MEDICAL HINTS. 
187 
the attack can usually be warded off by prompt treatment. Sometimes, 
however, the patient suddenly falls down insensible. 
Treatment .—The patient should at once be drenched all over, especially 
on the head and along the spine, with cold water, and this treatment 
should be kept up for a considerable time. Six grains of calomel should 
be placed at the back of the tongue, and, if the patient is conscious, 
washed down with a saline such as fruit salts; in very urgent cases a 
turpentine or hot-water enema should be given as quickly as possible. 
The patient can then be put to bed, with cold wet cloths wrapped round 
the head and adjusted along the spine; these should be frequently 
changed and wetted, the cooler the water the better, and this treatment 
should be persisted in till the patient is roused and sensible. When 
procurable, an ice-bag may be applied to the head. 
Concussion of the brain . 
This term is applied to the partial suspension of the functions of the 
brain, produced by the severe shaking of its substance by a fall or blow. 
Symptoms .—At first the patient lies in an unconscious condition, skin 
cold and clammy, pulse and breathing very feeble, and temperature ex¬ 
tremely low; he can be slightly roused by shouting; he cries out if he 
is moved, or when painful applications are made, but quickly relapses 
into insensibility. The stage of unconsciousness may pass off almost at 
once, it may be prolonged for hours or days, or the patient may never 
recover from it. The second stage—that of reaction—is marked by 
returning consciousness and frequently by vomiting, the skin becomes 
warm and gradually the patient recovers; on the other hand, inflamma¬ 
tion of the brain may set in, or he may again become unconscious and die. 
Treatment .—Keep patient perfectly quiet in bed, in a darkened room, 
give a milk diet, and if he is much excited, apply cold cloths or an ice- 
bag to the head. If there is much prostration apply a hot-water bottle, 
and restore the circulation by rubbing the limbs. When reaction sets 
in, give five grains of calomel. 
Stimulants should be avoided in cases of concussion of the brain, 
unless the collapse is very alarming (when ammonia should be given), 
as they tend to cause too violent reaction, which might be followed by 
inflammation of the brain and its coverings. 
