the confections has been said may offer license to divine of powders and the like. Let him con- epilepsy, I shall, in conclusion, lead you tinually wear about his head a garland to some practical things. If you come made from the skin of the forehead of upon an epileptic at the hour of the an ass; let him wear the skin of a wolf paroxysm, do as prescribed in the chap- on his naked flesh, and wear about his ter on the cure of the paroxysm. In the neck the things prescribed to be worn period of quiet, consider the patient's there; on his fingers let him wear the age, complexion, preceding routine, rings. The epilepsy will be bad, yes, and such things, and enjoin upon him extremely bad, if it does not de- the proper routine of the six non- part when the things prescribed are natural things. Then eject the offending diligently observed; where this is the humor according to the need, and case, you should have recourse to empty the offending member; soothe cautery. For I have cured many men, with pills; let the patient use theriaca among them one sixty years of age or some mixture, and every month a who had suffered this disease for many vomit, provided he be capable of it. Ad- years. minister gargles, capitipurgings, mas- Praise be to God. Amen.

Refer ences 1. Maioc chi , R. Codice Diplomatico cicli' the pole of the frontal lobe conscious- L’niversitàl di Pavia. Pavia, 1913. Voi. ness is lost early in the seizure. li. 5. The idea of retraction of nerves which 2. Neub erg er , M. History of Medicine. moved the muscles and limbs was re- Translation—Ernest Playfair. Oxford peated by the experienced surgeon Am- Univ. Press, 1925. Vol. II, pt. 1. broise Pare and was refuted only 250 3. Sudh off . Archiv. f. d. ges. Med. 2:21, years ago by Thomas Willis. 1908; 16:117, 1925; 17:243, 1925. 6. An excellent list of precipitating causes. 4. Thorndike , L. History of Magic and Ex- Seizures are unduly frequent during perimental Science. New York, Colum- physical inactivity and after unpleasant bia University Press, 1934. Vol. IV. emotional strain. 7. Although Hippocrates ridiculed the no- Note s tion that goats caused convulsions, 1. This explanation was given also by John pointing out that Nubians, a goat herd- of Gaddesden and by Bernard Gordon. ing people, were not particularly af- Modern authorities believe the word fected, the bucking contortions of the epilepsy comes from the Greek word goat bore too close a resemblance to meaning “seized.” clonic convulsive movements to permit 2. But Hippocrates made it clear that the dissociation of the two. Today the word “sacred disease” referred to the belief for epilepsy among the Chinese is the that patients with epilepsy were divinely “goat disease.” possessed. 8. I axil in his book on epilepsy in children, 3. Probably the dream state discussed fully 1602, argued with considerable heat by Hughlings Jackson. against the practice of giving patients 4. He seems to say that the frontal areas of urine to drink. the brain are the seat of memory. Pen- 9. This is a curious and naive commentary field agrees that if there is a lesion of on the psychology of medical practice.