In one variety of the disease the child may exhibit for some time symptoms of deranged health, such as loss of appetite, wandering pains, deranged state of the bowels, headache, crick in the neck, and a growing weakness. Accompanying these symptoms there may be occasional chills, pale countenance, and disturbed temper. At length the child complains of headache, or if an infant, gives signs of it by putting its hands to its head, rolling it uneasily about. To this succeeds vomiting, the child becomes dull and heavy, complaining of weariness, and is sensitive to light and noise. Thus the disease may continue for several days, but by degrees febrile paroxysms are observed, the vomiting continues, the bowels are generally torpid, the urine scanty and frequently voided. The child gradually becomes dull and stupid. He becomes greatly emaciated, the pulse increases, decided symptoms of pressure on the brain are seen, in starting, screaming, and partial or complete convulsions, with insensibility, squinting, glazed eye, etc. This state may continue for two or three days, until at length it is terminated by a convulsion or coma.

Again, the disease may be sudden in its development, and marked by high fever. The child complains of severe pain in its head, or pressing it with its hands, and rolling it from side to side, indicates the locality of the suffering; or it may lie still, heavy, and dull, with an occasional cry of pain. The eyes are sometimes heavy, and have a muddy expression, but they are more frequently bright and restless, having a peculiar stare and moving quickly from one object to another. The child is generally wakeful, or sleeping restlessly, drowsy, but waking up suddenly, crying or screaming, as from fright. There is an entire loss of appetite, nausea, and vomiting.

Thus far the disease may have advanced with more or less rapidity, but at length the fever rapidly becomes intense, with occasional intermissions; there is great heat in the head, severe headache, delirium, and often loud outcries. The eyes are bright but sunken, the pupils contracted, and painfully sensitive to light, as the ears are to sound. The pulse varied, sometimes quick, at others irregular or intermitting. The vomiting usually continues, and the constipation increases.

As the disease advances, the symptoms gradually change from those of excitement to those consequent on effusion or pressure. The headache is less complained of, although the head is still rolled about uneasily; the delirium subsides or occurs occasionally; the sensibility of the eye is gradually lost, the pupil is generally dilated, and it is evident the patient can no longer see; the eye is rolled about, turned upward, or squinting takes place; the hearing, which may for a time have been acute, at length diminishes, until the infant seems unconscious of sound. The convulsions, which may have occurred at intervals from the commencement of the disease, now increase in frequency and sometimes in strength, or perhaps there may be convulsions of one side of the body and paralysis of the other.

About this time a new symptom is developed, the sharp piercing scream, which the child utters from time to time, which adds so much to the distress of the mother, but which is not in reality the result of pain. During the intervals of the convulsions, consciousness and sensibility diminish until they are finally lost. The child now lies quiet, occasionally moving the head of throwing about an arm or leg; the eyes are open or only half closed, and acquire' a glazed appearance; the face is pallid, sometimes wax-like, without expression; sometimes sunken and anxious, as representing the last conscious feeling; the vomiting rarely continues; the bowels are sometimes evacuated unconsciously, but generally confined. The attack terminates by a convulsion or in coma.

The duration of this form of the disease varies from thirty-six hours to ten or twelve days.

Another variety of this disease has been called the "water-stroke." It consists of a sudden almost instantaneous effusion of fluid within the brain, and may occur either idiopathically, or as the result of obstructed secretion from some other organ, or as a secondary affection in the course of some other disease, as smallpox, measles, or other febrile eruptions, or on the sudden stoppage of diarrhoea, dysentery, or profuse perspiration. The child may go to bed apparently well, or suffering from some other disease, and in the morning it may be found dead. Or it may be attacked by a convulsion, followed by paralysis, or apparent apoplexy, with insensibility, stertorous breathing, dilated or contracted pupils, terminating in death after a few hours.

Treatment

Medical aid should be obtained as soon as possible. The external application of cold is highly beneficial. The best way of applying it is by filling a bladder with pounded ice, and placing it on the head.

Aconite should be given in the commencement of the disease if the skin is hot and the pulse quick.

Dose

One drop, or six globules in a tumbler half-full of water, a tablespoonful once in two hours; or two globules on the tongue at the same intervals.

Belladonna,

Great heat and severe pain in the head; burying the head in the pillow or moving it from side to side; sensitiveness to light or noise; shooting or burning pains in the head, eyes red and sparkling, or with a wild expression; contraction or dilation of the pupils; violent delirium; drowsiness and stupor; loss of consciousness; frantic screams; low muttering; nausea, vomiting, and convulsions.

Dose

One drop, or six globules, in a tumbler half-full of water, a teaspoonful at a dose. If in alternation with Hyosciamus or Hellebore, give one or two hours apart; if alone, give every one or two hours, according to severity of symptoms.

Hyosciamus

Especially where there are violent convulsions; loss of consciousness; delirium; redness of the face with wild or fixed look; picking at the bedclothes.

Dose

Same as Belladonna.

Stramonium

The symptoms resemble those indicating Belladonna or Hyosciamus; the spasmodic or convulsive symptoms are more prominent.

Hellebore

A highly important remedy in all well marked and severe cases. There is total loss of nervous control; the senses are generally obtuse, and the head feels stupefied; the look is fixed and vacant; the eyes turned upward and remain half open during sleep.

Dose

Same as Belladonna.

Opium. Lethargic sleep, with snoring respiration: confusion or giddiness after waking. Give once in two or three hours.

Bryonia

Constipation, yellow-coated tongue; hurried, laborious, and anxious respiration; great thirst, delirium, sudden starts with cries.

Rhus

In the low protracted form of the disease, and also where there is headache, giddiness, and heaviness of the head; aching, pressing pain in the back of the head, with creeping sensation; drowsiness, convulsive movement of the limbs, and great restlessness at night.

Dose

Same as Belladonna. Give once in two or three hours.

Arsenic

Particularly in the chronic variety, where there is debility, weak and irregular pulse, and marked intermission in the disease.

Sulphur

Particularly towards the termination of the disease; also where the appropriate remedy seems to have lost effect, in which case two or three doses may be given, and then return again to the original remedy.