Treatment consists in removing the patient at once to bed in a quiet well-ventilated room, the head being slightly raised. If he is uncon scious, practically nothing can be done except to keep him undisturbed till consciousness returns. Then he is to be fed on a simple, nourishing diet, milk especially, all stimulants being forbidden. His bowels must be regu lated, but not with strong medicines; an in jection of warm soapy water is very useful. Nothing further should be attempted without medical advice.
Cross Paralysis is the name given to the paralysis of one side of the body and the opposite side of the face. It indicates that the cause of the paralysis is situated towards the base of the brain.
Paraplegia is the term applied to paralysis proceeding from disease of the spinal cord. The extent of the paralysis naturally depends on the level in the spinal cord where the dis ease exists. If it be low down, the functions of the bowels and bladder are interfered with, and the legs are paralysed; if it be much higher up, the muscles of the trunk are also involved, and the upper limbs. Usually it is the lower half of the body that is affected. Both motion and sensation may be paralysed, or owing to a peculiar distribution of the dis ease in the cord motion may be paralysed on one side and sensation on the other.
The symptoms, thus, generally include par alysis of the lower limbs, and involuntary dis-' charges from the bowel and bladder. While the person cannot move his legs by the power of his own will, they may move involuntarily and start spasmodically because of reflex action (see p. 132).
The treatment depends on the cause of the disease, which may be inflammatory action in Part of the cord, effusion of blood into the cord, disease of the vertebrae, want of due supply of blood to the cord, syphilis, and other causes. This it is often difficult to determine.
Till competent advice can be obtained the patient is simply to be kept clean and dry, and to be given simple, nourishing diet. Deep sores are apt to form, and to guard against this, watchfulness is necessary.
Aphasia (Greek a, not, and phasi$, speech) is the term first used by the French physician Trousseau to denote loss of the power of speech due to disease of the brain, and not to paralysis of the organs of speech. It has various forms difficult of distinguishing. One form has been called aphemia (a, not, and phevii, I speak), in which the person has lost the power of willing the combined movements which go to produce speech. At the same time he can read to him self, write, and understand what is said to him, but cannot himself produce the movements that will enable him to express himself. In
another form, called amnesia (a, not, and mfzeme, memory), the person loses memory of words, so that he cannot speak, nor read to himself, nor write. He may retain a few words, which be employs indiscriminately. He can repeat words dictated to him, and seems to understand what is said. In agraphia (a, not, and grapho, I write) there is loss of power to write, not from paralysis of the hand or fingers, but from inability to express ideas in writing. At the same time the person may be able to read and speak, but when he or she tries to write, jargon is the only result, though the letters can be formed quite distinctly and properly. These affections, all grouped under the name aphasia, were attributed by the late M. Broca of Paris to disease situated in a special region on the left side of the brain in front. The disease is sometimes transitory, being due to slight congestion of part of the brain, occurring after long illnesses, more espe cially fevers. Much more frequently, however, it is partially or entirely permanent, caused by apoplexy, softening of the brain, or the pressure of a tumour. Sometimes aphasia occurs alone ; at other times it is accompanied by paralysis of one side of the body, generally the right side.
The treatment demands the aid of a physi cian, and consists in attention to the bowels, the use of good easily-digested food, avoidance of all excitements, and the employment of tonics, such as iron, quinine, and strychnine.
Local Paralysis is the phrase used to sig nify that one muscle or a group of muscles is affected. It does not spring from disease of the brain or spinal cord, but from some disease of, or injury to, a particular nerve-trunk. An accident, for instance, to an arm may have so bruised or otherwise injured one of the nerves that it is cut off from its centre in the cord, and consequently wastes. The muscles to which this nerve proceeded are consequently deprived of its influence, and are therefore paralysed. In fracture such an injury might be caused by the ragged ends of the broken bone. A tumour pressing on the nerve might produce the same results. If a sensory nerve is involved, then the region of skin supplied by that nerve is devoid of sensibility. The trouble of such local paraylais is that the muscles, de prived of their nerve supply, speedily waste, lose their power of responding to a stimulus, and become weak and soft. Facial palsy is an example of this kind of paralysis.