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The Journal

of the

Michigan State Medical Society

The Official Organ of the State and County

Medical Societies

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Michigan State Medical Society

OF THE

ISSUED MONTHLY UNDER THE DIRECTION OF THE COUNCIL

Vol. XXI

GRAND RAPIDS, MICHIGAN, JANUARY, 1922

No. 1

Original Articles

tion of importance in this endeavor has been accorded the various preparations of bro

mide. THE LUMINAL TREATMENT OF

In 1912 Alfred Hauptman(1) reported the EPILEPSY

treatment of a series of cases of rather se

vere epilepsy with a new drug-Luminal. JAMES M. STANTON, M. D.

He was very favorably impressed with the DETROIT, MICH.

use of this substance and reported no inAmong the patients that present them

jurious by-effects of any kind after months selves to the neurologist few can be found

of daily administration of this drug. Kutmore common or more interesting that that zinsky(2), Fuchs(3) and Debrowski(4) in 1914 great group characterized by recurrent con

reported separate series of cases treated with vulsive seizures of a more or less stereotyped the drug. They all had observed either nature to which are given the name—“The marked reduction in the number, or comEpilepsies.”

plete cessation of the seizures. Fuchs, howFor the discussion of a type of treatment ever, spoke of the seizures recurring with of a condition as ill defined as this entity; if greater frequency after withdrawal of the it may be called an entity it would seem wise drug. Grinke(5) in a discussion of a paper to first make clear the type of treated case by Dercum in 1916 was the first in this counfrom which my conclusions are drawn. At try to mention the use of Luminal. Derthe present time epilepsy may best be re- cum(6) in 1919 reported upon the use of the garded as a symptom, the result of an in- drug.

drug. He found that one and one-half to creased excitability of the cerebral cortex two grains of luminal given daily almost from stimuli of exogenous or endogenous uniformly controlled inhibited the origin.

seizures. It is obvious in view of this situation that Grinke(5) reported in 1920 his experience the treatment of the condition must be based with over one hundred cases

cases of epilepsy upon either the removal of the sources of treated with this drug. He has found that the stimuli; or, of a lowering of the cortical luminal in doses of one and one-half to two threshold of excitability. It is obvious that grains, once or twice daily, is capable of the ideal method would be the removal of causing an arrest of convulsions in epilepsy. the sources of the stimuli. However, in a Some of his patients have been free from atlarge proportion of the number of patients tacks for three to four years. He has obshowing this disorder, the sources of stimu- served no harmful effects from the long conlation are impossible of detection by our tinued administration of this drug. He is present means of physical and functional thoroughly convinced of the superiority of examination. It is largely in this group of luminal over the bromides in the treatment patients that I have used luminal. There of these cases. remains, also, a certain number of cases Kirk(7) presented a report of two hundred where the source of the stimuli is discover- cases of epilepsy treated with luminal at the able, but in which it is not possible to re- Arkansas State Hospital for Nervous Dismove or effect the source of the excitation. eases. He reports an immediate decrease From this it is obvious that the therapeu- in the number of seizures in all cases and a tic

approach to a relatively large group of complete cessation of the seizures in a large patients suffering with this disorder must number of the cases. He remarks that no

measures that lower the bad effects were observed on the kidneys, ttreshold of cortical excitability. Up to stomach, circulation, temperature and res

a comparatively short time, the posi- piration. There is no evidence, he feels, to

or

depend upon

within

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