APOPLEXF. 215 



observed, with remarkable regularity, in diseases affecting the space 

 in the posterior cranial cavity, no matter what their nature or location. 

 Among my pupils I have noticed that the interest in brain-diseases 

 rapidly increases when it becomes evident that, in many cases, a sure 

 diagnosis can only be made within certain limits. Not unfrequently 

 we are obliged to stop at the diagnosis of a disease encroaching on 

 one side of the cerebrum, or on the posterior cranial fossa. In the 

 following chapters we shall show under what circumstances we can go 

 further, and how, in other cases, a certain diagnosis may be made of 

 the nature and exact seat of the disease. 



TREATMENT. As may be readily understood, the treatment of 

 partial anaemia and necrosis promises little benefit. In thrombosis and 

 embolism of the cerebral arteries, the obstruction to^the supply of 

 blood cannot be removed by therapeutic remedies. Hence the indica- 

 tion would be to favor the development of a collateral circulation, 

 without exposing the patient to new danger from too great collateral 

 fluxion. It is very difficult to fulfil these indications, and we may 

 readily do harm instead of good. The purer the symptoms of partial 

 paralysis, the more obstinate they remain ; if no symptoms of irrita- 

 tion accompany them, the more a strengthening and stimulant treat- 

 ment is indicated. Hence we always find the administration of stimu- 

 lants recommended in the treatment of softening of the brain. If, on 

 the other hand, the symptoms of irritation caused by fluxionary hyper- 

 gemia, such as severe headache, contractions, etc., are prominent, it is 

 advisable to use cold, and apply leeches behind the ears repeatedly. 

 We should be careful about venesection, as it is readily followed by 

 collapse. From what has been said, it is evident that we can give no 

 general rules, but the treatment must be suited to each case. We 

 shall speak of the treatment of partial anaemia of the brain, induced 

 by collateral oedema and compression of the capillaries, when we treat 

 of the diseases that this form of partial anaemia accompanies. 



CHAPTER V. 



CEREBRAL HAEMORRHAGE APOPLECTIC STROKE APOPLEXIA SAN- 

 GUINEA. 



BY the term stroke, or apoplexy, was originally meant, as the word 

 indicates, the sudden occurrence of complete functional inactivity of the 

 brain. Apoplexy is divided into various forms, according as the paral- 

 ysis is induced by an extravasation of blood or by a serous effusion, 

 or as organic diseases can or cannot be found as the cause : thus we 

 have Apoplexia sanguinea. A. serosa, A. nervosa, etc. In the present 

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