,%6 DISEASES Class I. 2. 3. i& 



cephalus internus, with general debility. The cure of this dif~ 

 cafe is effected by different ways ; it confifts in difcharging the 

 water by an external aperture ; and by fo far inflaming the cyft. 

 and tefticle, that they afterwards grow together, and thus pre- 

 vent in future any fecretion or effufion of mucus j the difeafe is 

 thus cured, not by the revivefcence of the abforbent power of the 

 lymphatics, but by the prevention of fecretion by the adhefion of 

 the vagina to the teftis. This I believe is performed with lefs 

 pain, and is more certainly manageable by tapping, or difcharg- 

 ing the fluid by means of a trocar, and after the evacuation of it 

 to fill the cyft with a mixture of wine and water for a few min- 

 utes till the neceffary degree of ftimulus is produced, and then to 

 withdraw it; as recommended by Mr. Earle. See alfo Medical 

 Commentaries by Dr. Duncan for 1793. 



12. Hydrocephalus internus, or dropfy of the ventricles of the 

 brain, is fatal to many children, and fome adults. When this 

 difeafe is lefs in quantity, it probably produces a fever, termed a 

 nervous fever, and which is fometimes called a worm fever, ac- 

 cording to the opinion of Dr. Gilchrift, in the Scots Medical 

 Effays. This fever is attended with great inirritability, as appears 

 from the dilated pupils of the eyes, in which it correfponds with 

 the dropfy of the brain. And the latter difeafe has its parox- 

 yfms of quick impulfe, and in that refpe£t correfponds with oth- 

 er fevers with inirritability. 



The hydrocephalus internus is diitinguifned from apoplexy by 

 its being attended with fever, and from nervous fever by the 

 paroxyfms being very irregular, with perfect intermiflions many 

 times in a day. In nervous fever the pain of the head generally 

 affects the middle of the forehead ; in hydrocephalus internus it 

 is generally on one fide of the head. One of the earlieft crite- 

 rions is the patient being uneafy on raifmg his head from the pil- 

 low, and wifhing to lie down again immediately ; which I fup- 

 pofe is owing to the preffure of the water on the larger trunks 

 of the blood-veffels entering the cavity being more intolerable 

 than on the fmaller ones ; for if the larger trunks are comprefF- 

 ed, it mull inconvenience the branches alfo ; but if fome of the 

 fmall branches are compreffed only, the trunks are not fo imme- 

 diate! v incommoded. 



Biifters on the head, and mercurial ointment externally, with 

 calomel internally, are principally recommended in this fatal dif- 

 eafe. When the patient cannot bear to be railed up in bed with- 

 out great uneaunefs, it is a bad fymptom. So I believe is deaf- 

 nefs, which is commonly miftaken for ftupor. See Clafs I. 2. 

 5. 6. And when the dilatation of the pupil of either eye, or the 

 fquiuting is very apparent, or the pupils of both eyes much diia- 



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