Apoplexy and Softening of the Brain. 89 



but sometimes slow, of a more or less profound unconsciousness, 

 attended or followed by paralytic troubles. The history of the 

 case may assist, any blow on the head, or sustained by falling, 

 striking a wall or post, or wearing a yoke, is to be noted. Any 

 extraordinary exertion or excitement must be considered. Aiiy 

 sign of injury about the head ; the congestion of the cephalic 

 mucous membranes in contrast witfi the pallor of shock; the 

 onset of the attack without convulsions (or with them as in epi- 

 ■ lepsy) ; the deep coma indicating cerebral haemorrhage or nar- 

 cotic poisoning ; the absence of the odor of alcohol, opium, or 

 other narcotic from the breath ; the turning of the eyes to one 

 side and the inequality of the pupils on the two sides ; the turn- 

 ing of the head to the same side as the eyes ; the slow, labored, 

 usually stertorous breathing ; the slow, full, soft pulse ; the oc- 

 casionally rigid condition of the'muscles and finally the paralysis, 

 hemiplegic and less frequently monoplegia or paraplegic, make 

 up the diagnostic picture. 



Urcemia and diabetic coma may be excluded by examination of 

 the urine, pulmonary apoplexy or cedema by the predominance of 

 respiratory troubles, and fulminant anthrax by the examination 

 of the blood and by the fact that this disease does not prevail in 

 the locality. 



Treatment is very unsatisfactory in the lower animals, as the 

 disease is very fatal, and unless recoveries are complete, they are 

 not pecuniarily desirable. It is only in the slighter cases, there- 

 fore, that treatment can be recommended. At the very outset no- 

 thing is better than a full bleeding in a large stream from the 

 jugular vein or temporal artery. Ice, snow, or cold water should 

 meanwhile be applied to the cranial region. Absolute rest should 

 be given, any harness that would impede circulation or respiration 

 removed, and hot water or stimulating embrocations applied to 

 the limbs. 



When consciousness returns and the patient can swallow, an 

 active purgative may be administered, or barium chloride or 

 eserine may be given subcutem. Any recurring heat of the head 

 may be met by renewal of cold applications, and the force of the 

 circulation may be kept in check by small doses of bromides or 

 aconite. In case of the formation of a clot, iodide of potassium 

 and other .alkaline agents may be resorted to. Quiet and the 



