16 COMA, OR SLEEPY STAGGERS. 



wards and ram the head against wall or rack, or any thing that 

 happens to oppose its advancement, the patient, though thus ar- 

 rested in his progress, still continuing, as he thinks, to advance, by 

 performing a trotting motion with his fore-legs ; or, he may stand 

 still, boring his head with all his might, and breathing so hard and 

 stertorously, that he alarms every person within his reach, lest 

 each hard-fetched respiration should end in a throe of delirium 

 and convulsion. These lethargic symptoms seldom continue any 

 length of time : they may increase in intensity, and end in apo- 

 plexy and death ; they more commonly are interrupted by a pa- 

 roxysm of phrenitis or mad staggers. The bowels participating 

 in the general torpor of the system, no dung is passed. 



Pathology. — It appears to me, that during the comatose stage 

 the bloodvessels of the brain must be in a state of surcharge or 

 congestion ; that this may increase and end in rupture, and extra- 

 vasation or hemorrhage, giving rise to apoplexy or sudden death; 

 or that it may only prove the prelude to increased vascular action, 

 and that inflammation, as I believe it commonly does, results 

 from it. In fact, I believe it to be very analogous to what we 

 observe taking place in congestion of the lungs. 



ENCEPHALITIS- PHRENITIS— MAD STAGGERS. 



Those who make use of the term encephaJon to denote both the 

 brain and its membranes, employ its derivative, encephalitis, to ex- 

 press inflammation affecting both those parts ; and in this sense it is 

 certainly the most appropriate name for the disease we are about 

 to describe. Inflammation attacking the encephalon mostly does 

 so in the acute form, producing that violent delirium pathologists 

 have designated by the term phrenitis, and which veterinarians 

 recognise as mad staggers : these are consequently nothing but 

 appellations for a symptom, though certainly one of a character so 

 prominent and absorbing, that it is apt to draw off the attention 

 from all the others. The nosology of mad staggers arising from 

 inflammation is therefore encephalitis ; and an advantage in adopt- 

 ing this in place of phrenitis, is, that it will apply to any form of 

 inflammation, chronic as well as acute, and in which phrenitic 

 symptoms, or mad staggers, may not happen to be present. 



