. Epilepsy, a study of the idiopathic disease. s. One patientinvariably had his first nocturnal fit at In others,again, some exciting cause appears to be necessary for theirrecurrence, such as fatigue, a heavy meal, the excitement ofthe play or of a dance. Some writers have endeavoured to account for the incidenceof the seizures by the normal variations which take place inthe alkalinity of the blood.^ Haig^ has explained the morecommon incidence of epileptic fits during the early morninghours and forenoon, on the ground of the existence at thistime of the alkaline tide, which sets f


. Epilepsy, a study of the idiopathic disease. s. One patientinvariably had his first nocturnal fit at In others,again, some exciting cause appears to be necessary for theirrecurrence, such as fatigue, a heavy meal, the excitement ofthe play or of a dance. Some writers have endeavoured to account for the incidenceof the seizures by the normal variations which take place inthe alkalinity of the blood.^ Haig^ has explained the morecommon incidence of epileptic fits during the early morninghours and forenoon, on the ground of the existence at thistime of the alkaline tide, which sets free uric acid andfavours its circulation in the blood stream. There is reasonto suppose also that fits are more common during the processof digestion than at other times. Various tabulated summaries are found in works uponepilepsy, giving the hourly incidence of large numbers of ^See Arch, de Neurolocjie, 1897, ii. p. ^Haig, op. cit. CHART 7. An Average Case of Serial Epilepsy. JAN. FEB. MAR. APRIL MAY JUNE JULY AUG. SEP. OCT. NOV. SdzTz NOCTURNAL AND DIURxNAL FITS 107 iits. Tables of this kind are found in the works of Spratling,^Clark,^ and others. It is seen from these that there is nohour of the day or night, which is free from the occurrence ofepileptic attacks, although fits are more common at somehours than at others, the three most frequent periods being3 to 5 , noon to 2 , and 9 to 10 ; the leastcommon being in the late afternoon, from 5. to 7 I have endeavoured to test these points by noting the hourlyincidence of fits over some weeks, from a number of cases ofthe major type of epilepsy at the Chalfont Colony, with thefollowing results: Chart 11 showing the hourly incidence of major epileptic fitsfrom sixty-two epileptics at the Chalfont Colony. 1 2 3 4 5 6 7 9 10 11 12 1 2 3 4 5 7 8 9 10 11 12 of fits k T\ \ ^ A-h \ ^ /\/X X . / V ^ :v\ /_^—>^ / V^ \ / V 1 This chart was constructed from t


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