Congestion of the brain we understand an undue quantity of blood, arterial or venous, or both, in the vessels of the brain, causing pressure upon the cerebral substance or its ventricles.
There are two varieties of cerebral congestion, the active and the passive form.
By the active variety we understand too much arterial blood in the vessels of the brain. By the passive we understand that there is too great a quantity of venous blood in the veins and sinuses of the brain.
By the active variety we understand too much arterial blood in the vessels of the brain. By the passive we understand that there is too great a quantity of venous blood in the veins and sinuses of the brain.
General Symptoms of Cerebral Congestion: The first and principal one is headache. It is usually of a throbbing character, but the patient may complain simply of a heaviness and dull aching. It may affect the whole head or any portion, either the front, back, or top. This headache is usually aggravated by noise, motion, and, especially, from mental exertion.
The next prominent symptom is sleeplessness - insomnia. Many patients with cerebral congestion lie awake night after night without getting any sleep. Sometimes they drop off to sleep for a few moments, but are soon awake again. The sleeplessness is usually accompanied with headache. The little sleep which these patients get is usually associated with dreams. There is a surplus of blood in the brain; this causes pressure on the brain, and excites it to activity. The patient, when awake, does too much mental work. When asleep, the action of the brain is still kept up. This causes the constant dreams. The dreams are usually of a troubled character.
Noises in the cars is another symptom of cerebral hyperaemia. It may be of a ringing character, or roaring like the waves of an ocean. Spots before the eyes is another symptom of this difficulty. Vertigo is another symptom of the disease under consideration. It is usually felt while walking, but in bad cases the least motion brings on dizziness.
I have a patient now who is suffering with several complaints - uterine difficulty, haemorrhoids, and also this cerebral congestion. When the patient takes treatment in the gynaecological chair she immediately becomes dizzy and unconscious. If she walks slowly she gets on pretty well, while any undue motion brings on dizziness.
Uncertainty of walking is another symptom. The patient is afraid he is going to fall backwards, forwards, or sideways. Numbness is almost always felt in some portion of the body in cases of this kind. It is usually felt on one side, either the right or left. Sometimes along the side of the leg, at other times on the side of the face. This is a dangerous symptom. In pretty bad cases you notice numbness of the tongue or lips. This is usually associated with thickness of speech. These patients usually have red faces. This color of the face is observed to be of a deep red, often of a dark, dusky, bluish appearance. The face usually feels hot, and generally there is a marked degree of mental confusion. The patient does not think as readily as he ordinarily does. Any effort at mental work aggravates the headache. The patient has a frequent desire to urinate. Constipation is present in most cases. The tongue is usually coated yellowish. Most of the patients are irritable, nervous, easily excited.
The symptoms I have now given you are those of an ordinary case of cerebral congestion, where the blood is making pressure either locally or generally on the substance of the brain.
There are three sub-varieties of this difficulty. The first of these is the apoplectic variety. The second is the epileptic variety. The third is the maniacal variety.
The symptoms of the apoplectic or first sub-variety are those of an ordinary attack of apoplexy. The patient has been complaining, perhaps, for several days of hot face, noises in the ears and spots before the eyes. Suddenly he falls out of his chair, or lies down and passes into a condition of stupor. When you talk to him he probably looks about, mutters something, says yes or no, but as soon as you stop speaking he drops back into this stupid condition again. If you get him to complain at all, he complains of feeling hot, tired and numb. On examination, you find that there is no marked paralysis of the face or leg. The breathing is heavy, but probably not stertorous. He remains in this condition for a few hours, perhaps a day or so. Under proper treatment he recovers, and is quite as well as he was before.
In the second variety, the epileptic form, we find the following general symptoms: The patient complains of hot face or headache; suddenly, without any premonitory symptoms, more than those which we have already mentioned, he falls to the floor, and has a convulsive seizure. There is jerking of the limbs, arms and legs, frothing at the mouth, and a number of the general symptoms observed during an attack of epilepsy. These pass off in the course of a few moments. The patient recovers his intelligence, but is, perhaps, sleepy or stupid for several hours. Under proper treatment the patient never has another seizure of an epileptic form.
In the third, or maniacal form, the following symptoms or manifestations of disease are observed: The patient complains of headache, sleeplessness, noises in the ears, is irritable, nervous, and has been so for several days, when suddenly he becomes the subject of delusions, hallucinations, and, in all probability, undertakes some violent act.
There is one case reported, where a gentleman suffering from this difficulty, while waiting at a depot for a train, suddenly threw off his coat, rushed through a crowd, throwing all to one side that came into his way. He kept on running for several hours; after a while he found himself out in the country, without his coat, valise or anything. He recovered, went back to town, and under proper treatment had no more trouble. He suffered from cerebral congestion which, for a time, made him a maniac, due to the undue pressure on the substance of the brain.
Another case, where a gentleman travelling suddenly became maniacal. He thought people were trying to injure him in some way, and to frighten them off, he struck several people, and tried to kill them. Policemen controlled him for some time, and he finally recovered. He was a respectable man, and everybody knew him. He never had another attack. He was suffering from cerebral congestion, which was the cause of his acts.
Diagnosis. - The diagnosis is not very difficult to make. When you see a patient who complains of headache, sleeplessness, red face, numbness and noises in the ears, spots before the eyes, is irritable, and you take all these symptoms grouped together, you will know that they only point to one thing, which is general congestion of the brain.
Prognosis: If the patient is young, comparatively speaking, in the prime of life, and his surroundings can be controlled, the prognosis is favorable. If he is pretty well advanced in life, has organic changes of the vessels of the brain, if he is broken down physically, if his surroundings are bad, the prognosis is not good.
Treatment: The treatment of cases of this kind is very important. If you are called to a case where the patient is unconscious, and has the general symptoms of the apoplectic variety, loosen the clothing and elevate the head of the bed so that the head will be somewhat higher than the feet. You do this so as to allow the blood to pass away from the brain readily. It is well then to apply bags or bladders of ice to the head. If the patient is conscious enough, give him some cold water or let him suck a little ice. Keep the patient perfectly quiet, free from all noise and company. A great many doctors, when they find a patient unconscious, at once send for a battery, being determined to awake the patient, or bring him to. This is a great mistake, and should never be done. The patient should be kept quiet. There is too much pressure there now, and if this is increased, the blood vessels will burst, and then you have a case of apoplexy instead of congestion. There is then a certain amount of damage done that you cannot overcome. If you keep him at rest for some time, the chances are that the patient will recover by the congestion gradually diminishing. Do not trouble the patient about eating for some little time.
If there is a history of obstinate constipation, after a few hours give him an injection of eastile soapsuds and warm water, so as to remove the pressure from the spine, and allow a free circulation of the blood.
Bathe the feet in cold water. Do not give the patient any stimulants. He needs nothing of the kind.
He should be kept perfectly straight in bed. Care should be exercised that the neck is not bent, so that there is no obstruction to the free circulation of the blood. The next thing is the administration of medicines. The first remedy to use is Aconite, because this is one of the most important remedies in the new school of medicine, and is the best remedy to be given in diseases of this kind. You give it for the red, flushed face, thirst, restlessness, delirium, frightened at objects in the room, as, for instance, lights, and when the patient complains of numbness, cannot feel his feet or hands or face.
Homeopathic therapeutics
The next remedy is Belladonna. The patient is very stupid; the face is dark, purplish-red. If the patient complains at all he complains of intense headache, the eyes are congested, intolerance of light, numbness, incontinence of urine.
The next remedy is Conium. This is to be given when there is a great deal of dizziness, vertigo. Vertigo is aggravated on making the least motion; turning over in bed brings on extreme vertigo. This is an excellent indication for Conium.
The next remedy is Gelsemium. This is to be given to a patient suffering from malarial fever, and suffering from vertigo before the attack, and during it as soon as his fever sets in. Incontinence of urine; bluish appearance of the whole body; the skin; imperfect vision; attacks of blindness.
Pulsatilla. - This is given where the subject is a woman, where there is some menstrual difficulty, especially some form of menorrhoea; also if all the blood is in the brain and none in the feet or hands. The patient complains of cold and chilliness, varicose veins, and, while being in this state, is disposed to cry.
Veratrum Viride. - If the patient complains of great headache; dark, dusky appearance of the face; great disposition to spasms and muscular contractions.
Nux Vomica. - This is to be given to the subject who has been overworked mentally, suffering from a frontal headache, sleeplessness, and constipation.
Glonoine or Nitro-glycerine. - This is to be given in cases of women, especially when the headache is at the top of the head, extremely violent in character, and ordinarily associated with uterine difficulty, womb enlargement, and induration.
The following are the principal remedies for the various sub-varieties of this disease:
For the apoplectic variety, Belladonna, Veratrum viride, and Glonoine.
For the epileptic form the best remedies are Belladonna, Glonoine, and Veratrum viride.
For the maniacal form, Belladonna, Veratrum viride, especially, and Glonoine.
Where the trouble is due to a surplus of venous blood in the brain, the best remedies are Pulsatilla, Gelsemium and Conium.
Where the cases are more arterial than venous, markedly so, give Belladonna and Aconite.
Of course, there are many other remedies given in a disease of this kind. Remedies which are little used are sometimes necessary. Therefore, you may sometimes use Sulphur, Calc. carb., or a number of other remedies.
I once had a case of malarial fever. I thought the indications called for Arsenic, and gave it. The patient did not get well, although I gave it for a week. Sulphur was then given, and she improved at once. I thought the Sulphur would make the Arsenic act better, and I therefore returned to Arsenic. She at once became worse again. I then concluded that Arsenic was not the remedy, and gave her Sulphur. She soon became perfectly well. Since that I have treated the whole family.
When you are called to any case, make up your mind what is best to be done and do it. Do not jump from one measure to another, as you will accomplish nothing. You want to stick right down to what you consider right.
If your patient has recovered from his immediate attack of congestion, supposing he has had one of those periods, and has gone to bed, as soon as he recovers consciousness and gets into a pretty good condition then you should commence to give him the massage treatment, and this should be kept up for some time. Then you should use electricity - not about the head, but about the body. Using electricity about the head is a dangerous thing.
Dr. Hammond, of New York, while once treating a patient with electricity, had him suddenly go into a condition of vertigo, and he had great difficulty in bringing him back to consciousness. If a patient should die under such circumstances it would be a very lamentable matter.
Shampooing is another condition to be used. It brings the blood to the surface. Cold to the feet is also useful in treating this difficulty. Let a stream of running water strike the feet. By the first action the blood is driven out of the feet, but reaction sets in, and the blood flows to the feet, and the patient is often able to go to sleep.
Where there is general congestion, no acute attack having taken place, advise them to sleep with the head high. This enables the blood to pass away from the brain easily. The neck should be straight and not bent.
Some persons go to bed too early. There is too much disturbance. The first sleep is disturbed, and the patient cannot return to sleep. If the patient will go to bed late, and then sleep until daylight without any interruption, it will do him more good. The patient should go to bed very late, when everything is perfectly quiet.
Eating a little cracker or something of that kind is a good means of inducing sleep. The patient thereby excites the stomach, and the blood is taken away from the brain.
The use of a hop pillow induces sleep in many instances.
Patients with this difficulty, and subjects of cerebral congestion, ought to exercise quite a good deal when it is coming on. They ought to wear a free, large, easy-walking shoe, and ought to walk one, two, or three miles a day. They should walk in the morning and in the evening. It is also well for them to ride horseback. This helps many of them. The use of these measures will help the majority of cases of cerebral congestion.
The next remedy is Conium. This is to be given when there is a great deal of dizziness, vertigo. Vertigo is aggravated on making the least motion; turning over in bed brings on extreme vertigo. This is an excellent indication for Conium.
The next remedy is Gelsemium. This is to be given to a patient suffering from malarial fever, and suffering from vertigo before the attack, and during it as soon as his fever sets in. Incontinence of urine; bluish appearance of the whole body; the skin; imperfect vision; attacks of blindness.
Pulsatilla. - This is given where the subject is a woman, where there is some menstrual difficulty, especially some form of menorrhoea; also if all the blood is in the brain and none in the feet or hands. The patient complains of cold and chilliness, varicose veins, and, while being in this state, is disposed to cry.
Veratrum Viride. - If the patient complains of great headache; dark, dusky appearance of the face; great disposition to spasms and muscular contractions.
Nux Vomica. - This is to be given to the subject who has been overworked mentally, suffering from a frontal headache, sleeplessness, and constipation.
Glonoine or Nitro-glycerine. - This is to be given in cases of women, especially when the headache is at the top of the head, extremely violent in character, and ordinarily associated with uterine difficulty, womb enlargement, and induration.
The following are the principal remedies for the various sub-varieties of this disease:
For the apoplectic variety, Belladonna, Veratrum viride, and Glonoine.
For the epileptic form the best remedies are Belladonna, Glonoine, and Veratrum viride.
For the maniacal form, Belladonna, Veratrum viride, especially, and Glonoine.
Where the trouble is due to a surplus of venous blood in the brain, the best remedies are Pulsatilla, Gelsemium and Conium.
Where the cases are more arterial than venous, markedly so, give Belladonna and Aconite.
Of course, there are many other remedies given in a disease of this kind. Remedies which are little used are sometimes necessary. Therefore, you may sometimes use Sulphur, Calc. carb., or a number of other remedies.
I once had a case of malarial fever. I thought the indications called for Arsenic, and gave it. The patient did not get well, although I gave it for a week. Sulphur was then given, and she improved at once. I thought the Sulphur would make the Arsenic act better, and I therefore returned to Arsenic. She at once became worse again. I then concluded that Arsenic was not the remedy, and gave her Sulphur. She soon became perfectly well. Since that I have treated the whole family.
When you are called to any case, make up your mind what is best to be done and do it. Do not jump from one measure to another, as you will accomplish nothing. You want to stick right down to what you consider right.
If your patient has recovered from his immediate attack of congestion, supposing he has had one of those periods, and has gone to bed, as soon as he recovers consciousness and gets into a pretty good condition then you should commence to give him the massage treatment, and this should be kept up for some time. Then you should use electricity - not about the head, but about the body. Using electricity about the head is a dangerous thing.
Dr. Hammond, of New York, while once treating a patient with electricity, had him suddenly go into a condition of vertigo, and he had great difficulty in bringing him back to consciousness. If a patient should die under such circumstances it would be a very lamentable matter.
Shampooing is another condition to be used. It brings the blood to the surface. Cold to the feet is also useful in treating this difficulty. Let a stream of running water strike the feet. By the first action the blood is driven out of the feet, but reaction sets in, and the blood flows to the feet, and the patient is often able to go to sleep.
Where there is general congestion, no acute attack having taken place, advise them to sleep with the head high. This enables the blood to pass away from the brain easily. The neck should be straight and not bent.
Some persons go to bed too early. There is too much disturbance. The first sleep is disturbed, and the patient cannot return to sleep. If the patient will go to bed late, and then sleep until daylight without any interruption, it will do him more good. The patient should go to bed very late, when everything is perfectly quiet.
Eating a little cracker or something of that kind is a good means of inducing sleep. The patient thereby excites the stomach, and the blood is taken away from the brain.
The use of a hop pillow induces sleep in many instances.
Patients with this difficulty, and subjects of cerebral congestion, ought to exercise quite a good deal when it is coming on. They ought to wear a free, large, easy-walking shoe, and ought to walk one, two, or three miles a day. They should walk in the morning and in the evening. It is also well for them to ride horseback. This helps many of them. The use of these measures will help the majority of cases of cerebral congestion.
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