Kossmann (1901) wrote that in 1760, before he had bought (gekauft hatte) his title "de Sauvages," Bossier first introduced the word eclampsia. He said that de Sauvages was a typical Frenchman in that he took it badly whenever his title was omitted, that he had mistaken the meaning of the Greek word from which he derived eclampsia, that none of the supporting references he cited was correct, and that we owe the word to de Sauvages' slovenly scholarship.
Kossman was in error. De Sauvages published under that name at least as early as 1739, and there is no indication in the Biographisches Lexicon (Hirsch 1887) that he had not been born as de Sauvages. He did acquire the title de Lacroix later. De Sauvages (1739) differentiated eclampsia from epilepsy in his Pathologia Methodica , the three editions of which were forerunners of the Nosologia, that Kossmann cited. He indicated that epilepsy is chronic and that the fits recur over long periods of time; all convulsions of acute causation de Sauvages called eclampsia, spelled with one c in the first and second editions and two in later editions. He attributed the source of the word to Hippocrates in the sense of Epilepsia puerilis, which Kossmann considered to be erroneous. In later editions he cited de Gorris's Definitionem Medicorum , Hippocrates, and the Coan Prognosis, in none of which the word appears, according to Kossmann.
Part of the discrepancy is explained by the questionable authorship of many writings that have been attributed to Hippocrates. Most scholars do not accept the sixth book of Epidemics as being his, but in Section I No. 5, the word does appear and has been translated as "epilepsy", both before and after de Sauvages' time. Galen (Vol.17, pt.I, p. 824, Kuehn, [ed]: 1829) translated eklamyieV as "fulgores" (lightning, shining, brilliancy) but after four half-pages of discussion of its significance concluded that here it probably means epilepsy. Nearly a century after de Sauvages, Grimm (1837)translated the word as Fallsucht (epilepsy). The word does not appear in the edition of de Gorris's definitions (1578) that I have seen, but it may be in others. Perhaps de Sauvages cited the wrong dictionary, for he is vindicated by another one. Castelli (1682) in his Lexicon Medicum defined eclampsis as brightness, lightning, effulgence, or shining forth as in a flashing glance ("splendorum, fulgorum, effulgiscentium, et emicationem, qualis ex oculis aliquando prodeunt"). He cited several writings attributed to Hippocrates in which the word was used metaphorically to mean the shining vital flame in puberty and the vigorous years of life ("emicatione flamme vitalis in pubertate et aetatis vigora"). Under Effulgescentia he wrote "vide ecclampsis". In an earlier edition (1651) eclampsis did not appear, but effulgescentia had several definitions, the first of which is a disorder characteristic of boys, the most familiar being epilepsy ("quas Graeci eklamyiaV vocant Hipp. praesertim significant morbum puerorum proprium, aut certe perquam familiarissimum, id est, Epilepsium"). Castelli, who followed Galen's discussion just mentioned, wrote that to some the word denoted the tempermental changes to warmth or the effulgent vital flame of youth and early manhood. Others considered the interpretation to be the bodily development and perfection during early adulthood.
Blancard (variously Blancardo, Blankaard 1683), in his Lexicon Medicum, defined eclampsis as "effulgio", and wrote that some authors had called the circulation eclampsis because they thought that a flashing principle in the heart ("luminoso principe in corde") impelled the blood. The word disappeared from his later editions.
In the third edition (1759) of Pathologia Methodica, de Sauvages listed several species of eclampsia in relation to such acute causes as severe hemorrhage, various sources of pain, vermicular infestations, and other such factors as had been noted by Hippocrates. One species was Eclampsia parturientium and de Savauges indicated that Mauriceau had described the disease.
Vogel (1764), Cullen (17771), Sagar (1776), in their classifications of diseases, adapted de Sauvages' Eclampsia parturientium, but dropped one of the two c's. Interestingly, the taxonomists defined both Convulsio gravidarum and Eclampsia parturientium (or parturientes) as different genera and with no cross references between the two.
Gutsch (1776), a student of J.C. Gehler in Leipzig, may have been the first German obstetrician to take up the word, and for a generation the German use of it seems to have been confined to that center. Kossmann (1901) wrote that the word reappeared in France in 1844, but Ryan (1831) said that was generally used there in his time. This is confirmed by the listing of publications in the Index Catalog of the Library of the Surgeon General's Office (1890) where the word eclampsia appears in the titles of 31 books or monographs from six European countries, before 1845; there were many from France.
Ryan (1831)recognized the specificity of what he called distocia convulsiva. He gave as synonyms "labor with convulsions", "convulsio apoplectica", "apoplexia hysterica", "apoplexia lactusa", "apoplexia sympathetica", and "eclampsia". When consciousness returns between fits Ryan called them epileptiform, and when coma or stertor supervened he called them apoplectic or eclamptic convulsions. He wrote that convulsions may occur during the last three months of pregnancy, in labor, or after delivery, and that the prognosis is unfavorable "as a third of those afflicted are destroyed." Postpartum eclampsia is less dangerous, he said.
Bossier de Sauvages' (1759) use of the word eclampsia as a generic term for convulsions having an acute cause persisted for more than 200 years. Stedman's Medical Dictionary (1957) defined eclampsia as "convulsions of an epileptoid character" and listed several varieties. Puerperal eclampsia was defined as convulsions of uremic or other origin, occurring in the latter part of pregnancy or during labor. There was no mention of the puerperium. The twentieth edition of 1961 discarded all but the obstetric definition "coma and convulsions that develop during or immediately after pregnancy, related to proteinurea, edema, and hypertension." Puerperal eclampsia was described as following delivery, which is technically correct but a misleading guide to interpretation of much of the literature of the past century.
In "Symbol" font, "y" is Greek psi, V is Greek final sigma (lower case).