ANTIFEBRIN 
IN THE 
TREATMENT OF EPIEEPSY. 
BY 
THEODORE DILLER, M.D, 
Danville, Pa., 
Assistant Physician in the State Hospital for the Insane, 
Danville, Pa. 
REPRINTED FROM THE THERAPEUTIC GAZETTE, JUNE 15, 1889. 
DETROIT, MICH. ; 
GEORGE S. DAVES, 
1889. ANTIFEBRIN 
IN THE 
TREATMENT OF EPILEPSY. 
NINE cases of epilepsy in this hospital in 
which the treatment by antifebrin was 
inaugurated were not in the least selected, 
but were simply taken in a hap-hazard way. 
As a matter of fact, they represent a wide 
dissimilarity in many respects ; and it has 
seemed to me that a group of cases which 
would comprise as many phases of the dis- 
ease as possible would be the best suited 
upon which to test the efficacy of a new 
therapeutic agent. The fact must not be 
lost sight of, however, that while these cases 
present important differences, yet they are 
all alike, in that each one has a degree of 
psychical disturbance which is considered 
by two reputable physicians to be of such 
nature as to require detention in a hospi- 
tal for the insane. The drug was given, 
with more or less interruption, during a pe- 
riod of about four and a half months,— 
viz., during part of October, and all of No- 
vember, December, January, and February. 
For greater convenience in calculation, and 
because of the possibility that the effects of 
1 2 
the remedy were not fully established until 
after it had been administered a short time, 
I consider that the drug has been taken 
only during the months of November, De- 
cember, January, and February last; but, in 
comparing number of fits occurring in these 
months with those which took place in pre- 
vious months, it would be obviously unfair 
to include the month of October in either 
list. So, in drawing comparisons, this month 
is omitted from consideration. 
The drug was administered three times a 
day, dry, upon the tongue. Dose : 4 grains, 
except in Cases III. and VIII., where this 
amount was doubled. As the powder is 
tasteless and practically insoluble, this mode 
of administration, I think, will generally be 
found to be the best. Some patients, how- 
ever, might prefer capsules, and, of course, 
the dose could easily be given in this way. 
For obvious reasons, the only observa- 
tions which could be made in the space of 
four months of the effects of any agent in 
the treatment of epilepsy, would be upon 
the frequency and character of the fits, and, 
to a less extent, upon the general physical, 
mental, and moral stains of the patient. 
Any estimate of the drug as a ctirative agent, 
based upon such meagre data, would be im- 
mature and unprofitable. 
I will as briefly as possible cite the cases, 
all females, and make comments upon them 
afterwards. 
Case I.—Aged 29 ; admitted 1884. Case 
of nine (?) years’ standing ; dark hair and 
eyes; rather undersized woman ; slight 
figure ; fair physical health; intellect very 3 
dull. Sits quietly in one place all day. No 
history of head injury, but large cicatrix 
noted just back of left frontal eminence, 
probably result of an old burn. 
Case II.—Aged 16 ; stupid, expressionless 
face ; silly, unmeaning grin. At times she is 
quite cyanotic ; comprehends only simplest 
ideas ; unable to attend to personal wants. 
General health poor. Refused medicine very 
frequently. 
Case III.—Aged about 40. Fits very vio- 
lent. She is nervous and uncertain in her 
movements. Moderately bright at times. 
Has periods of violent excitement after a 
fit. 
Case IV.—Aged 15. Mental power very 
limited. Silly in manner, and, after a series 
of fits, seems to be for a time totally uncon- 
scious of her surroundings. Fits can be con- 
trolled by the use of bromides, but this treat- 
ment has a marked depressing effect, both 
mentally and physically. 
Case Y.—Aged 34. Laborer’s wife ; has 
had epileptic fits for past nineteen (?) years. 
Mother is an epileptic. Fits of grand-mal 
type ; often nocturnal; always violent. Pa- 
tient reads, sews, etc. She is pretty bright 
mentally, but apt to complain of trivial 
matters. 
Case VI.—Aged 43; single; average height; 
slight figure ; blonde ; admitted 1884. His- 
tory says she has from four to eight fits per 
week. Acts in a silly, child-like manner. 
Fits very violent. 
Case VII.—Aged 34 ; single ; bright and 
ladylike ordinarily, but easily depressed in 
spirits ; has violent outbursts of temper ; un- 4 
stable in character. Fits of grand-mal vari- 
ety and without an aura. 
Case YIII.—Aged 42 ; married. Tall, thin 
woman ; bilious temperament; stupid and 
morose. Sews and does light work pretty 
well; has periods of very violent excite- 
ment, which last several days. After they 
have subsided she has no remembrance of 
them. 
Case IX.—Aged 13 ; admitted 1887 ; very 
dull and stupid ; gets fits in series ; at times 
in the status epilepticus. Before actual onset 
of such a period she is usually much excited, 
tears clothing, throws any article she can out 
the window. Obstinate ; apt to pick skin 
into open sores with pin. General health is 
poor. 
The annexed table will be found conven- 
ient for drawing comparisons as to the num- 
ber of fits occurring in each case while 
under the bromide and antifebrin treatments 
respectively. 5 
Total 
l 
I 
II 
III 
IV 
V 
VI 
VII 
VIII 
IX 
Cases. 
vO 
10 
HI H to H ►H 
*-H to VI M O VO o 
May. 
OO 
QO 
00 
*-< OJ *-H 
00 10 10 CvU) >-< oooo On 
June. 
74 
4^UtotoOwOtoO 
July- 
68 
O VO O On On 00 ►-< to 00 
August. 
CV 
hH to 
Oo *<I hOj O O vO 
September. 
October. 
On 
G) 00-4- OOM-f' *-< VO to 
November. 
On 
-£*■ 
O C\GJ 4* G) Go to OOGi 
December. 
ON 
L/i 
H-t HH 
VO 000O On OO VO O Gv tO 
January. 
M 
OO 
47 
OOJ O tO to VO tO 
February. 
Cv 
CnjW 
On o OO O On VO 00 
C/lIhO Oi|M tnjco cn|to 
Average number of 
fits per month 
from May to Sep- 
tember, inclusive. 
On 
ON OV to On to O to 
fcJ-|MrfkjCC IwjH* »H IH fcvjM Ww 
Average number of 
fits per month from 
November to Feb- 
ruary, inclusive. 
Table of Epileptic Fits. 6 
Cases I. and V. took the antifebrin during 
the four months continuously, except two 
weeks in December. The administration of 
the drug in the remainder of the cases was 
interrupted to a greater or less extent. This 
because of refusal to receive the medicine, 
mental excitement, etc.; but from December 
2 to 14 the treatment was in all cases sus- 
pended because of a failure of the supply of 
the drug. 
The remedy appeared to be well borne in 
all cases. The mental and physical depres- 
sion and gastric disturbance observed so often 
in the bromide treatment were not apparent. 
It will be observed that the greatest decreases 
in the number of fits under the antifebrin 
treatment are in Cases I. and V. There is 
less of a decrease in Cases III., IV., VI., and 
VIII., while in the remaining cases—II., VII., 
and IX.—there is slight increase. Of this 
last group, however, it may be said that the 
remedy did not have a fair chance, as it was 
so much of the time refused by the patient 
or set aside for a tonic treatment. 
In Cases II. and III. no fits occurred in the 
month of September, and in Case IV. only one 
fit in each of the months of June and July. 
This while patient was under the influence of 
the bromide treatment. It shows well the 
strong controlling influence of this treatment 
when we compare the records with those of 
months immediately before or after the months 
mentioned. It will be noticed that no such 
marked contrasts are recorded under the an- 
tifebrin treatment. The antifebrin did not 
succeed in any one case, having an average of 
over ten fits a month, in completely abolishing 7 
the attacks during a single month, as was the 
case under the bromide treatment. Yet in 
the two cases (I. and V.) responding best to 
the antifebrin treatment the seizures were 
pretty uniformly diminished in number each 
of the four months this treatment was pur- 
sued. This is also, though in less degree, 
true of the remaining five cases, particularly 
if we leave out of consideration Cases II. and 
IX. 
To conclude, it may be said : 
1. That in all the cases in which the drug 
was given continuously there was noted a 
reduction in the number of fits, ranging from 
about twenty-five to seventy-five per cent., as 
compared with other months during which 
patients were on bromide and tonic treat- 
ments alternately. 
2. The remedy was in all cases well borne, 
producing no apparent mental or physical 
depression. This in marked contrast with 
depressant effects noted after a course of 
bromide treatment. 
3. No skin eruption was produced. 
4. In any given case, in which a great num- 
ber of fits are occurring, and where it is de- 
sirable to control them as soon as possible, the 
bromides would be of far more value than 
antifebrin.