CEREBRAL HAEMORRHAGE. 345 



by a formation of cell-elements tending to form a capsule. In 

 other instances inflammatory changes may be established, 

 and softening of contiguous structures or an abscess may 

 result. 



Symptoms. — As we have no power of obtaining information 

 in the case of our patients from a knowledge of subjective 

 phenomena, the first indications are usually sudden and 

 obvious interference with cerebral functions, loss of conscious- 

 ness, common sensation and control over voluntary move- 

 ments; the disturbance of motor-power is usually more 

 complete than that of sensation. In the slighter instances of 

 blood-extravasation, the loss of control over voluntary move- 

 ment may, although general, be incomplete, or it may be 

 limited to certain sets of muscles — a form of hemiplegia. 

 When extensive the motorial power may be completely lost, 

 the animal falling to the ground in a state of profound coma ; 

 while when laid there, certain convulsive movements may be 

 executed by particular muscles or sets of muscles. Although 

 these in a general sense may be regarded as representing the 

 indications of cerebral haemorrhage, apoplexy proper, it must 

 never be forgotten that in moderate cases of blood-extrava- 

 sation the symptoms vary in accordance with the parts of the 

 brain-substance which are the seat of the effusion. In all, 

 however, their accession is sudden, and in the more extensive 

 fatal in their results; chiefly from the impairment of the 

 vagus power and pneumonic complications. With the less 

 extensive efliisions, should the symptoms not show'progression 

 or fresh exacerbation after the second or third day, a certain 

 amount of hope may be entertained of recovery, with, it may 

 be, impairment of some local activity. 



Treatment. — When the truly apoplectic sjrmptoms of coma, 

 with more or less impairment of motion and sensation, occur 

 in connection with appreciable or non-appreciable causes, the 

 ordinary resorted to practice of blood-abstraction ought to be 

 carried out with much caution, and only under particular con- 

 ditions; otherwise, from our present knowledge of cerebral 

 functions, and the influence of blood or serous extravasation 

 on the normal operation of these, we are disposed to think it 

 is better to trust to less dangerous remedies and the recupera- 

 tive powers of the animal body. When the sudden disturb- 



