Epilepsy and Convulsive Disorders in Children
- Author:
Edward N. Bridge, M.D. McGraw Hill
Book Co. 1949. 670 pp. $8.50.
This capacious volume belongs to a class of American book difficult for a British reader to appreciate at first sight. It is addressed to a more miscellaneous public than we think is advisable, with the result that much of the matter appears repetitive, and much is too technical for the layman. But with the proviso that it should really have been twins, Dr Bridge’s work can be welcomed as a most comprehensive, solidly scientific and timely contribution to the study of epilepsy in children. The author is a pedriatrician of distinction who had charge of the Johns Hopkins Clinic for epileptic children for sixteen years, and he presents the results of the intensive study of nearly a thousand cases. The clinic was on the grand transatlantic scale and included a full-time social worker to keep in touch with home and school conditions, an observation ward for clinical research, and laboratories with technical staff. ” The problem of diagnosis is not one of searching for a single cause but of evaluating the relative importance of (a) heredity, (b) structural defects in the brain, (c) physiological disturbances, (d) personality maladjustments and (e) environmental strains in producing the symptoms of recurrent seizures.” This rather scattered approach does not, however, prevent sound investigation into the pathological aspects of epilepsy, the chapters on effects of cerebral birth injury, on dietary treatment, on physiological influences and on the electro-encephalograph, being particularly full and illuminating. There appears to be less confidence in drug treatment for children and more in diets than would be shown by many specialists in this country.
Perhaps for the first time in a book of this description, the psychological and social aspects of epilepsy receive adequate attention. Dr Bridge follows Adolf Meyer in believing that very few cases in children are purely psychogenetic. He believes, however, the incidence of fits can be largely determined by environmental factors and influenced by mental hygiene. Even more obvious and important, from the standpoint of preventive medicine, is the effect of unintelligent treatment in producing the so-called ” epileptic * personality The advice offered to parents on the handling of children, and to doctors on the handling of parents, is so wise and comprehensive that one would like to see it condensed and issued in pamphlet form for the British public. The inferiority feelings, from which inevitably we British are beginning to suffer, will be relieved by noting that as regards the placing of epileptics in industry, and in the.provision of residential accommodation, we seem to be well ahead.
It is to be hoped that dollar shortage will not prevent the circulation of this most valuable work among medical and sociological graduates and students in this country. L. F.
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