SECT. VII.—ON PHLEGMON OF THE BRAIN.
When the brain is inflamed, it is often so swelled that the sutures of the skull are separated. The pain is very strong and permanent; there is much anxiety, and much redness of the countenance, with swelling; the eyes protrude, and the head swells. We must let blood from the arm, and also detract by the nose, and from the vessels below the tongue. We are also to use the fomentations suitable for inflammations of the head, and cataplasms of a moistening and concocting nature.
Commentary. This Section is taken from Aëtius (vi, 25), or Oribasius (Synops. viii, 11.) See also Avicenna (iii, i, 3, c. 4); Haly Abbas (Theor. ix, 4, and Pract. v, 14); Alsaharavius (Pract. i, 2, 9.)
The Arabians call it massera. Phlegmon of the brain, according to Haly Abbas, is attended with swelling of the brain, so as to occasion a separation at the sutures, redness of the face, acuteness of vision, and sympathetic affection of the stomach. He recommends bleeding at the arm, cooling laxatives, applications of cold things to the head, and so forth. The translator of Alsaharavius calls it ‘flegmon’ and ‘apostema in cerebro;’ says it is occasioned by a collection of corrupted blood in the vessels of the brain; and directs general bleeding, opening of the nasal vein, or of the sublingual. Avicenna’s account is nowise different from our author’s.
Hippocrates makes mention of sphacelus of the brain, which, he says, generally proves fatal in three days. (Aphor. vii, 48.) From the Commentary of Galen it would appear that by sphacelus he meant that state which is the result of an extreme degree of inflammation. Another of his commentators, Theophilus, states that by sphacelus was meant incipient mortification. (Ed. Dietz, ii, 537.) It was therefore a species of ramollissement. See an elaborate disquisition into the nature of the sphacelus of Hippocrates by Dr. Coray. (Ad Hippocrat. de Aer. &c. 64.)