200 DISEASES OF THE BRAIN. 



to the nerve-elements of the brain, we do not consider the great simi- 

 larity of the symptoms of hydrocephalus to those of hydrocephaloid as 

 very strange. Different as are the modes of origin of the two dis- 

 eases, we believe that in both of them there is ultimately the same 

 pathological disturbance, that is, capillary anaemia. 



Lastly, in anaemia of the brain, morbid symptoms in the mental 

 functions preponderate ; there are sleeplessness, great excitement, deliri- 

 um, etc. In some cases this state increases to paroxysms of frenzy and 

 decided maniacal attacks. The latter are seen in persons who have 

 had no food or drink for a long time, but they are also not unfrequently 

 seen in weakly, bloodless patients, if their anaemia has been greatly 

 increased by exhausting diseases and abstractions of blood. 



TREATMENT. If the anaemia of the brain be one symptom of gen- 

 eral impoverishment of the blood, this is to be treated by limiting the 

 consumption and increasing the supply of suitable nourishment. A 

 consideration of the etiology and other circumstances of each case gives 

 the indications for treatment. If profound and continued faintness, 

 convulsions, and other signs of excessive hyperaemia of the brain come 

 on after extensive loss of blood, even transfusion may be necessary. 

 In treating the exhausting diarrhoea of infants, we should think early, 

 of the danger of hydrocephaloid, and attempt to prevent it by giving 

 raw flesh, wine, etc. If, nevertheless, the symptoms above described 

 come on, a false interpretation of them is very dangerous. If the 

 practitioner be misled into applying leeches or employing debilitating 

 treatment, the children usually die. But if he sees through the con- 

 dition and, in spite of the restlessness, twitching, and consequent 

 sopor, gives concentrated broths and large doses of stimulants, cam- 

 phor, ether, but especially of strong wine, he often attains the hap- 

 piest and most surprising results. In the form of anaemia of the brain 

 which occurs as one symptom of general impoverishment of the blood, 

 it is also very important that, until the normal quantity and quality of 

 the blood is reestablished, we see that the heart does not receive too 

 little blood ; and it is just as important for us to combat any tempo- 

 rary weakness of the heart, that prevents it driving its blood energet- 

 ically into the arteries. Very many patients, with impoverished blood, 

 and convalescents die, solely because the physician has neglected to 

 give them the strictest orders to maintain a horizontal position. If 

 we permit exhausted patients to rise to stool, or to leave the bed too 

 soon, the feet are readily overloaded with blood, the heart receives tcxj 

 little ; consequently a sufficient supply does not go to the brain ; the 

 patient swoons, and not unfrequently does not awake from the fainting- 

 tit. On this very point I have had an experience in my private prac- 

 tice which will always prove a warning to me, not to permit convales- 



