INTRODUCTION: The influence of the Enlightenment is evident with the mention of Herman Boerhave. The strong European influence draws attention with minimal expression of the social and medical concepts of pre-Colombian cultures such as the Aztec and Mayan. METHODS: A medical and cultural conceptual analysis of the text "Medical-moral report of the very painful, and rigorous disease of epilepsy" is carried out. RESULTS: The physicians of the Enlightenment managed to define epilepsy, classify its seizures, explain its causes and pathophysiology, as well as carry out a comprehensive approach. This biomedical concept complemented and coincided with theological explanations of epilepsy. CONCLUSION: The Enlightenment was fundamental for a systematized development to explain epilepsy, which in some ways persists until today. The influence of the Aztec and Mayan cultures in this text is minimal.