second, and this again by a
third within a few months. Then attacks occur more frequently until a
regular periodicity--from one a day to one a year--is reached after about
five years, and this frequently persists throughout life.

The effect of epilepsy on the general health is not serious, but it has a
more serious effect on the mind, for epileptic children cannot go to school
(though special schools are now doing something towards removing this
serious disability), and grow up with an imperfect mental training. They
become moody, fretful, ill-tempered, unmanageable, and at puberty fall
victims to self-abuse, which helps to lead to neurasthenia. Then they may
drift slowly into a state of mental weakness, and often require as much
care as imbeciles. If the fits are severe from an early age, arrest of
mental development and imbecility follow. If the disease be very mild in
character, and especially if it be _petit mal_, the victim may be very
precocious, get "pushed" at school, and later become eccentric or insane.

Adult victims necessarily lead a semi-invalid life, often cut off from
wholesome work and from the pleasures of life, and become hypersensitive,
timid, impulsive, forgetful, irritable, incapable of concentration,
suspicious, show evidences of a weakened mind, have few interests, and are
difficult to manage.

About 10 per cent--the very severe cases--go on to insanity; either
temporary attacks of mania, calling for restraint, or permanent epileptic
dementia with progressive loss of mind. Some victims are accidentally
killed in, or die as a result of a fit; about 25 per cent--severe cases
again--die in _status epilepticus_, but the majority after being sufferers
throughout life are finally carried off by some other disease.

There are many exceptions to this general course. Some patients have
attacks very infrequently, and are possessed of brilliant talent, though
apt to be eccentric. Others may have a number of seizures in youth, and
then "outgrow" the complaint.

A few victims are attacked only after excessive alcoholic or sexual
indulgence, some women only during their menses, while other women are free
from attacks during pregnancy, which state, however (contrary to popular
belief), commonly aggravates the trouble. Victims may be free from attacks
during the duration of, and for some time after, an infectious disease;
while Spratling says that a consumptive epileptic may have no fits for
months, or eve