The  next  important  element  is  free  purgation.  This  has  a  powerful  influ-
ence on  the  cerebral  circulation,  by  filling  the  capacious  vessels  of  the  intes-
tinal canal.  It  should  always  be  employed,  but  its  slowness  renders  it  an
inefficient  substitute  for  bleeding  if  the  symptoms  are  urgent  and  venesec-
tion is  distinctly  indicated.  Croton  oil  or  calomel  is  the  most  convenient
agent,  ft  is  unfortunate  that  at  present  we  have  no  purgative  that  can  be
used  hypodermically.     With  the  same  object  a  diuretic  should  be  given.
To  promote  the  contraction  of  the  cerebral  vesssls,  ice  may  be  applied  to
the  head,  provided  the  patient  is  not  collapsed,  and  a  grain  of  ergotine  may
be  injected  under  the  skin.  Mustard  plasters  to  the  nape  of  the  neck  may
be  employed  for  the  same  purpose,  to  induce  reflex  contraction  of  the  arteries,
if  the  patient's  condition  is  one  of  pallor  and  collapse.  The  old  practice  of
applying  them  to  the  soles  and  calves  rests  on  an  intelligible  basis,  since  even
from  these  distant  parts  an  effect  may  be  produced  on  the  cerebral  vessels,
and  the  dilatation  of  the  vessels  of  the  surface  must  aid  in  attracting  the
blood  from  the  brain.
Alcohol  should  be  avoided  unless  the  patient's  collapse  and  cardiac  depres-
sion are  extreme.  If  a  mild  stimulant  is  indicated,  ammonia  may  be  given.
