DISEASES OF THE BRAIN AND NERVOUS SYSTEM. 77 



of any, or all portions of the contents of the cranial cavity. 

 Various terms are applied to disease of this character, such as 

 " sleepy staggers," " coma," " phrenitis," cerebritis," and " cere- 

 bral meningitis," the latter being formerly recognized as blind or 

 sleepy staggers. These several terms merely apply to the various 

 stages of the acute disease as it gradually invades the membranes 

 covci ing the brain, or the substance of the brain itself. It some- 

 times appears to invade at once the whole of the parts within 

 the skull, or, beginning in one part, it extends rapidly to all the 

 rest, so that the term encephalitis seems to be more applicable 

 than those just ^numerated. It is a matter of impossibility for 

 us to tell precisely what are the pathological conditions of the parts 

 affected. Nor are the symptoms always the same. They may 

 range from a state of phrenzy to one of coma. Still, in our treat- 

 ment, we shall not be led astray ; for, being an acute affection, (or 

 affections, as some persons may term it,) we have to treat it on the 

 same general principles which obtain in many or all diseases of 

 an acute character, viz. : by means of sedatives, laxatives, cold 

 water, spare diet, and rest. 



Should the patient die during the acute stage of disease of ths 

 brain, an autopsy will reveal great vascularity and softening of 

 the cerebral mass, and thickening of its membranes ; but should 

 the disease run on unchecked to a fatal termination, pus and 

 fluid may be found within the lateral ventricles of the brain. 

 This enables us to explain the difference between the symptoms 

 which prevail in the early and latter stages of the malady ; for, 

 at the commencement of the acute stage, the loss of equilibrium 

 in the circulation sends the red arterial blood, in undue quanti- 

 ties, to the brain — the part, perhaps, most predisposed to diseased 

 action, or, it may be, at the time actually in a pathological con- 

 dition ; hence the loss of equilibrium in the circulation — which, 

 in consequence of accelerated respiration, becomes highly charged 

 with oxygen, acts as a potent stimulus, not only to the nervous 

 system, but to the muscular system also, producing those active 

 and phrenitic symptoms which have led us to infer that the patient 

 is going or is actually mad; hence the name which some per- 

 sons have applied, " mad staggers." This activity can not last 

 long ; for it is potent to exhaust the vital forces. Organs and 

 parts of the body become overworked ; then comes organic 

 changes — softening of the brain, effusion, formation of pus, whioL 



