After the stomach has been empty ten minutes, the patient should take a double dose of bromides (Chapter XIX) and go to bed.  Next morning he will be well, whereas if he eats but a single piece of bread-and-butter he will probably have a fit within five minutes.

Unfortunately, in 60 per cent of cases, there is no warning at all, while in those cases which do exhibit an aura, the measures mentioned above more often fail than succeed.

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CHAPTER VI

FIRST-AID TO VICTIMS

“First-aid is the assistance which can be given in case of emergency by those who, with certain easily acquired knowledge are in a position, not only to relieve the sufferer, but also to prevent further mischief being done pending the arrival of a doctor.”—­Dickey.

Never try to cut short a fit.  Placing smelling-salts beneath the nose, together with all other remedies for people who have “fainted”, are useless in epilepsy.

Lay the patient on his back, with head slightly raised; admit air freely; remove scarf or collar and tie, unfasten waistcoat, shirt, stays or other tight garments, and if it be known or observed that the victim wears artificial teeth, remove them.

If five people are at hand, let two persons grasp each a leg of the victim, holding it above the ankle and above the knee; two others should each hold a hand and the shoulder; the fifth supports the head.  Do not kneel opposite the feet or you may receive a severe kick.  Prevent the limbs from striking the floor, but allow them full play.  If the victim rolls on his face gently turn him on his back.

Roll a large handkerchief up from the side (not diagonally) and holding one end firmly, tie a knot in the other end, and place it between the teeth to protect the tongue; or slide the handle of a spoon or a piece of smooth wood between the teeth, and thus hold the tongue down.  Soft articles like cork and indiarubber should not be used, for if they are bitten through, the rear portion will fall down the throat and choke the victim.

After the fit, lower the head to one side to clear any vomitus which, if left, might be drawn into the windpipe, lift the patient on to a couch, cover him warmly, and let him sleep.  An epileptic’s bed should be placed on the ground floor; if his bed be upstairs, it is difficult to get him there after an attack, while he may at any time fall downstairs and be killed.

Any effort to rouse him will only make the post-epileptic stupor more severe, but whether he sleeps or not, he must carefully be watched, for patients in this state are apt to slip away, often half-clothed, and travel towards nowhere in particular at a wonderfully rapid rate.

If several fits follow one another, or if one is very long or severe, send for a doctor.