Abstract
The third chapter of the book proceeds to the detailed presentation and analysis of the medical files of John Hughlings Jackson’s epileptic patients, who were hospitalized at the National Hospital for the Paralysed and Epileptic, during the period 1870–1895. More particularly, it aims at a chronological presentation of the archival data. For this reason, it is divided into four subperiods: (i) 1870–1879, (ii) 1880–1885, (iii) 1886–1890 and (iv) 1891–1895. From this perspective, it focuses on the diachronic, quantitative presentation of a variety of elements: epileptic patients’ gender, their age, their marital status, the time of being ill before their admittance to the National Hospital, the length of their hospitalization, their occupation, their address of residence, the means of treatment and the result of hospitalization. The meticulous reference to these data is going to facilitate their qualitative, sociological and epistemological, analysis that is going to follow in the next two chapters of the book.
[…]. the question of the archive is not, we repeat, a question
of the past […]. It is a question of the future, the question of
the future itself, the question of a response, of a promise and
of a responsibility for tomorrow.
J. Derrida, Archive Fever. A Freudian Impression
By this word [archive], I do not mean the mass of texts gathered
together at a given period, those from some past epoch which have
survived erasure. I mean the set of rules which at a given period
and for a given society, define: 1. The limits and forms of the sayable.
[…] 2. The limits and forms of conversation. […] 3. The limits and
forms of memory […] 4. The limits and forms of reactivation[…] 5.
The limits and forms of appropriation[…].
M. Foucault, Politics and the study of discourse
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Notes
- 1.
In fact, David Wire became the first chairman of the National Hospital Board and was regularly presiding at the board’s weekly meetings.
- 2.
It is worth mentioning that these doctors did not have yet any specialized, neurological education and training. When the National Hospital opened its gates, and for many years afterwards, physicians with a clearly neurological specialization were extremely rare. As we are going to demonstrate in the following sections, neurology was just making its first steps as a distinct medical specialty.
- 3.
At this point, it should be stressed that the medical files that were examined belonged to Jackson’s inpatients, that is, to epileptic patients who were hospitalized at the National Hospital. The medical files of the incomparably higher number of the outpatients, who were just visiting the hospital’s outpatient department for diagnosis and consultation, were not examined. Additionally, it should be mentioned that in a very small number of cases – mainly, during the first subperiod under study – there was also written in the file the name of another National Hospital’s doctor. However, since it was not clarified who had been the physician in charge, we have included them in Jackson’s inpatients, as well.
- 4.
We should notice that we have included a small number of patients in the category of epileptics, even though there was recorded no definite diagnosis in the category “disease”. However, their medical file included the exact number and specific character of their (epileptic) fits. Thus, the omission of the diagnosis was, in a way, replaced by the detailed description of their general condition.
- 5.
We should underline that there are no available data for Jackson’s inpatients during the first decade of the hospital’s functioning, that is, the years 1860–1870. This is the reason why our study begins from 1870 onwards.
- 6.
As we have already stressed, all data are from the collective volumes of John Hughlings Jackson’s inpatients’ medical files, which are available at UCL’s Institute of Neurology (Queen Square, London).
- 7.
As there were no specific details in the majority of the cases, the improvement of their condition consisted, presumably, in the decline in the number of epileptic seizures, without implying, however, that they were discharged free of seizures. Their full recovery was clearly demonstrated by the word “cured”.
- 8.
We can see that Esquirol’s theory, as it was presented in the first chapter, was still in use, and it would be used as one of the main etiological factors in cases of epilepsy, as we are going to see in the next subperiods.
- 9.
It should be noted that, from 1882 onwards, we follow our own pagination, since there were no numbers in the files’ pages.
- 10.
Especially, during the first years under examination, secretaries’ handwriting was peculiarly indecipherable, possibly, due to the bulk of data that had to be recorded, the relatively limited time and the lack of training for that kind of activity. As a result, there was an insuperable difficulty in reading and identifying them.
- 11.
Faradic currents were named after the English chemist and physician Michael Faraday (1791–1867) and were used as a remedy to excite the muscles and nerves of the body.
- 12.
At this point, we should underline that we do not refer in our analysis to those epileptics, who had undergone a surgery to treat another neurological disorder, from which they were also suffering. Our analysis is strictly limited to those epileptic patients, who had undergone a surgery to confront exclusively their epileptic seizures.
- 13.
It had been impossible to define the term “hemial” with a medical/neurological term. It could be that Jackson’s secretary, due to the bulk of data that had to be recorded, or due to the lack of specialized knowledge, misheard and, probably, confused what Jackson himself had actually dictated her.
- 14.
The ‘National Society for the Employment of Epileptics’, today ‘Epilepsy Society’, is located in Chalfont St. Peter, southeast Buckinghamshire. The study of its archives, in case an organized and accessible archive has been preserved, could lead to a further research and comparative analysis with the archives of the National Hospital.
- 15.
At this point, it is worth mentioning that there was to be found a great number of articles on epilepsy in medical journals, during the second half of the nineteenth century, such as in the Lancet, the Brain and the British Medical Journal; to their content, we are going to return in the next two chapters.
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Lekka, V. (2015). Unrolling the Archives’ Thread: Epilepsy and Epileptics at the National Hospital for the Paralysed and Epileptic. In: The Neurological Emergence of Epilepsy. Boston Studies in the Philosophy and History of Science, vol 305. Springer, Cham. https://doi.org/10.1007/978-3-319-06293-8_3
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