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JAMA 100 Years Ago
May 24/31, 2000


Author Affiliations

JenniferReiling, Editorial Assistant

JAMA. 2000;283(20):2634. doi:10.1001/jama.283.20.2634-JJY00014-3-1

The association of idiopathic epilepsy—grand mal—with the lymphatic constitution—persistence of thymus gland, hyperplasia of lymph nodes, and of spleen—has been emphasized of late by Ohlmacher. The association of lymphatism and of idiopathic grand mal has been so strikingly frequent in the autopsies in Ohlmacher's laboratory at Gallipolis, Ohio, that a thorough study of the literature bearing on persistent thymus and on the lymphatic state became necessary. The clinical condition of thymic asthma, or laryngismus stridulus, of infancy is connected on the one hand with the lymphatic constitution, of which enlarged thymus is often but a part, and on the other hand clinicians are wont to associate it with rickets. Tetany and infantile convulsions are also referred to "the rickety diathesis." With these considerations in view, and guided also by gross pathologic evidences of rickets in some of the epileptics, Ohlmacher was led to think more and more of the relation of idiopathic grand mal and rickets; and, all things considered, he became convinced that rickets plays an important role in the development of epilepsy.2 Ohlmacher3 refers, with a certain sense of satisfaction, to the fact that Gowers in 1885 had reached the same conclusions from purely clinical data obtained from a careful study of the infantile period of ninety-eight cases of epilepsy. Gowers was so strongly impressed with the apparent influence of rickets on the development of epilepsy that he was led to suggest that a considerable proportion of cases of epilepsy are really within the range of preventable diseases. This is reason, then, for continued effort toward clearing up the relationship of rickets, epilepsy, and the lymphatic constitution. We are as yet in the dark as regards the essential nature of rickets, and the lymphatic state. But at all events, infant hygiene and feeding should be brought up to the highest standard so as to do what can be done, in the light of our present knowledge, to prevent epilepsy and other neuroses that seem to have some connection with such diseases of infancy as rickets.