THE PROPER USE OF PHENOBARBITAL IN THE TREATMENT OF THE EPILEPSIES

The conception that the epilepsies constitute a convulsive syndrome due entirely to pathologic changes within the brain is waning. Pathologists have ceased to consider the morphologic changes found in the nervous tissue of the so-called idiopathic epilepsy as causal but rather as a result or corollary of the convulsions. In organic brain diseases, almost identical lesions may in one instance be associated with convulsions and not in another. The idea of Lennox and Cobb that a functional element consisting of various physicochemical factors and an unknown "convulsive capacity" plays a variable but always a large rôle in the production of the convulsion along with the structural brain changes is an acceptable hypothesis.

Thus the solution of the epilepsies may be made by purely biochemical means and their probable rational treatment directed on such a basis. Yet until such therapy is discovered the economic and sociological problem of the large number