The position of the brain and the membranes which invest it, has already been explained in the chapter on Anatomy. Inflammation of the brain itself, is called Encephalitis, of the Dura Mater or membrane next the skull, Meningitis, of the covering next the brain, Arachnoiditis. As it would be difficult to discriminate between these varieties of inflammation, and not essential to the treatment, it will be only necessary to give some of the prominent symptoms which characterize inflammation of the brain and its investing membranes.

Diagnosis

The attack may come on suddenly, with but little pain, but characterized by a drowsy sensation and great stupor, sensitiveness to light, dizziness, and contracted pupil. This is more frequently the form of attack in old persons. More commonly however, there is severe pain, heat and fullness in the head; throbbing of the arteries, irritability, vertigo, sleeplessness, or restless sleep, with disturbed dreams, or starting as in affright, stupor, unsteady gait. The pulse is full, sometimes suppressed, but generally rapid. As the disease increases and assumes a distinct character, the pain in the head may become dull and heavy, and be aggravated by the slightest movement, the head hot and burning, the countenance flushed and wild, the eyes shining and red, the pupils contracted; great sensitiveness to light, grating of the teeth, great stupor and stertorous breathing, delirium, mild, or wild and raving. The deeper the interior of the brain is affected, the more the senses become stupified, until the patient may become entirely unconscious. The thirst is intense, the skin dry and hot, and the pulse generally small, frequent, and tremulous.

Treatment.* - External application should be made to the head of cold water, taking care to remove the cloths frequently before they become warm, or what is still better, the application of a bladder, filled with pounded ice. The latter is much the best as the cold is continuous.

Aconite

Particularly at the commencement of the disease, and when there is violent inflammatory fever, burning pains in the head, redness of the face and delirium. It is often indicated before or in alternation with Belladonna.

Belladonna is a very important and in fact the principal remedy in this disease. Where there are violent burning and shooting pains in the head, together with great heat and violent pulsations in the head, and redness of the face. Red, sparkling eyes, with furious look, loss of consciousness, sometimes low mutterings, at others furious delirium, convulsions, spasmodic constriction of the throat, vomiting, etc. The patient buries the head in the pillow and is exceedingly sensitive to light or noise. In alternation with Aconite, or perhaps Hyoscia-mils, or Stramonium.

Hyosciamus

Drowsiness, loss of consciousness, wild and talkative, or muttering delirium, talking about his own affairs, dilation of the pupils; picking the bed clothes, redness of face; inarticulate speech.

Stramonium

Constant jerks of the limbs, moans, and tossing during sleep, and frequently absence of mind on walking; timidity and fear.

Bryonia

Prolonged shiverings, with heat in the head, thirst; constant inclination to sleep, with delirium, starts, cries, pressive burning or shooting pain in the head.

Opium

Lethargic sleep, with snoring, half open eyes, dizziness on waking, frequent vomiting, entire apathy and indifference to every thing.

Administration

Two drops, or six globules, in a tumbler of water, a tablespoonful every one or two hours, and sometimes in exceedingly severe cases every half hour, until the severity of the symptoms abates. Diet and Regimen. - The same as in fevers.

• For general directions as to the administration of remedies, see page 12.