The Birkenhead News and Wirral General Advertiser. — 1910-07-23 (Birkenhead, Merseyside, England)

DALZELL'S INTERESTIMI PAPER.  Dr. W. R. Dalzell, M.A., M.B. (hon. surgeon to the Borough Hospital, Birkenhead) read a valuable paper at the meeting of the Preventive Medicine and Vital Statistical Section on "The Relation of Epilepsy to crime, and the control, supervision, and, if necessary, detention of Epileptics by local authorities or the State." In the course of the paper he said  Those of us whose classical attainments have survived the lapse of years, and the wear and tear of a more or less prolonged period of professional practice will remember that the word epilepsy means essentially a sudden seizure, a true falling sickness," said Dr. Dalzell in opening a discussion on the relation of epilepsy to crime, the supervision, and if hecessury, the detention of epileptics by a local authority or the State. He defined epilepsy as a motor neurosis, whose manifestations are periodic and sudden, characterised by convulsions varying in intensity, and often masked, accompanied by loss of consciousness, more or less obvious and associated with general mental disturbance, amounting frequently to unmistakeable insanity. He proposed to treat his subject in an attractive way, which would make it of general interest. He spoke of how Shakespeare in Othello" represented the Moor of Venice as goaded by the insinuations and innuendo of that arch villian lap, on hearing that the chastity of Desdemona had been impugned, rushed headlong into a paroxysm of rage, and after a frenzied outburst of incoherent passion, fell into a trance. Said lago:—  MI lord is falling into an epilepsy, This is the second tit; he had one yesterday. Whereupon, busybody ignorance and superstition, in the person of the much maligned Cassio advised:— _ . .  I.l7tivb lisiM about the temples, a piece of old quackery, which is overruled by lago, the embodiment of scientific enlightenment, who cried:— No, forbear, . .  ------, The lethargy must have his quiet course; and by and bye, Breaks out to savage madness. Look he stares; lie will recover straight.  There was the whole tragedy in a nutshell. The subsequent smothering of the unfortunate Desdemona, and the repentant suicide of the Moor himself were but the final touches of genius which made the masterpiece complete and true to nature. Dr. Dahell held that difficulty aud danger lay rather in those masked forms of epilepsy, where the public at large are exposed to the sudden and unprovoked attacks of irresponsible maniacs, who may be quite unconscious of their frenzied paroxysms of impulsive fury. The most dangerous cases of impulsive homicidal mania outside alcoholic insanity ace lo be found amongst those people who are not known to be subject to this disease until some dire tragedy proclaims the fact. Subsequent inquiry may bring to light the fact that it has been known to relatives or friends that there has been something wrong with these people, which, had it been known to those who are familiar with such cases, might have led to prevention of these deplorable calamities. But, is it not common knowledge that these are among the very skeletons in the supboard of family • history which are most sedulously concealed from public view? Until the public can be induced to look upon such diseases as cases for tender treatment find not as indelible disgrace, so long will such eases continue to be concealed, and be a constant danger, a standing menace to the community. It appears to me, therefore, that we must advocate in the first instance some scheme for the instruction of the public in this matter, in order that we may get the necessary information, and before notification can become possible, and with a view to placing the local authority in a position to take such steps as may be deemed advisable for the cure and prevention of this disease, and for the control, supervision, and if necessary the detention of such cases. Even then there will remain a large number of cases of potential danger, whose condition is never suspected, even by the sufferers themselves. It would be hard indeed to know how to deal with these most difficult cases were it not for the fact that they always betray at some time or another early in their career, symptoms which an experienced eye and a trained mind would rightly interpret. If it be agreed that these most dangerous and obscure forms of epilepsy frequently go unrecognised owing to a lack of experience, even among those on whom we most rely to guide us in dealing with such cases, steps must be taken to surmount the difficulty, and attain our object of prevention, and if possible, cure, before the disease has advanced too far. I would suggest, therefore, that every medical man should have a special training in the wards of our public asylums, not only by taking I out a systematic course of lectures on insanity, but by undergoing a special residential course of instruction, which, to my mind, is as essential as a similar residential .course in a general hospital. Any remedial