PARTIAL HYrEILEMIA AND (EDEMA OF THE BRAIN. 193 



ui old remedy, from which I have seen great benefit and, lastly, the 

 administration of active purges, are also among the more common 

 remedies. In acute threatening hyperaemia of the brain, croton-oil is 

 peculiarly in repute, while, in chronic cases, pills of aloes, colocynth, 

 jalap, etc., are usually prescribed. If, as occasionally happens, there 

 be fluxion to the brain, instead of to the pelvis, at the menstrual period, 

 we may apply leeches to the cervix of the uterus, or cups to the inside 

 of the thighs. Occasionally, also, the application of leeches about the 

 anus has a wonderful effect, as is shown by the well-known histories 

 of the patients that Goethe so much ridicules under the name of 

 " proktophantasmisten." 



In congestive hyperaemia resulting from compression of the jugular 

 veins or vena cava, as well as in that occurring from heart and lung 

 diseases, venesection or leeches behind the ears may be employed, if 

 the obstruction to the flow of blood cannot be removed. We have 

 shown that congestion, by arresting the supply of arterial blood to the 

 brain, diminishes or removes the excitability of the brain filaments and 

 ganglia. The greater freedom of escape we give the venous blood, 

 the sooner we shall succeed in removing the symptoms of depression 

 and the paralysis. This may be done by the application of leeches 

 behind the ears, since this moderates the tension in the veins outside 

 of the skull, with which the emissaria Santorini communicate ; or by 

 venesection, by which the tension in the anonymous veins is dimin- 

 ished, because less blood enters them from the arm. In such cases we 

 cannot expect any thing from the employment of cold, or from laxatives 

 and blisters. 



In hyperaemia of the brain resulting from too much nourishment, 

 instant diminution of the quantity of blood may be urgently indicated, 

 and a well-timed venesection not unfrequently prevents a threatening 

 apoplexy. It is very important to regulate the mode of life of such 

 patients, to show them the danger of prolonged, luxurious meals, and to 

 let them eat little, drink water instead of wine, and walk a great deal. 



Of course, in each case, peculiar circumstances will require some 

 deviation from the plans of treatment advised, and different directions 

 as to regimen. 



CHAPTER II. 



PABTIAL HYPEE^MIA AND PARTIAL CEDEMA OF THE BKAIN. 



A SHOUT consideration of partial hyperaemia of the brain will de- 

 cidedly facilitate the comprehension of the symptoms of diseases ol 

 the brain limited to circumscribed spots. 



