erful remedies, howover, are cathartics, which dropsical patients in general bear more easily than emetics; those in most general use are, gamboge, jalap, colo eynth, scammony, calomel, and elaterium: this last should be exhibited in the form of a pill, or given in diluted spirits, in doses of half a grain or more, every hour, until vomiting or catharsis is excited ; but the most powerful remedy is the crys tals of tartar, which should be adminis tered in doses of two drachms every hour, till copious evacuations are procur ed either by stool or urine, giving at the same time tepid liquids plentifully ; this medicine should be repeated every, or every other, morning, according to the strength of the patient. As the thirst is a very distressing symptom in this dis ease, the patient should be allowed to take as much water, or mild mucilagi nous liquids, acidulated with the crystals of tartar, as he feels disposed for ; bot tled cyder, drank in considerable quan tities, is sometimes of service ; diuretics must be administered, and they should be combined with tonics and aromatics, or with essential oils. The most power ful medicine of this class, however, is the digitalis, and it is most efficacious when joined with some of the above diu retics ; it should he given in such doses as to affect the state of the pulse, and if it do not speedily afterwards act as a diu retic, it will be of little avail to perse vere in its exhibition ; as the perspira tion is often greatly diminished, diapho retics have sometimes been employed with advantage, or opiates combined with ipecacuanha, and the action of the ves sels upon the surface will be excited by friction, particularly in the morning, and it will be more serviceable if made from below upwards ; if the above methods should be of no avail, we must try mer cury, and it should be pushed so far as to affect the mouth, and its effects on the system must not be allowed un til the swelling subsides. The debility of the system will be removed by studi ously avoiding all the remote causes in our power, by gentle exercise, by sup porting the integuments of the lower extremities by means of bandages pro perly applied, as a well constructed laced stocking, and by the employment of bark, quassia, sulphuric acid, and chalybeates, and they will be more efficacimo when combined with diuretics ; the vapour bath has been employed with considera ble advantage, especially when assisted by frictions ; if the disease arise in conse quence of obstructions of the viscera, or syphilis, some of the preparations amt. cury will be necessary, employing at the same time chalybeates and tonics. The pulse has been sometimes, although rare ly, found full, hard, and tense, in which case blood-letting is advisable.
Hydrocephalus generally attacks chit. dren, and very often comes on in a very gradual manner ; one of the earliest crime terions is, the patient being uneasy on rais ing his head from the pillow,and wishing to lie down again immediately r it fre quently commences with languor, pains in the limbs, and head-ach ; the patient is affected with nausea and vomiting se veral times in the course of the day, the pain of the head is usually confined to ene side, or extends from just above the eye brows to the temples ; sometimes, how ever, it is universal over the whole of the head ; the head-ach frequently al- ternates with the affection of the sto mach, and the head is now and then ob served to lean more to one than the other side ; the eyes are painfully sensible to the light, there is moaning and watchful ness; or, if the patient sleep, he grinds his teeth, picks his nose, and often awakes suddenly in a fright ; the bowels are costive, and are with difficulty acted upon by the strongest purgatives ; the pulse is more frequent than in health, but regular ; these symptoms go on in creasing, the pupils become dilated, and the axes of the eyes are turned in differ ent directions; the vomiting and pain of the head become more distressing, there is some difficulty of breathing, the heat of the body, and of the head in particular, is increased, pyrexy comes on, of which there are perfect intermissions many times in the course of the day, with an evident exacerbation in the evening ; the countenance is occasionally flushed, and the pulse, from being frequent, now be comes slow and irregular; as the dis ease advances, the pain of the head same what abates, and a degree of stupor or coma succeeds the watchfulness of the former stage, and if the patients be roue.
ed, they are fretful, and often utter disso nant and loud screams, the hands are of ten lifted up to the bead, and the stra bismus becomes more considerable, the pupils are more dilated, and scareely con tract when exposed to a strong light ; sometimes there is a total defect of vi sion ; they swallow liquids with unwil lingness and some apparent difficulty ; the vomiting now ceases, the disposition to costiveness continues ; now and then, however, dark stools are evacuated, in which worms are frequently observed ? when the disease has continued in this state for a few days, the pulse again be comes regular and frequent, but very weak ; the breath is drawn with difficulty, and with a stertorous noise, the patient is frequently affected with loud shriek. ings, red spots appear on different parts of the body, particularly about the joints, and at length convulsions come on, and close the scene.
Treatment. As this disease frequently runs rapidly to its fatal termination, we must employ the most active remedies in the first stage : the most powerful reme dy, at the commencement of this deplo rable disease, is blood-letting : in children it will be sufficient to apply leeches to the temples at proper intervals ; in adults we may, with great propriety, employ general blood-letting; commonly, how ever, local blood-letting will be most ser viceable ; costiveness must be obviated by the more active cathartics,as adomel,com blued with gamboge, ecammony or elate rium, and by the employment of clysters; the head should be shaved, and a large blister applied over the whole of it, or between the shoulders; it will be pro per to keep up the discharge occasioned by 4. blister for sometime, in which case an alternation of them from the head to The back, or behind the ears, will be at tended with more beneficial effects than a perpetual blister; the velocity of the circulation will be diminished by the ex hibition of the digitalis, and if we have reason to conclude that an effusion has taken place, the absorption of the fluid will be promoted' by combining the digi talis with calomel ; the latter must, how ever, be administered at proper intervals, in such doses as will produce some affec tion of the mouth ; opiates should be given at the same time, and if the patient be very much debilitated, it will be pro per to exhibit bark and chalybeates errhines may be tried, as one grain of tur. both mineral, mixed with from ten to fif teen grains of sugar, or liquorice pow der ; this should be gradually blown up the nostrils; frequent electric shocks, from very small charges, are recommend. ed to be passed through the head in all directions. The hydrocephalus is some times symptomatic of worms, disorders of the bowels, or mesenteric affection ; when this is the case, the disease will ge nerally be removed in a short time, by the employment of mercurial cathartics, combined with other active purgatives, by blisters, and by some of the prepara tions of iron.