274 DISEASES OF THE BRAIN. 



during life. If the symptoms of cerebral tumor occur in a person who 

 shows signs of carcinoma, tubercle, aneurism, or parasites in some 

 other organ, we are justified in presuming that the cerebral growth is 

 of the same nature as the other tumor, neoplasia, or parasite ; but this 

 aid to diagnosis fails in most cases, except where there are tubercles 

 of the brain in persons with tuberculosis of the lungs, and syphilomata 

 of the brain in persons with the same affections of other organs. Car- 

 cinoma of the brain is, as a rule, primary and solitary ; aneurism of a 

 cerebral artery is usually the only one in the body, and, when cysti- 

 cerci and echinococci enter the brain, as a rule they also are limited 

 to that organ. 



The age of the patient gives some indication as to the nature of 

 the tumor. Most frequently children are affected with tubercle, young 

 adults with benignant tumors, especially sarcoma and glioma, and per- 

 sons of advanced years with carcinoma. In his classical observations 

 on brain-diseases, Griesinger has shown that, under some circum- 

 stances, it is possible to make a diagnosis of cysticerci in the brain, 

 even when there are none in other parts of the body. The large num- 

 ber of these small parasites, and their customary seat in the superficial 

 layers of the cerebrum, explain the severe psychical disturbances and 

 the epileptiform attacks, while the absence of a large compressing 

 body explains the non-occurrence of symptoms of paralysis, on which 

 factors Griesinger founded the diagnosis in his case. On the other 

 hand, I regard Griesinger's experiment, of compressing both carotids 

 firmly against the transverse processes of the cervical vertebrae, as entire- 

 ly useless for the diagnosis of basilar aneurism, and he, too, says it is 

 " purely theoretical." The occurrence of convulsions during this act 

 is not at all significant of an aneurism, even of an obliterated one. In 

 many other diseases, also, where there is any thing encroaching on the 

 mtracranial space, compression of both carotids causes dizziness and 

 loss of consciousness with or without convulsions. 



TREATMENT. We can do but little to remove carcinoma, sarcoma, 

 and the neoplasia generally, in other organs, by the hunger-treatment, 

 by the administration of iodine, arsenic, etc., and these remedies are 

 of no more benefit in tumors of the brain. They hasten the fatal re- 

 sult instead of retarding it. The treatment can only be palliative and 

 symptomatic. It is useless, and annoys the patient, to apply a seton 

 or issue to the nape of the neck. On the contrary, it is advisable to 

 guard him in every way from hyperaemia of the brain, by which 

 acute swelling of the tumor and threatening attacks are most fre- 

 quently caused ; to regulate the nutrition and mode of life ; to attend 

 to the bowels, etc. Apoplectic or inflammatory attacks must be com- 

 bated by venesection, local bleeding, ice-compresses, etc., as before 



