MED! he drinking of it to receive the vapour or fleam into the eyes. Of the Apoplexy. This difeafe is a fudden abolition of all the fenfes, external and internal, and off all voluntary motion, commonly attended with a ftrong pulfe, laborious breathing, a deep fleep, and fnorting. There is no difference between a perfon afleep and in an apoplexy, but that the one can be awaked, and the other cannot. The caufes of this difeafe are a particular conformation of the body, as a fhort neck, for fome have fewer vertebrae in their necks than others ; a grofs, plethoric, fat, phlegmatic conflitution ; polypous concretions in the carotid and vertebral arteries, or about the heart, dr within the flcull, which are known by an unequal pulfe, a vertigo, and fometimes a momentary lofs of fight ; an inflammatory thicknefs of the blood, preceded by a fever attended by the head ach, rednefs of the face and eyes, an advanced age, attended with a glutinous, cold, catarrhous, leucophlegmatic conflitution. The forerunners of an apoplexy in thefe lafl, are, dulnefs, inadtivity, drowfinefs, fleepinefs, llownefs of fpeech and in giving anfwers, vertigoes, tremblings, oppreffions in deep, night niares ; weak, watery, and turgid eyes ; pituitous vomiting, and laborious breathing on the lead motion. Other caufes may be. whatever comprefies the veffels ©f the brain; as, a plethora, a cacochymy, attended with fulnefsof the vefiels; a hot conflitution; tumors within the flcull ; the velocity of the blood increafed towards the head, and diminifhed downwards ; compreffion of the veins without the flcull, which bring the blood back from the brain ; the effufion of any fluid comprefling the dura and pia mater externally ; the effufion of any fluid within the brain, which by its preffure hurts the origin of the nerves-; this is the mofl: common caufe of apoplexies, and proceeds from blood in the plethorical, from a {harp ferum in the hydropical and leucophlegmatical, and from an atrabilious acrimony in the melancholic, the fcorbutic, and the podagric. Violent paffions of the mind, and intenfe fludy, are prejudicial to thefe. There are three degrees of an apoplexy. The firfl: is, when the vital fluids are, by the force of violent diftentions, driven from the lower and outv/ard parts of the body, to the external parts of the head, and to the brain and its meninges, by the carotid arteries ; whereby their veflels are expanded, and the free circulation through them impeded. While this flagnation of the blood continues, the external and internal fenfes are abolilhed ; and as the ftoppage goes off they are gradually reftored. Such are the fits that hypochondriacal and hyfterical perfons are fubjeifl to. The fecond degree is, when the flagnation continues To long that the ferum oozes through the veffels, and falls upon the fides of the medulla oblongata or fpinalis, and To flops the influx of the nervous fluid, and produces a hemiplexia or a palfy. The highefl degree is, when the fine veffels of the pia V©l. III. N°. 73. 2 l
CINE. 97 mater are broke, and the extravafated blood occupies the bafis of the brain. The firfl may be cured by timely bleeding ; the fecond, though it does not fitddenly kill, yet it generally renders the patient infirm ever after : the third is altnoit always mortal. The immediate forerunners of an apoplexy, a: trembling, flaggering, a giddinefs in the head, a vertigo, dimnefs of fight, a ftupor, fleepinefs, forgetfulnefs, noiftr in the ears, more deep and laborious breathing, the nightmare. A flight apoplexy goes of in a profufe, equal, rofeid, warm fweat ; a large quantity of thick urine, by the bleeding piles, the flowing of the menfes, a diarrhoea, or a fever. If it is more fevere, it'ufually terminates in a paralytic diforder ; and is feldoin curTole, but always leaves behind it a great defeifl of memory, judgment, and motion. Bleed in the arm to 12 ounces, and then in the jugular to 7 ounces ; immediately after which, give an ounce and a half, or two ounces, of emetic wine. Apply a large flrong blifler to the neck, hold the patient upright in bed, and let the fpirit of fal ammoniac, highly redlified, be held to his nofe. Let there be ftrong fridlions of the head, feet, and hands ; and let the patient be carried upright backwards and forewards about the room, b^two ftrong men. Strong bliflers (hould be applied to the head, neck, back, and calves of the legs. Sharp clyflers fhould be thrown up into the body, which have a tendency to excite the patient, and to caufe a revulfiom Shawadvifes, during the fit, to bleed largely in the arm, or rather in the jugular, to apply flrong volatiles to the nofe, to blow fneezing powders up the nofe, as alfo to mb the temples with fpirituous cephalic mixtures. Likewife to blow in the mouth and noftrils the fmoke of tobacco from an inverted pipe. Thofe who have once had a fit of the apoplexy, are very liable to be feized with it again ; and if they are plethoric, the beft prefervative is bleeding once in three months, and ufing themfelves to a fpare diet; taking medicines which ftrengthen gently, and abftaining from cares and all intenfe applications of the mind ; not neglecting iffues and fetons, nor the drinking fuitable mineral waters. Of the Palsy. A Palsy is a lax immobility of any mufcle, not to be overcome by the will of the patient. Sometimes the fenfation of the part is abfolutely aboliihed, and fometimes there remains a dull fenfe of feeling, with a kind of tingling therein. It may be caufed by all things that bring on an apoplexy ; that render the nerves unfit to tranfmit the animal fpirits ; that hinder the entrance of the arterial blood into the mufcle. Hence the nature of a paraplegia or hemiplegia, and the palfy of a particular part, may be underftood Hence a palfy may proceed from an apoplexy, an epilepfy, extreme and lafling pains, fuppreffions of the ufual b evacuations,.
