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Show ..,. M‘JU cumrnnssron or THE BRAIN. COMPRESSION or THE BRAIN. hrane is not only the immediately investing membrane but it passes down into the substance of the brain, and is th; vehicle of the vessels. These vessels are the agents, and may be said to be the seat of the inflammation in all cases. But the symptoms of inflammation will be very different, as they it seems very likely that many of our best surgical writers of the last age formed their opinions respecting the cause of symptoms only from what they saw during operation, and not as the result of investigation by dissection. They could not else have confounded the effect of matter and serum lodging are the consequence of a general injury to the brain, or as they follow the progress of inflammation from the bone and dura mater to the surface of the brain. If a man be lying stunned, and inflammation accedes be: fore the return of sensibility, the pupils of the eyes become on the brain, with that of depression of the bone, or eil'usion of blood. From what I have seen in dissection, I am convinced that they have attributed to the matter lying on the surface of the dura mater, that which was more correctly more contracted, the pulse harder and quick, the tongue dry ; he withdraws his hand from the surgeon; his feature s have an unpleasant frown, and the check is fuller and red. If we now wait for the return of the senses, before we use evacuants, we may be terribly deceived by the powers of the " 1""un mm, l \lkktil‘f _. 6 My 291 system rapidly failing under the pressure of this additional in Jury to the brain. If the senses be awake, and the inflammation then accedes to be assigned to the effect of deep disease and suppuration of the substance of the brain. As to the question, whether the symptoms of oppression can proceed merely from the degree of compression caused by a little purulent matter 9 I can only say, that I have seen a much greater degree of compression occasioned by a depressed bone, or a coagulum of bloo¢ without producing the same effect. This makes me suppose that the comatose affec« it will be marked by the fever, and intense pain of the head: tion in those cases of ulceration, is the consequence of the inflammatory action which accompanied the purulent discharge, by a flushed countenance, inflamed eye, intolerance of light: or the ulceration, not of the compression from the pus merely. tinnitus aurum, and watchfulness. Then when the paroxl ysm still rises, there is fiereeness of the countenance delirium The conclusion which we ought to draw from this evident error is, that wherever the function of the brain, and its due and violent struggles. , V 7 There must be here a vigorous plan of treatment pursued. )1 the texture of the brain may suil‘er permanently, or the pa: tient sink irrecoverably into the oppression from over action and effusion. We must bleed largely and repeat edly; brisli be made use of as descriptive of it ; as with the failure of the purges must be given, and repeated, with antimonials ' and to symptoms-compression is a cause. when the stroke of the pulsation of the caroti d and tem'porai arteries are somewhat subdued, there may be blisters laraelr applied to the head and neck. influence on the other functions of the body, are morbidly diminished, Oppression is the only term which can properly sensibility there is atorpor, and want of activity, which creeps over every faculty of mind and body-r. Oppression relates But to speak more particularly of COMPRESSION or THE onus, these are the symptoms, so far as I have been enabled I to observe-- or conrnnssron or THE BRAIN. l SPEAK now of compression of the brain; beca use I W153: to remove the confusion which results from the complication. "f symptoms of compression, concussion, and inflammatinn '* To me it appears that it is not the blood, or matter, or fluid, in the cavities, or in the surface of the brain, which is so apt to be attended with the symptoms of oppression, as when the fluid is in the substance of the brain This may be illustrated by the eti'cct of fluid in the thorax, and in the cellu. lar membrane of the lungs. The one is long tolerable, the other quickly =ull'ocutcs. "cor . r. r.- ‘9 now most» |