484 CEREBRAL APOPLEXY. 



but some striking cases I have had in my own practice have, 

 greatly altered my former opinions ; and I find I am very 

 much borne out in these altered views by the reports of 

 others. At the same time, I wish it to be understood that 

 arteriotomy is in no case to be confided in unless blood can 

 be obtained from one or both temporal arteries in a full and 

 fast stream. A dribbling or tardy current will avail 

 nothing, and need not be persisted in." 



My views with regard to blood-letting in encephalitis 

 are that in the earlier stage it may be of use, but as the 

 disease advances we must rely more on relieving the blood- 

 vessels of the head by the direct application of cold, and 

 perhaps using rubefacients to the extremities and trunk, so 

 as to determine the blood from the head. Setons, blisters, 

 &c., are only of use in chronic forms of the disease. 



CEREBRAL APOPLEXY. 



An animal, when seized with cerebral apoplexy, suffers 

 from a sudden pressure on the brain, as the result of deter- 

 mination of blood and extravasation. The muscular appa- 

 ratus is more or less completely paralyzed, but the heart 

 and lungs continue to act. This condition of the system is 

 termed the comatose. In reply to the question, What is 

 coma ? Dr Watson says : " It is that condition in which 

 the functions of animal life are suspended, with the excep- 

 tions of the mixed function of respiration ; while the 

 functions of organic life, and especially of the circulation, 

 continue in action. There is neither thought, nor the 

 power of voluntary motion, nor sensation, but the pulmo- 

 nary branches of the par vagum continue to excite, through 

 the medulla oblongata, the involuntary movements of the 

 thorax. When this upper part of the cranio-spinal axis 

 becomes involved in the disease, and its reflex power 



