ear ring or roar. Disease of the ear will often produce this syraptom, even when the disease is not severe at the time. In ether instances, brain exhaustion, or congestion (overfulness of blood) of the brain, may give rise to it. If it be heard only in one ear, we may be confident that the cause is in that ear itself. Deafness, or hardness of hearing, in various degrees, may proceed from cold in the head, very large doses of quinine, typhus or typhoid fever, wax accumulated in the ears, disease or injury of the ears, brain disease. Headache. Pain in the head may depend in different cases upon neuralgia, rheumatism, overful- ness of blood {congestion hypercEviia); blood- poisoning (as by alcohol, opium, etc.); fever (remittent, typhoid, etc.) ; disease of the brain, sympathetic irritation (as with uterine disorder, etc.). Skill as well as care may often be neces- sary to make out, in an actual case, to which of these a headache belongs. Neu- ralgic headache is nearly always on one side only or chiefly, and extends to the face also ; it is shooting or darting, and there is with it some tenderness on pressui-e. RheumatisTn of the scalp is usually accompanied by stiffness of the muscles that move the head and neck. Headache from fulness of blood or fever is attended by heat of the head ; the pain is then apt to be throbbing in character. Pain from disease of the braiji is generally in one spot, either fixed or in -spells (periodic or paroxysmal) ; and some other sign of brain disease is also present with it. Expression of the Face. Acute disease is apt to alter this more than that which is chronic ; but it is often changed in both. An anxious or distressed expression giving way to serenity is always a good sign, unless it be the result oi 7norii- fication or palsy coming on. Great anxiety is seen especially m organic diseases of the heart, and in acute disorders of the abdomen, as well as in melancholy . Terror belongs habitually to deliriuvi tremens, also called mania-a-potu, or the horrors. 480 Rage is now and then seen in insanity, and in some, not all, cases of hydrophobia. Insane persons, although not always very peculiar in countenance, have mostly an expression by which their derangement can be recognized by those accustomed to observing it. Collapse, that is, extreme prostration, as from the shock of a railroad accident, an attack of cholera, or the dying state from any cause, has its own characteristic ex- pression, more easily understood when seen than described. Shrunken cheeks, pale or livid, with mouth drawn down at the cor- ners, and white, glassy eyes ; these with clammy coldness to the touch, gasping res- piration, and a thready or absent pulse at the wrist, mark this condition. Delirium. This is a disorder or confusion of mind, in acute disease, not fixed for a long time like insanity, but depending upon a tempor- ary cause. It is present in many attacks of maladies attended by fever ; as severe remit- tent, typhus, typhoid, scarlet, or yellow fever, etc. A few persons are liable to tran- sient delirium during almost any brief at- tack of illness. Mania-a-potu, as already said, has a characteristic delirium, in which, almost always, there is extreme terror, from imaginary enemies or dangers of some kind. Grown people are affected by delirium usually under circumstances which, in a child, would bring on convulsions. Stupor.

AI-modernized reading of the original text

ear ring or roar. Disease of the ear will often produce this symptom, even when the disease is not severe at the time. In ether instances, brain exhaustion, or congestion (overfulness of blood) of the brain, may give rise to it. If it be heard only in one ear, we may be confident that the cause is in that ear itself. Deafness, or hardness of hearing, in various degrees, may proceed from cold in the head, very large doses of quinine, typhus or typhoid fever, wax accumulated in the ears, disease or injury of the ears, brain disease. Headache. Pain in the head may depend in different cases upon neuralgia, rheumatism, overfulness of blood {congestion hypercEviia); bloodpoisoning (as by alcohol, opium, etc.); fever (remittent, typhoid, etc.) ; disease of the brain, sympathetic irritation (as with uterine disorder, etc.). Skill as well as care may often be necessary to make out, in an actual case, to which of these a headache belongs. Neuralgic headache is nearly always on one side only or chiefly, and extends to the face also ; it is shooting or darting, and there is with it some tenderness on pressure. RheumatisTn of the scalp is usually accompanied by stiffness of the muscles that move the head and neck. Headache from fulness of blood or fever is attended by heat of the head ; the pain is then apt to be throbbing in character. Pain from disease of the brain is generally in one spot, either fixed or in spells (periodic or paroxysmal) ; and some other sign of brain disease is also present with it. Expression of the Face. Acute disease is apt to alter this more than that which is chronic ; but it is often changed in both. An anxious or distressed expression giving way to serenity is always a good sign, unless it be the result of mortification or palsy coming on. Great anxiety is seen especially m organic diseases of the heart, and in acute disorders of the abdomen, as well as in melancholy . Terror belongs habitually to delirium tremens, also called mania-a-potu, or the horrors. Rage is now and then seen in insanity, and in some, not all, cases of hydrophobia. Insane persons, although not always very peculiar in countenance, have mostly an expression by which their derangement can be recognized by those accustomed to observing it. Collapse, that is, extreme prostration, as from the shock of a railroad accident, an attack of cholera, or the dying state from any cause, has its own characteristic expression, more easily understood when seen than described. Shrunken cheeks, pale or livid, with mouth drawn down at the corners, and white, glassy eyes ; these with clammy coldness to the touch, gasping respiration, and a thready or absent pulse at the wrist, mark this condition. Delirium. This is a disorder or confusion of mind, in acute disease, not fixed for a long time like insanity, but depending upon a temporary cause. It is present in many attacks of maladies attended by fever ; as severe remittent, typhus, typhoid, scarlet, or yellow fever, etc. A few persons are liable to transient delirium during almost any brief attack of illness. Mania-a-potu, as already said, has a characteristic delirium, in which, almost always, there is extreme terror, from imaginary enemies or dangers of some kind. Grown people are affected by delirium usually under circumstances which, in a child, would bring on convulsions. Stupor.

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