THE PROBLEM OF COMMOTION
In spite of diligent research and much discussion, the problem of commotion still contains many mysteries. Various theories have been developed as to the effect of traumatism to the skull. Some authors have paid especial attention to vascular changes, and have held that vasomotor disturbances or hemorrhages in the brain substance are responsible for the symptoms of commotion. Others contend that sudden and violent displacements of the cerebrospinal fluid could, according to hydrodynamic principles, produce the nervous disturbances. Finally, a few authors have postulated cellular changes brought about by the trauma.In cases of hemorrhage and laceration of nervous tissue, there is no difficulty in understanding the clinical sequences of the traumatism, but hydrodynamic waves of the cerebrospinal fluid and cellular changes were purely hypothetic. Cellular changes after commotion have only been demonstrated as more or less extensive, late degeneration. Anatomic examination during the acute stage