24 APOPLEXY. 



and its membranes with blood — a heav}' congested state of them, 

 which on some occasions has ended in rupture and extravasation ; 

 though more commonly it has produced serous effusion into the 

 cavities of the brain. In reference, however, to this state of effu- 

 sion, we find it observed by Dr. Copland, that " the inference 

 clearly deducible from faithfully observed facts, is, that the effu- 

 sion is not the cause but the consequence of the apoplexy ; and 

 that a considerable portion of the effusion takes place either imme- 

 diately before or soon after death." It was the discovery of blood 

 in one case, and of serum in another, that gave rise to a division 

 of the forms of disease by the older physicians into sanguineous 

 and serous apoplexy ; though, from the foregoing observations, 

 there would appear to be no practical ground for the support of such 

 presumed distinction ; and it is said, cases have occurred in which 

 nothing extraordinary has been discoverable either in the brain or 

 its membranes. Mostly, the disease will be found to have its origin 

 in pressure upon the brain, or else in some disturbed or interrupted 

 state of the circulation of blood through it ; and should we by any 

 means succeed in taking off or relieving this pressure while the 

 powers of re-action still survive, there may be a chance of the 

 patient's recovery. 



The following very interesting case of 



Apoplexy caused by a tumour upon the forehead, 

 was inserted in The Veterinarian for 1840, by Mr. Relph, 

 veterinary surgeon, Sebergham, near Carlisle. 



" A mare had a firm circumscribed tumour upon the right parietal bone, 

 which, though originally no larger than a nutmeg, had within the last five 

 months acquired the bulk of an orange. She always evinced much dread of 

 having it touched. While working one day in a thrashing machine, she was 

 seized with an apoplectic fit, and, while she lay insensible, the tumour was 

 observed to have become flattened, irregular, and diffused, and to have ex- 

 tended to the right orbit. She was bled twice during the fit ; and then an 

 incision was made into the tumour, and about an ounce and a half of coagu- 

 lated blood let out : after which, became apparent a perforation through the 

 parietes of the skull. She died an hour afterwards without a struggle. Exa- 

 mination of the tumour discovered a small opening through which a probe 

 passed into the cranium by the side of the longitudinal sinus ; and upon both 

 sides of this there existed effusion of blood. The structure of the brain itself 

 was natural." 



