Water in the Head. Acute Hydrocephalus.
This, like enlargement of the brain, is likewise a disease of childhood, and often attacks scrofulous children.
Being an inflammatory disease, it is important to have early notice of its existence, and, if possible, to be aware of its approach; which we may be, frequently, by observing the following premonitory
Symptoms; namely, a disturbance of the digestive functions, indicated by a capricious appetite, the food at one time being disliked, at another devoured greedily; a foul tongue, offensive breath, enlarged and sometimes tender belly, torpid bowels, stools light colored from having no bile, or dark from vitiated bile, fetid, sour smelling, slimy and lumpy. The child loses its healthy look, and grows paler and thinner. Its customary spirit and activity are gone; it is heavy, languid, dejected; it is fretful, irritable, uneasy; and sometimes is a little tottering in its gait.
After these warning symptoms, the disease may begin in one of three ways:
The pains in the head become more severe and frequent, and are sharp and shooting, causing the little patient to wake and shriek out. As the drowsy state advances, the shrieking gives place to moaning. Beside these symptoms, there are stiffness in the back of the neck, pain in the limbs, great tenderness of the scalp, vomiting, sighing, intolerance of light, knitting of the brows, increased disturbance of stomach and bowels. This stage may last ten to fourteen days, the child growing more weak and peevish.
Another form of attack is marked by acute pain in the bead and high fever, convulsions, flushed face, brilliant eyes, intolerance of light and sound, pain and tenderness in the belly, stupor, great irritability of stomach, causing retching and vomiting upon every attempt to sit up in bed.
The third mode of attack is very insidious, the early symptoms being mild and hardly noticeable, or not even occurring at all. In such case, the convulsions or palsy come suddenly, without notice, bringing swift and unexpected destruction. This has sometimes been called water stroke.
The First Stage is the period of increased sensibility and excitement, caused by inflammation, in which the pulse is quick and irregular.
The 5econd Stage is one of diminished sensibility, or lethargy, during which water is effused upon the brain, and the pulse is slow.
The Third Period is one of palsy and convulsions, with squinting of the eyes, rolling of the head, stupor, and a rapid, thread like pulse.
Treatment. The first or inflammatory stage of the fever is very important, and must be controlled for five or six days. Scammony and croton oil (33) may be chosen for this purpose. Apply cold water, ice, etc., to the head. Use tinct. veratrum viride or (355).
In the second stage, put poultices upon the back of the neck, and one upon the bowels if they are very tender.
In the third stage, effusion having taken place, use the warm bath, or the vapor bath, also digitalis, squills, and iodide of potassium, (144), (128), (302), (130). The effusion, if permanent, may be drawn off.
Confine the child to a darkened room, of moderate temperature, excluding all noise and causes of excitement, and let him lie upon a hair mattress, with his head somewhat elevated.
Diet. Gruel only during the stage of excitement, during that of collapse, it should be nourishing, but mild and easy of digestion, as beef tea, plain chicken or mutton broth, and animal jellies. At the same time, support the patient by the cautious use of the aromatic spirit of ammonia, ten drops every four hours, valerian, wine whey, and infusion of gentian, columbo, or quassia, (64), (66).
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