CHAPTER V. ON THE PAROXYSM OF EPILEPTICS
* * * * sluggishness, vertigo, heaviness of the tendons, plethora
and distension of the veins in the neck; and much nausea
indeed after food, but also, not unfrequently, with abstinence,
there is a faint nausea; and phlegm is often vomited; want of
appetite and indigestion after little food: they have flatulence
and meteorism in the hypochondria. These symptoms, indeed,
are constant.
But, if it be near the accession of the paroxysm, there are
before the sight circular flashes of purple or black colours, or
of all mixed together, so as to exhibit the appearance of the
rainbow expanded in the heavens; noises in the ears; a heavy
smell; they are passionate, and unreasonably peevish. They
fall down then, some from any such cause as lowness of spirits,
but others from gazing intently on a running stream, a rolling
wheel, or a turning top. But sometimes the smell of heavy
odours, such as of the gagate stone (
jet), makes them fall
down. In these cases, the ailment is fixed in the head, and
from it the disorder springs; but, in others, it arises also from
the nerves remote from the head, which sympathise with the
primary organ. Wherefore the great fingers of the hands, and the
great toes of the feet are contracted; pain, torpor, and trembling
succeed, and a rush of them to the head takes place. If the
mischief spread until it reach the head, a crash takes place,
in these cases, as if from the stroke of a piece of wood, or of
stone; and, when they rise up, they tell how they have been
maliciously struck by some person. This deception occurs to
those who are attacked with the ailment for the first time.
But those to whom the affection has become habitual, whenever
the disease recurs, and has already seized the finger, or is
commencing in any part, having from experience a foreknowledge
of what is about to happen, call, from among those who
are present, upon their customary assistants, and entreat them
to bind, pull aside, and stretch the affected members; and
they themselves tear at their own members, as if pulling out
the disease; and such assistance has sometimes put off the
attack for a day. But, in many cases, there is the dread as of
a wild beast rushing upon them, or the phantasy of a shadow;
and thus they have fallen down.
In the attack, the person lies insensible; the hands are
clasped together by the spasm; the legs not only plaited
together, but also dashed about hither and thither by the
tendons. The calamity bears a resemblance to slaughtered
bulls; the neck bent, the head variously distorted, for sometimes
it is arched, as it were, forwards, so that the chin rests
upon the breast; and sometimes it is retracted to the back, as
if forcibly drawn thither by the hair, when it rests on this
shoulder or on that. They gape wide, the mouth is dry; the
tongue protrudes, so as to incur the risk of a great wound, or
of a piece of it being cut off, should the teeth come forcibly
together with the spasm; the eyes rolled inwards, the eyelids
for the most part are separated, and affected with palpitation;
but should they wish to shut the lids they cannot bring them
together, insomuch that the white of the eyes can be seen
from below. The eyebrows sometimes relaxed towards the
mesal space, as in those who are frowning, and sometimes
retracted to the temples abnormally, so that the skin about the
forehead is greatly stretched, and the wrinkles in the intersuperciliary
space disappear: the cheeks are ruddy and quivering;
the lips sometimes compressed together to a sharp point,
and sometimes separated towards the sides, when they are
stretched over the teeth, like as in persons smiling.
As the illness increases lividity of countenance also supervenes,
distension of the vessels in the neck, inability of speech
as in suffocation; insensibility even if you call loudly. The
utterance a moaning and lamentation; and the respiration a
sense of suffocation, as in a person who is throttled; the pulse
strong, and quick, and small in the beginning,--great, slow,
and feeble in the end, and irregular throughout; tentigo of
the genital organs. Such sufferings do they endure towards
the end of the attack.
But when they come to the termination of the illness, there
are unconscious discharges of the urine, and watery discharges
from the bowels, and in some cases an evacuation also of the
semen, from the constriction and compression of the vessels, or
from the pruriency of the pain, and titillation of the humours;
for in these cases the pains are seated in the nerves. The
mouth watery; phlegm copious, thick, cold, and, if you should
draw it forth, you might drag out a quantity of it in the form
of a thread. But, if with length of time and much pain, the
matters within the chest ferment, but the restrained spirit
(
pneuma) agitates all things, and there is a convulsion and disorder
of the same, a flood, as it were, of humours swells up to
the organs of respiration, the mouth, and the nose; and if
along with the humours the spirit be mixed, it appears like
the relief of all the former feelings of suffocation. They
accordingly spit out foam, as the sea ejects froth in mighty
tempests; and then at length they rise up, the ailment now
being at an end. At the termination, they are torpid in their
members at first, experience heaviness of the head, and loss
of strength, and are languid, pale, spiritless, and dejected,
from the suffering and shame of the dreadful malady.
