The most characteristic symptom of cerebral hemorrhage is paralysis. Very slight effusion produces this effect, and, in general, its intensity is in direct ratio of the extent of the effusion. It also arises from disease of the brain or its membranes, injuries of the brain and spinal cord, diseases of the cord or its membranes, or any injury of the large nervous networks, the action of lead, etc. The nerves of motion as well as those of sensaton may be paralyzed, and when it exists on one side of the body it is called hemiplegia, and when confined to the lower limbs, paraplegia. When the muscles of the mouth or of an extremity are affected, it is called partial paralysis, and when both sides, whether in their extent or in some of their parts, are deprived of motion, it is termed general paralysis.

At the very moment of the effusion it acquires all at once its highest degree of intensity, then remains stationary or begins to diminish. Sometimes the paralyzed part has not previously experienced any disturbance with respect to either sensation or motion; sometimes, however, the patient has experienced in these parts pricking sensations, numbness, permanent or transient, an unusual feeling of cold, a sense of weight, and a certain degree of debility. The part paralyzed suggests the locality of the effusion or injury, but these are only of interest to the pathologist. When the affected muscles degenerate or atrophy, it is called wasting palsy, and when characterized by slow progress, and tremulousness increases to such extent that the agitation prevents sleep, all locomotion, difficulty of chewing and swallowing, etc., it is called paralysis agitans.

TREATMENT. -- If dependent upon cerebral hemorrhage, the treatment of apoplexy should be instituted, and afterwards the use of derivatives such as purgatives, alteratives, diuretics, etc., and the use of local stimulants. The patient should be restricted in his diet, and all causes of cerebral excitement, whether physical or moral, should be avoided. The bowels should be well acted upon, and the condition of the bladder attended to. When the organic disease is removed, and all symptoms of vascular excitement have subsided, recourse should be had to nux vomica, or strychnine, tonics and galvanism. In giving strychnine, the lowest dose should be given at first, and cautiously increased. Macrotin, viburnin, xanthoxylin, and rhusin are also good remedies. The local treatment consists in stimulating liniments, blisters to the spine, etc.

Those who may desire my counsel and opinion of their cases, as to nature and curableness, will please write as directed on page 390.