134 < LIVERPOOL VETERINARY MEDICAL ASSOCIATION. 
proof, I must refer you to his great work, and can only say that 
ansemia brought about by such conditions would be evident by 
the absence at all times of congestion or effusion in the cranial 
cavity. Nor do we always find these even in fatal cases, or cases 
that would have proved fatal if allowed to live sufficiently long. 
If effusion were extensive, recovery would be at all times impos¬ 
sible, and the extent of the extravasation makes, I think, all the 
difference in the cases we have to treat. 
Closely connected with this condition of brain-ansemia is the 
subject of sleep and narcosis arising from the administration of 
chloroform and ether. 
To account for these conditions of the system Mr. Fleming 
adopts the usually received theory of ansemia as the conditions 
existing in them; but this, too, has been called in question no 
later than last year by a Dr. Kennedy, of Dublin, in the Dublin 
Journal of Medical Science. In it he states his views, based on 
actual observation. He says :—“ A man of middle age whilst 
drunk had his skull severely burnt at a lime-kiln, where he had 
fallen asleep. In a short time very urgent symptoms of pressure 
appeared, and he was trephined over the centre of the parietal 
bone. Subsequently the opening was enlarged and the brain 
exposed, the dura mater having been removed to allow of free 
vent of pus. Whilst in this state I had the dressing of the case 
for several weeks, and plenty of opportunities for seeing the 
patient both asleep and awake, and I never saw him asleep that 
I did not observe marked congestion of the vessels, more particu¬ 
larly what seemed to be the veins, whilst all the vessels visible 
assumed a dark hue; and when the patient awoke it was very 
interesting to observe, first an increase in the rapidity of the 
circulation, and then a change in the colour of the blood, and it 
sometimes seemed as if new vessels, or at least some not seen 
before, had made their appearance.” Now these views are 
adverse to Durham's views, and which Mr. Fleming adopts. 
They are—that “ during sleep the brain is in a comparatively 
bloodless condition." 
Kennedy, too, contests the opinion of Hammond in reference 
to the state of the fontanelle in infants, who says that “ the 
anterior fontanelle was always depressed during sleep, and 
elevated during wakefulness." While Kennedy found, during a 
series of observations extending over two years in the Rotunda 
Hospital, that whether the infants were sleeping or waking, no 
appreciable difference could be observed, and he could only detect 
a distinct elevation in two, and both these infants were crying 
lustily.” 
But I must not waste further time by looking into any more of 
these side issues; but as these states and conditions of the brain 
