Dropsy of the Brain. Chronic Hydrocephalus.
Acute hydrocephalus is an inflammation; chronic hyclrocephalus, now to be considered, is a dropsy. It often begins before birth. It consists in the accumulation of enormous quantities of water within the brain, sometimes within its ventricles, at other times upon its surface. When it occurs soon after birth, it advances slowly and imperceptibly, the enlargement of the head being the first thing noticed.
The skull being tender in infancy, it separates at the fontanelles, as the fluid accumulates, and the head, at times, attains an enormous size, so great that the child cannot carry it upright, but lets it droop laterally upon the shoulder, or forward upon the breast.
As the disease advances, the senses become blunted, the child is deaf or blind, the intellect is weakened, perhaps idiocy appears, the flesh and strength pass away, convulsions and paralysis come in their turn, and a stupor is apt to occur which ends in death.
Treatment. The remedies may be external, or internal, or both.
Internal Remedies. These should be purgatives (33), (31), or diuretics and alternatives (302), (145), (144).
External Remedies. Apply an ointment of the iodide of potassium to the scalp every night (185). A tight bandage applied over the whole head will sometimes have a favorable effect. Another expedient is to puncture the skull and draw off the water. Tapping the brain has effected a cure in many cases, and perhaps promises the most relief of any remedy we have. In newly~ born children with this affection, it is the best means.
As may be expected, none of these remedies are likely to give the benefit desired, and an operative interference above proposed constitutes a risk which it is perhaps better to run even if it results in the death of the child, rather than have it become a hopeless invalid with epileptic convulsions and the other manifestations of an impaired brain.
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