cause of apoplexy is an extravasation of fluids, or a preternatural fulness of the vessels, has afforded a subject of much controversy among medical writers. To refute this conjecture, they have quoted an instance of the hydrocephalus, or dropsy of the brain, where the head was increased to more than double its natural size, without producing one apoplectic symptom. Le Cat, in his ingenious Reflection, published in the Philosophical Transactions, relates, that, when he opened the head of M. de Frequienne, late president of the Parliament of Paris, who died of an apoplexy, he found about a tea-spoonful of blood extravasated between the third and fourth ventricles of the brain: hence Le Cat deduces the impossibility of so trifling a quantity being capable of pressing on the origin of the nerves, so as totally to intercept the course of the animal spirits. According to this writer, the extravasated blood, usually found in the brain of a person dying of an apoplexy, so far from being the cause of death, is an accident owing to the convulsive motions of the dura mater (a strong membrane, covering all the cavity of the cranium) as well as the vessels of the whole basis of the scull; and that, in general, it is occasioned by the matter of gout, or rheumatism, settling on this source of the nerves. The swelling and distension of the dura mater, causes a stagnation of the blood vessels of the brain, some of the weakest of which burst, while all the canals of the nerves become constricted and closed; a circumstance which sufficiently accounts for the consequent fatal event. It will not surely be contended, that these ruptured vessels concur in the production of those spirits which impart motion to the heart, as it is well known that this organ receives the influence of numerous nerves at a time, all which ought to share in an accident consisting merely in the rupture of a capillary vessel.
These reflections are here offered, to repress that hypothetical confidence which many practitioners profess for their theories; and to discountenance the precipitate and excessive use of the lancet. This practice is plausibly suggested by an idea, that it is too great a proportion of blood which destroys the patient; but, besides that so ill-founded an opinion may prove fatal to those persons who are liable to apoplectic attacks, a prejudice in favour of the theory may prevent others from inquiring into the true cause, and discovering the remedies adequate to the cure of that fatal disorder.
In Heister's Medical Observations, a case is related, of a person who died of an apoplexy, in consequence of his being constantly exposed to the scent of three or four flower-pots of white lillies, which were kept in his chamber. This melancholy fact should deter those to whom such odours are sensibly prejudicial, from continuing long within the sphere of their deleterious influence.—See Dropsy of the Brain, and Epilepsy.
APOTHECARY, is an appellation given to persons who vend and compound medicinal drugs; though most of them likewise prescribe for diseases, and attend patients, as well in slight as in the most dangerous cases. We forbear to animadvert upon the propriety, safety, or expediency of the latter practice.
