Page:Transactions of the Provincial Medical and Surgical Association, volume 4.djvu/298

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196
MEDICAL TOPOGRAPHY

epilepsy as a disease, if not peculiar to scrofulous constitutions, yet of decidedly more frequent occurrence in them than in other persons; and were this otherwise, the following very strong opinion of a most observant and experienced practitioner, would be to me sufficient reason for placing the disease in its present position: "I conceive (says Dr. Cheyne) that epilepsy is as certain a manifestation of the strumous diathesis as tubercular consumption, psoas abscess, hereditary insanity, or certain congenital malformations or defects of organization which are inherited only from scrofulous parents. I have no recollection of a case of cerebral epilepsy in a patient who, when due inquiry was made, did not appear to inherit a strong disposition to scrofula."[1] Be this as it may, I think I am justified by the tables, as well as by the result of my own observation and inquiries, to regard epilepsy as of very frequent occurrence in the Landsend district. Ninety-seven cases in seventeen years, or upwards of five annually, in a list of patients averaging between 500 and 600, is certainly a larger proportion of cases than I have been accustomed to observe elsewhere; and if the reports before referred to can be admitted as authentic evidence of the proportional prevalence of diseases at the places mentioned, epilepsy is less frequent, by one-half, at least, both at London and Plymouth.

Tubes mesenterica.—If the diagnosis of this disease were always unequivocally established, there could be no question as to the propriety of its classification among strumous affections. It is, no doubt,

  1. Cyclopedia of Pract. Med., vol. II. p. 90.