CEREBRAL HEMORRHAGE 237 



fatifiTio on the slightest exertion, loss of appetite, and a tendency to vom- 

 iting is noticed, and even general convulsions. 



Therapeutics. — The therapeutic treatment consists in stimulants, 

 such as wine, ether, camphoi', atropia, caffein, friction to the skin, smelling 

 spirits of ammonia, stimulation of the phrenic nerve by the faradic 

 battery, etc. In the chronic form nutritive diet, blood-producing food, 

 and tonics. 



Cerebral Hemorrhage. 



(Apoplcxia Sanguitiijc; Hemorrhagica Cerebri.) 



Etiology. — The chief cause of cerebral hemorrhage is an increased 

 pressure on the vessels containing the l)lood, and where the walls of these 

 vessels present some abnormal condition by which they are debilitated or 

 weakened. This condition of the walls of the vessels may be caused l^y 

 atheromatous degeneration, or by some disturbances in the nutritive 

 process of those parts, as in serious diseases of an infectious nature, such 

 as distemper, leuka?mia, and also in certain forms of poisoning. Great 

 exertion, intense physical excitement, or great heat may also produce this 

 condition. 



Pathological Anatomy. — Hemorrhages appear, as a rule, on the cere- 

 brum, and occur from a capillary hemorrhage and are indicated by a slight 

 red coloration which cannot be wiped off; but in the most serious forms 

 you may find a distinct number of spots which Ijecome confluent. In 

 some cases there is a considerable bloody discharge, indicating the l)reak- 

 ing down of some large blood-vessel. If the blood-vessel is located in the 

 hemisphere near the surface, the dura mater appears distended at the 

 affected location; the convolutions of the brain are flattened and the fur- 

 rows depressed. The substance of the brain is always more or less de- 

 stroyed, and, if the animal does not die quickly, the discharged blood lying 

 in the tissues forms clots very rapidly. Its fluid parts become absorbed, 

 fibrinous substances are formed, and the blood-corpuscles destroyed, 

 being altered into a chocolate-colored emulsion which finally becomes ab- 

 sorbed. The coloring matter of the blood remains on the brain as a rose- 

 colored pigmentation. The centre becomes smaller and smaller, until the 

 development of numerous connective-tissue adhesions unite it to the 

 wall, or an apoplectic cyst is formed, which has a smooth inner wall filled 

 with serum. This cyst takes the shape of the surrounding tissues. 



Clinical Symptoms. — Capillary hemorrhage appears occasionally in 

 some of the grave infectious diseases, and may cause little or no disturb- 

 ance of the general system that can be recognized during life, or there may 

 be slight manifestations of the condition, such as dizziness, partial loss of 



