2(J6 PATHOLOGY OF EPILEPSY, ETC. 



to the occurrence of one or both of those sources of 

 disordered cerebral circulation.* 



That the brain is in itself capable of considerable 

 enlargement we see not only in the temporary ele- 

 vation and expansion of the organ synchronously 

 with respiration, in cases where it has been exposed 

 by the operation of trephining, but also in the tension 

 of the fontanelles in infants during paroxysms of 

 anger or convulsions, and, in a still more striking 

 degree, during the continuous and extreme aug- 

 mentation of the head in chronic hydrocephalus. 



While conversely in cases of death by hanging, 

 it is found that though the eyes are almost forced 

 out of the orbits, and the blood-vessels of the con- 

 junctiva often give way under the pressure of the 

 congestion, the integuments of the face and the 

 scalp being at the same time inordinately swollen 

 and engorged, the brain itself, which is equally ex- 

 posed to the influence of the same obstructed cir- 

 culation, remains comparatively unaffected in its 

 appearance, and does not present anything like the 

 intense degree of hypcrremia which might a priori 

 have been expected. 



* It has often occurred to me, that the careful examination of 

 tlic state of the venous opening in the foramen laccrum postcrius in 

 fatal cases of epilepsy and apoplexy would materially assist in 

 elucidating the pathology of those diseases. For as the greater 

 part of the cerebral blood flows from the iuteiior of the cranium 

 through those small curved openings in the base of the skull, it is 

 r\ i'lrnt that any narrowing of them by thidu-ning >f tin- lining 

 membrane, irregular < ISM lira! ion, etc., would create a constant 

 liability tu disordered circulation in the vessels of the brain. 



