§ 258. Causes: Keeping the head too warm; action of the sun on the bare head, nightly mental exertions, violent emotions, metastasis, abuse of spirituous drinks, onanism, mechanical injuries, worms, suppression of cutaneous eruptions, of bloody discharges, etc.

Course and terminations of the disease: It may become fatal in 24 hours; in full-grown persons it runs a course of from three to four days, but may last from seven days to a fortnight. It terminates in: (1.) Recovery. (2.) Softening, suppuration, with increased delirium, convulsions, etc., coma, paralysis set in; suppuration is attended with chills alternating with heat, etc.; sometimes the pus discharges by the ears. (3.) Exudation, which is not very rare among infants, inasmuch as the serous coat is very frequently the seat of the inflammation; this termination is always fatal. Death, however, may likewise take place by apoplexy, or paralysis of the brain. Encephalitis sometimes leaves vertigo, chronic headache, weakness of memory, strabismus, mental derangement, etc.; acute encephalitis may likewise pass into a chronic form.

Under the homoeopathic treatment, the prognosis is much more favourable than under the alloeopathic treatment, which, even now, though much more conformable to nature than formerly, is still very uncertain and dangerous. Sopor, grating of the teeth, strabismus, paralysis, singultus, masticating motion of the jaws, vomiting of black or grass-green substances, rumbling noise during deglutition, etc., are bad symptoms. If spasms alternate with delirium and coma, the prognosis is bad. Favourable symptoms are: bleeding at the nose, discharge from the ears, reappearance of suppressed secretions, etc.

§ 259. It has already been stated above, that there is a great variety of cerebral inflammations which are more or less violent. The fever is either syno-chal or typhoid. Encephalitis may likewise develop gastric symptoms. It occurs most frequently in children, particularly in those with prominent foreheads, and is apt to increase to acute hydrocephalus. Congestions of the brain, resembling encephalitis, are likewise frequent among children. A cerebral irritation is likewise apt to occur in infants, after weaning, and is characterized by a good deal of screaming, tossing about, redness and bloatedness of the face and eyes, and complete sleeplessness. It also exists in infants when they cease to vomit up the milk, which takes place during the first weeks alter parturition, and is very conducive to the health of the infants; they refuse to nurse when the vomiting stops.

Belladonna is the principal remedy for encephalitis, particularly in the above-mentioned cases of infants, and is more especially indicated by the following symptoms: Constant boring with the head into the pillow, excessive sensitiveness to noise and light, sopor, great heat in the head, red and bloated face, with visible throbbing of the carotid and temporal arteries, swelling of the veins, and the other symptoms mentioned in the preceding paragraph; sometimes hydrophobia phenomena are present.

If there should be a true synochal fever, it is advisable to give a few doses of Aconite, previous to the exhibition of Belladonna, even in acute hydrocephalus.

Encephalitis occasioned by insolution, is probably most easily cured by Camphor. In a case of stupor, with sopor, occasioned by a stroke of the sun, Opium afforded speedy relief.

Encephalitis erysipelatosa is a species of inflammation accompanying external injuries of the head, or occasioned by the sudden suppression of an acute cutaneous eruption or erysipelatous inflammation, particularly of the face; the meningeal membranes are the seat of the inflammation, which manifests itself by sudden, violent headache, delirium, etc. This species of encephalitis frequently leads to hydrocephalus. For this affection, Belladonna is likewise one of the most suitable remedies, which only yields to Rhus tox., when the inflammation was occasioned by the sudden suppression of erysipelas of the face. Encephalitis consequent upon the sudden disappearance of otitis, sometimes requires Pulsatilla. Belladonna, however, is the specific remedy when the cerebral inflammation is occasioned by suppression of scarlatina or purple-rush, or when it exists simultaneously with either of these affections. If such an inflammation should threaten to pass into hydrocephalus, Merc, sol. will frequently be able to prevent this. If effusion should actually have set in, Belladonna and Mercurius may still prove useful, but Arnica or Digitalis, or perhaps some other remedy as yet unknown to me, will be more suitable. The symptoms of incipient acute hydrocephalus, without previous inflammation, are frequently rapidly and permanently removed by a dose of Aconite followed by Belladonna.

In typhoid meningitis, the remedies which have been mentioned for typhus require to be resorted to, especially Bryonia, Cantharides, Helleborus, Hyoscya-mus, and Stramonium.