86 DISEASES CLASH I. 1.3. 12. 



cephalus interims, with great debility. The cure of this dis- 

 ease is affected by different ways; it consists in discharging the 

 water by an external aperture; and by so far inflaming the cyst 

 and testicle, that they afterwards grow together, and thus pre- 

 vent in future any secretion or effusion of mucus; the disease is 

 thus cured, not by the revivescence of the absorbent power of the 

 lymphatics, but by the prevention of secretion by the adhesion of 

 the vagina to the testis. This I believe is performed with less 

 pain, and is more certainly managable by tapping, or discharg- 

 ing the fluid by means of atrochar, and after the evacuation of it 

 to fill the cyst with a mixture of wine and water for a few mi- 

 nutes till the necessary degree of stimulus is produced, and then 

 to withdraw it; as recommended by Mr. Earle. See also Medi- 

 cal Commentaries by Dr. Duncan for 1793. 



12. Hydrocephalus internus, or dropsy of the ventricles of the 

 brain, is fatal to many children and some adults. When this 

 disease is less in quantity, it probably produces a fever, termed a 

 nervous fever, and which is sometimes called a worm fever, ac- 

 cording to the opinion of Dr. Gilchrist, in the Scots Medical 

 Essays. This fever is attended with great inirritability, as appears 

 from the dilated pupils of the eyes, in which it corresponds with 

 the dropsy of the brain. And the latter disease has its paroxysms 

 of quick impulse, and in that respect corresponds with other 

 fevers with inirritability. 



The hydrocephalus interns is distinguished from apoplexy by 

 its being attended with fever, and from nervous fever by the 

 paroxysms being very irregular, with perfect intermissions many 

 times in a day. In nervous fever the pain of the head generally 

 affects the middle of the forehead; in hydrocephalus internus it 

 is generally on one side of the head. One of the earliest crite- 

 rions is the patient being uneasy on raising his head from the pil- 

 low, and wishing to lie down again immediately; which I sup- 

 pose is owing to the pressure of the water on the larger trunks 

 of the blood-vessels entering the cavity being more intolerable 

 than on the smaller ones; for if the larger trunks are compress- 

 ed, it must inconvenience the branches also; but if some of the 

 small branches are compressed only, the trunks are not so imme- 

 diately incommoded. 



Blisters on the head, and mercurial ointment externally, with 

 calomel internally, are principally recommended in this fatal dis- 

 ease. When the patient cannot bear to be raised up in bed with- 

 out great uneasiness, it is a bad symptom. So I believe is deaf- 

 ness, which is commonly mistaken for stupor. See Class I. 2. 

 5. 6. And when the dilatation of the pupil of either eye, or the 

 squinting is very apparent, or the pupils of both eyes much di- 



