About forty years ago the idea established itself that epilepsy, exhibiting itself in one form or another as “fits,” and migraine, the severe periodic sick headache, were interconvertible manifestations of the same underlying morbid process in the brain.  Nothing in the way of a concrete cause, attackable on the material side, was elicited by this generalization.  Then the investigations of the pituitary in the last decade produced evidence of epilepsy-like and migraine-like symptoms in sufferers from tumors or other enlargements of it.  Reasoning back, cases of epilepsy and migraine began to be examined for evidences of involvement of the pituitary in their troubles.  These accumulated rapidly.  The physiognomy and physique of the pituito-centric were discovered in them.  The phenomena noted in Napoleon’s case were often present:  lowering of the pulse, chilliness, and an increased irritability of the bladder.  In women the attack often coincides with the menstrual period, a typical time of endocrine unbalance.  Finally X-ray examinations of the sella turcica, the bony lodging of the pituitary, clinched the matter:  it often appeared small, or enlarged, with erosions of the bone, signifying a desperate attempt of the gland to grow, and meet the needs of the organism.  The complex of appearances called migraine now becomes understandable.  There are a number of factors, such as fatigue, intense cold, or high sugar food like chocolate, which will cause an engorgement of the gland with blood and swelling of it.  But they do not concern us now.  Intense mental occupation, concentration as the popular term has it, acts as a patent excitor of the attack.

Brain work drives more blood into the brain and the gland.  Besides, mental activity is accompanied by increased function of the ante-pituitary, if intellectual, or of the post-pituitary if emotional.  Brain work then causes a temporary enlargement of the gland.  If, now, the bone container of the endocrine is too small to permit of much swelling, the bone will be pressed against or even worn into.  This means headache, severe, easily going on to the kind known as sick-headache.  The nerves which move the eyes in various directions lie next to the pituitary.  If, in its expansion, it moves sufficiently outward, it may press upon, irritate them or paralyze, and so evolve various eye disturbances in association with the headache.  No one can overrate this conception of migraine, for a number of men of genius have suffered from sick-headache and eye symptoms.

As for epilepsy, the problem is more complex.  One has to rule out first those who have organic destructive disease of the brain.  But they are out of our field:  genius predicates at least an intact brain.  Of the others a number may be interpreted upon an endocrine basis.  At least they will, in their physiognomy, physique, mentality, conduct and character, document the glandular constellation under which they live, and a proper understanding of which is necessary for