S. M. HENRY, M. D.
I desire to ask for some suggestions in the diagnosis and treatment of some peculiar conditions in my own son, a boy thirteen years of age. In February last, while I was away from home, my wife was awakened one night by a peculiar sound the boy was uttering in his sleep. On going to his room, she found him in a severe convulsion. She called in a nearby physician who told her that the difficulty was la grippe and prescribed for the boy accordingly. At least twice a week since that time, he has had an extremely severe convulsion, which involves all the muscles of the body. Almost every night he has spells when he awakens with a scream; there is severe cramping pain in his right side in the region of the liver; there is pain also in the right leg; this often in a form which resembles mild convulsions. All this wears off after a few moments.
I did not get home until April 4, some weeks after the first convulsion appeared. The doctor who had treated him advised circumcision, which was performed about April 10. This made no apparent difference with the general convulsive condition.
In the treatment that has been advised, he has had bromides in full quantity, passiflora, saline laxatives, oenanthe, jacaranda, echinacea, verbenin, nux vomica and worm powders. In addition we have tried suggestion, massage, high enemas, and have paid a great deal of attention to hygiene and diet. All we have done, however, seems to have been of no effect whatever.
The boy is quite bright, is very active, but is not real strong. When he was an infant he had an attack of pneumonia, with some mild symptoms of meningitis, but have seen no evidence of any effects from this since. We have always lived in a malarial district, but I have seen no effects from that. His heart is slightly irregular, but I cannot distinguish any abnormal valvular sounds. The bowels are regular, but the tongue is frequently coated with a yellowish fur, at which time his breath smells badly. When this is the case his nervous spells are much worse. His temperature is usually normal. I shall be glad to have any suggestions from any reader of this journal either through the journal or by letter direct. This is an exceedingly trying case, but I have confidence that others have had an experience with such cases that may be beneficial to me in this.
COMMENT.—This is a case undoubtedly in which the closest scrutiny will detect exact specific conditions which refer directly to specific remedies which perhaps have not heretofore been used in epilepsy. Each condition must be met accurately with reference to the condition itself. Every possible cause of reflex irritation must be discovered and removed, A strict orificial observation might reveal some hitherto overlooked cause. The stomach and intestinal tract must have close attention, general nutrition must be advanced and the nervous system must be built up. With epileptics, neurasthenics, those approaching insanity, and in others with a broken down nervous system, I have observed the foul breath and coated tongue, often only during and just following an attack. The indications the doctor has given are general and not sufficiently precise to suggest the exact remedy or remedies which must be found.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.