Some patients are obsessed by a peculiar sensation (the “aura”) just before a fit.  This warning takes many forms, the two most common being a “sinking” or feeling of distress in the stomach, and giddiness.  The character of the aura is very variable—­terror, excitement, numbness, tingling, irritability, twitching, a feeling of something passing up from the toes to the head, delusions of sight, smell, taste, or hearing (ringing, or buzzing, etc.), palpitation, throbbing in the head, an impulse to run or spin around—­any of these may warn a victim that a fit is at hand.  Some patients “lose themselves” and make curious mistakes in talking.

The warning is nearly always the same each time with the same patient, and is more common in mild than in severe cases.  Rarely, the attack does not go beyond this stage.

When the patient becomes conscious of the aura he should sit in a large chair, or lie down on the floor, well away from fire, and from anything that can be capsized.  He must never try to go upstairs to bed.  Some one should draw the blind, as light is irritating.

If the warning lasts some minutes, the patient should carry with him, a bottle of uncoated one-hundredth-grain tabloids of

Nitroglycerin, replacing the screw cap with a cork, so that they can quickly be extracted.  When the warning occurs, one—­or two—­should be taken, and the head bent forward.  The arteries are dilated, the blood-pressure thus lowered, and the attack may be averted.

The use of nitroglycerin is based on the theory that seizures are caused by anaemia due to vasomotor constriction.  Success is only occasional, but this is so welcome as to justify the habitual use of the method.

If the aura be brief, buy a few “pearls” of Amyl Nitrite, crush one in your handkerchief, and sniff the vapour.  This has the same affect as nitroglycerin, but the action occurs in 15 seconds and only persists 7 minutes.  A headache occasionally follows the use of these drugs, and they should not be employed without professional advice.

When the warning is felt in the hand or foot, a strap should be worn round the ankle or wrist, and pulled tight when the aura commences.  This sometimes aborts a fit, as biting a finger in which the aura commences may also do.

If a victim feels unwell after a meal, he must never eat the next meal at the usual time, simply because it is the usual time.

Should a patient feel unwell between, say, dinner and tea, instead of eating his tea he must empty his bowels by an enema, or croton oil (see chemist), and his stomach by drinking a pint of warm water in which has been stirred a tablespoonful of mustard powder and a teaspoonful of salt.  After vomiting, drink warm water.

Never attempt to empty the stomach at the onset of a definite aura, for if the seizure occurs, the vomit will probably obstruct the trachea, and suffocate the victim.