'IREATMBNT OF DISEASES- 247 



motion which is soon followed by death. Dr. Abemethy thinks that the 

 symptoms of concussion may properly be divided in three stages; the first 

 Is that state of insensibility and derangement of the bodily powers which im- 

 mediately succeeds the accident. The breathing is difficult, but in general 

 without stertor or snoring; the pulse intermits, and the extremities are cold. 

 This goes oflf gradually, and is succeeded by the second stage; in this, the 

 pulse and breathing are better, and though not regular, are sufficient to main 

 tain life, and to diffuse warmth over the extreme parts of the body. The 

 patient is inattentive to slight external impressions, though he feels when the 

 skin is pinched. As the effects of concussion diminish, he replies to questions 

 put to him in a loud tone of voice, particularly if they refer to his own suffer- 

 ing; otherwise he answers incoherently, and as if his attention was occupied by 

 something else. While the stupor remains there appears little inflammation of 

 the Drain, but as the stupor abates, the inflammation increases; and this consti- 

 tutes the third stage. Much caution and prudence are required in the treat- 

 ment of the first stage. A person is knocked down and becomes insensible; 

 many have seen or heard of bleeding being employed when a person has fallen 

 down suddenly, and the bystanders impatiently require that this shall be the 

 first article of the treatment. But the breathing is slow, the pulse intermitting 

 and the extremities cold; and to draw blood in such circumstances as these 

 would be taking the effectual method completely to extinguish life. Again, 

 suppose people were to reason from the resemblance of the state in which the 

 patient is in, to that of a person in a faint, and should as in that case give 

 stimulant liquors by the mouth, or apply pungent substances to the nose, there 

 is danger here, that by such appliances, the subsequent inflammation may be 

 increased. The utmost that should be tried is the endeavoring to restore the 

 heat of the extremities by friction with warm cloths or with stimulating embro- 

 cations; we must wait a little till we see whether the patient recovers from the 

 first stunning effect of the blow, and then be regulated in our future treatment 

 by the symptoms that occur. Those that we are principally to look for are 

 those of an inflammatory tendency; and to prevent the evils arising in the 

 after stages of concussion, we are to employ bleeding and purging, to keep the 

 patient in a dark room, to' enjoin perfect quiet, and to put in force the anti- 

 phlogistic (inflaming) regimen. 



2. Brain— Inflammation of.— Inflammation of the brain and its mem- 

 branes is characterized bj-- very violent feverish symptoms, great flushing of 

 !he face, redness of the eyes, intolerance of light and furious delirium; the 

 f kin is hot and dry, the pulse hard and frequent, the bowels are costive, and 

 there is a great feeling of tightness across the forehead. 



Causes. — These symptoms are occasioned by passions of the mind, by drink- 

 ing spirituous liquors; and in warm climates by exposure to the sun forming 

 what is called sun-stroke. 



Treatment. — Quiet both of mind and body with cooling aperient medi- 

 cines, abstinence from all rich and stimulating food and drink is the proper 

 treatment; in those of spare, weakly habit, it is sometimes owing to want of 

 vital energy, arid in this case the diet should be rich and stimulating; and the 



