Part 2

showing that practically the sexes were affected in equal proportions. Of the females there were--

Unmarried, 58.5 per cent. Married, 41.5 per cent.

The greater number amongst the unmarried females is probably due to the list including children, and also to the fact that epilepsy is not an attraction to a man who purposes matrimony. Of the married females--

The attacks were uninfluenced by marriage in 68.1 per cent. The attacks were diminished after marriage in 27.2 per cent. The attacks were increased after marriage in 4.5 per cent.

Thus, in the majority of cases, marriage seems to have no influence on the epileptic attacks of women, although in 27.2 per cent. the fits appear to have been diminished after that ceremony.

Of the married females there were--

Children in 82.3 per cent. No children in 17.6 per cent.

Age.--In one hundred cases the age at which the first attack of epilepsy took place will be seen from the following tables:--

Males. Females. Total.

From 1 to 10 years 9 14 23 From 10 to 20 years 11 23 34 From 20 to 30 years 14 9 23 From 30 to 40 years 10 6 16 From 40 to 50 years 1 0 1 From 50 to 60 years 2 1 3

It will thus be seen that, in males, the most prevalent period for the first invasion of epilepsy is from the tenth to the thirtieth year; in females, from the first to the twentieth year. In both sexes the disease rarely commences after forty. The following table shows the ages of the patients under observation:--

Males. Females. Total.

From 1 to 10 years 4 1 5 From 0 to 20 years 10 20 30 From 20 to 30 years 17 15 32 From 30 to 40 years 11 9 20 From 40 to 50 years 2 6 8 From 50 to 60 years 3 2 5

This indicates that cases of epilepsy comparatively rarely come under observation after the age of forty. A large series of cases would however be required to determine any definite conclusions as to the mortality and longevity of the patients.

Occupation and Profession.--These do not appear to have any special relation to the production of epilepsy.

Hereditary Tendency.--In each of the cases under observation a very careful inquiry was made into the family history. This was confined to the parents, grand parents, uncles, aunts, brothers, sisters, and children of the patient. The following are the results:--

No family history of epilepsy, insanity, nervous or other hereditary disorders in 59 per cent.

One or more members of family affected with one or more of the above disorders in 41 per cent.

Of these last, in which there was a tainted hereditary history, one or more members of the family suffered from--

Epilepsy in 63.4 per cent. Insanity in 12.1 per cent. Phthisis in 12.1 per cent. Asthma in 2.4 per cent. Apoplexy in 2.4 per cent. Hysteria in 2.4 per cent. Hemiplegia in 2.4 per cent. Spinal complaint in 2.4 per cent.

Concerning the above table, it is to be remarked that frequently the patient had several relatives suffering from different diseases; for example, one with epilepsy, a second with insanity, and so on. In such a case these have been classified under epilepsy, and, if this did not exist, under insanity, or other afflictions in the above order.

Of those cases in which epilepsy was present in the family of the patient, it existed in the following members:--

Father in 11.5 per cent. Mother in 7.6 per cent. Father, mother, and brother in 3.8 per cent. Mother and child in 3.8 per cent. Grandmother, mother, and two sisters in 3.8 per cent. Mother and sister in 3.8 per cent. Grandfather in 7.6 per cent. Grandmother in 3.8 per cent. Brother in 11.5 per cent. Sister in 11.5 per cent. Two brothers in 3.8 per cent. Sister and child in 7.6 per cent. Brother and uncle in 3.8 per cent. Two uncles in 3.8 per cent. Uncle in 3.8 per cent. Aunt in 3.8 per cent. Child in 3.8 per cent.

From these figures it will be seen that in no less than 41 per cent. of the total number of cases there was a distinct family history of hereditary disease. Of these no less than 87.5 per cent. were affections of the nervous system, and 12.1 per cent. of phthisis. Of the former 63.4 per cent. had relatives afflicted with epilepsy, and 12.1 per cent. with insanity. Epilepsy, according to these figures is eminently a hereditary disease, and it is possible even to a greater extent than is here represented; for the family history is often very difficult to arrive at, in the class of persons on whom most of these observations were made, who, either from ignorance or from prejudice, display a great want of knowledge concerning the health of their ancestors.

General health prior to the first attack.--As far as could be ascertained this was--

Unimpaired in 90 per cent. Delicate in 10 per cent.

By the term delicate is understood any chronic derangement of health. The figures serve to indicate that, in the large majority of cases epilepsy has no necessary connection with the impaired general health of the patient.

Special illnesses prior to the first attack.--There were--