10 Dr. Yeats on an Affection of the Brain. 



back part of the brain, which would continue sometimes tbi 

 two hours, causing insufferable distress within the scull, but 

 confined, as it would seem, to the cerebellum, as the crown and 

 fore-part of the head were not affected. A horizontal position 

 increased this suffering, and it was most acute about three or 

 four o'clock in the morning, after he had slept for some hours. 

 He felt considerable giddiness and confusion in his head when 

 he stooped upon any occasion. The symptoms evidently 

 indicated bleeding, but he would not submit to it in any way, 

 from the failure [of these means to procure relief on former 

 occasions. His sufferings and his danger, too, being now 

 greatly multiplied, he submitted, after much persuasion, to the 

 following plan : 



At my request a seton was inserted in the neck, by Sir Aslley 

 Cooper. Mr. J. was confined entirely to vegetable and fari- 

 naceous food ; barley-water, rennet whey, and suclj like, being 

 his only beverage, and he was desired to keep continually in 

 the erect position with his body, by sitting in a chair, not going 

 to bed at all, and to keep his head, which had been shaved for 

 the purpose, unremittingly moistened with a cold lotion (a so- 

 lution of muriate of ammonia, in vinegar and water). I put 

 him upon this plan from the idea that the blood did not readily 

 find an exit from the head, in the tortuous and complex circu- 

 lation of the brain, in the horizontal position; and, 2dly, the 

 veins of the brain had become weakened, from the long state 

 of distention in which they had existed ; they had not, there- 

 fore, sufficient power to propel their contents against gravity, 

 while the body was in the recumbent position, which, at the 

 same time, favoured the transmission of the blood to the head by 

 the arteries ; thus there was a supply, without a corresponding 

 discharge. The erect position facilitated the return of blood from 

 the heard, while it assisted to impede its progress thither, and 

 the coldness of the lotion gave a contractile power to the veins, 

 diminished their calibre, thus accelerated the transit of the 

 returning blood, and prevented the accumulation and the con- 

 sequent pain. 



The happy practical effect fully confirmed tlie soundness of 



