ACUTE HYDROCEPHALUS. 131 



in nearly one-third of the cases, l^ubercular deposits are also found 

 in various other parts of the body, in a vast majority of cases. 



Treatmeyit. — This should be strictly antiphlogistic, and should be 

 resolutely employed at once. The patient should be placed in 

 the erect posture, and blood should be drawn from the arm till 

 the approach of syncope ; below the age of five, it will be more 

 prudent to apply leeches to the temples or behind the ears; but 

 some physicians deem it right to abstract blood from the arm, 

 even in children of three or four years of age. The abstraction of 

 blood must be followed up by free purging ; and as the bowels 

 are always constipated, recourse must be had to the most active 

 purgatives, especially calomel and scammony ; in many cases, 

 the administration of croton oil will be found necessary to obtain 

 evacuation of the bowels. During the employment of these means, 

 the head should be shaved, and kept cool by the constant application 

 of cold lotions. Calomel may be administered in small regular 

 doses, till it causes green stools like chopped spinach. Great 

 excitement or delirium may be mitigated by giving very small doses 

 of tartar emetic in solution. When the force of the circulation and 

 the acuteness of the disease have diminished, blisters may be applied 

 to the nape of the neck. In the latter stages, digitalis, colchicum, 

 and a variety of remedies have been recommended, but the case 

 is almost beyond relief. There is, however, a combination of equal 

 parts of crude mercury and fresh squills, rolled into a mass, 

 which may be given in doses of five grains ter die^ and it causes a 

 great secretion of urine. 



Whatever mode of treatment be adopted, it should be had 

 recourse to at the very onset of the disease, for experience unfortu- 

 nately shows that little hope of recovery remains when the affection 

 has arrived even at the second stage. 



Cerebral exhaustion in children produces many symptoms like 

 hydrocephalus, for which it would be most dangerous to mistake it, 

 as the causes, nature, and treatment are quite opposite. It occurs to 

 children ill fed, or exhausted by depletion : the face is cool ; 

 the child very drowsy, and unable to hold its head up ; the 

 breathing irregular and sighing. One grand distinctive mark is, 

 that the fonianelle is sunkeii^ showing that there is no vascular 

 turgescence in the brain. Beef-tea, small doses of ammonia, 

 good nursing, and warmth, are the remedies. 



Chronic Hydrocephalus. — This disease seems to depend, not on 

 inflammation of the cerebral membranes, but on increased secretion 

 of the cerebro-spinal fluid, which is commonly connected with some 

 congenital lesion of the brain. Chronic hydrocephalus generally 

 exists at the period of the infant's birth, but it sometimes appears 

 during the first few years of infantile existence. It manifests itself 

 by a gradual enlargement of the cranium, which occasionally attains 



