Either the clotting of blood in a blood-vessel inside the skull causes throm- bosis and the sudden cutting off of the blood supply to a larger or smaller patch of brain, or a blood-vessel bursts and cerebral haemorrhage causes damage to brain substance of a greater or lesser degree.
The immediate effect of such an accident may be slight or it may be catastrophic. In the case of lesser degree there will be a sudden attack of weakness in a limb, or in the muscles of speech, or a sudden numbness which persists, or sudden confusion of thought.
When such happenings as these occur, especially in an old person the main need is for complete rest in bed with reassurance. Aconitum 30 should be given for a few doses to allay anxiety and engender calm, and then Arnica 30 two or three times a day for a few days to encourage healing of the brain injury and absorption of extravasated blood. All such cases must, of course, be under expert medical care.
In the more severe case the patient may fall unconscious and in this case aid should be summoned at once. No attempt should be made to get the patient upstairs and into bed, but a mattress may be brought to the room and placed under the patient with due cover- ings to maintain warmth. A dose of Arnica 200 may be slipped under the tongue and the head kept turned to one side to assist breathing and prevent saliva, or perhaps vomit, getting into the air passages. As such an accident is an alarming experience for those in attendance a dose or two of Aconitum may be indicated for them. It will be a great help to the doctor when he comes to find every one calm and able to describe exactly what has happened.
In a comatose patient with dusky, flushed face, noisy breathing puffing thecheeks out at each expiration, Opium 30 is the remedy of choice.