Sir Everard Home's Observations 
■478 
with head-aches, which are very severe when the body is 
placed in a horizontal posture.* 
When the smaller arteries of the cerebrum are preter- 
naturally enlarged while those of the cerebellum are not, de- 
lirium has taken place, followed by a fit resembling apo- 
plexy, and a paralytic affection of one side.-f 
An obstruction to the passage of the blood through the right 
internal carotid artery was attended by a succession of slight 
apoplectic fits, unaccompanied by any paralytic affection. 
An aneurismal enlargement of both the internal carotid 
arteries to the size of marbles projecting into the cavernous 
sinuses, was the only apparent cause of attacks of mania, with 
consciousness of being insane. § 
* In the case of a young lady who had suffered severely from head-aches, which 
were so violent at night when she lay without a pillow as to produce occasional deli- 
rium, after death the veins in the medullary and cortical substance of the brain were 
found considerably enlarged, 
f A man 60 years of age had from anxiety an apoplectic fit which lasted some 
hours, leaving a paralytic affection. In seven days, under a course of electricity, he 
recovered the use of the paralytic limbs. In four months, while under very great 
anxiety of mind, he became delirious, and one side became paralytic, in which state he 
died. There were no other appearances than those mentioned, 
t An officer had a succession of apoplectic fits at intervals of one, two, and 
three months; the first of six days continuance, the second a few hours, the third and 
fourth shorter ; the last terminated in death. On examining the brain, the right in- 
ternal carotid artery was filled with a solid coagulum of blood which extended some 
way into the smaller branches. 
§ A lady who had unequal spirits, and occasionally double vision, had an attack of 
giddiness and mania ; the eyes were red, the hands benumbed, and death ensued. On 
examining the brain, the aneurisms were discovered; and the optic nerves were found 
wasted. 
