IN about 50 per cent. of epileptics a family history of epilepsy or insanity is found (Gowers). In other words, a condition of the nervous system is inherited which easily determines the development of epileptic fits. After the disease is well established, certain changes in the brain are recognisable, but it is open to doubt whether such changes are not in the main secondary.Whether or not in the earlier stages of epilepsy there is any demonstrable abnormality in the nervous system (cerebro-spinal and sympathetic), we have to endeavour to explain the extraordinary fact that, without a moment's warning, an attack of unconsciousness associated with the most extreme muscular contractions, and followed by more or less prolonged coma, may develop. It is important to note that the very first fit may be a most severe one.An interference with consciousness and a disturbance of the musculature so sudden and appalling suggest a catastrophe in the brain equally sudden and of the gravest magnitude. Among the many conditions which are apt to be associated with fits indistinguishable from those of idiopathic epilepsy we may enumerate the following:(1) Very severe haemorrhage.(2) Various infantile conditions.(3) Eclampsia. (4) Organic brain disease.(5) Experimental local stimulation of cortex by electric current. (6) Uraemia. (7) Various poisons, such as lead, and noticeably absinthe.

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