298

APOPLEXY.

able to swallow, he ought to drink freely of some diluting openingliquor ; as a decoction of tamarinds and liquorice, cream-tartarwhey, or common whey with cream of tartar dissolved in it. Orhe may take any cooling purge, as Glauber's salts, manna dissolv-ed in an infusion of senna, tincture of rhubarb, or the like. Allspirits and other strong liquors are to be avoided. Even volatilesalts held to the nose do mischief. Vomits for the same reason,ought not to be given, or any thing that may increase the motionof the blood towards the head.

In the serous apoplexy the symptoms are nearly the same, onlythe pulse is not so strong, the countenance is less florid, and thebreathing less difficult. Bleeding is not so necessary here as inthe former case. It may, however, generally be performed oncewith safety and advantage, but should not be repeated. The pa-tient should be placed in the same posture as directed above, andshould have blistering plasters applied, and receive opening clys-ters in the same manner. Purges are here likewise necessary, andthe patient may drink strong balm tea. If he be inclined to sweat,it ought to be promoted by drinking small wine whey, or an infu-sion of Carduus benedictus. A plentiful perspiration kept up for aconsiderable time has often carried off a serous apoplexy. Outof a fit of serous apoplexy the cephalic and nervous medicinesrecommended in palsy will be proper, taking occasionally somestomachic purgative. If the disease arise in consequence of a sup-pression of piles, leeches should be applied to the hemorrhoidalveins, fomentations must be employed, and the intestines stimulat-ed by means of aloetic purges.

When apoplectic symptoms proceed from opium, or other nar-cotic substances taken into the stomach, vomits are necessary.The patient is generally relieved as soon as he has discharged thepoison in this way.

Persons of plethoric or apoplectic make, or those who have beenattacked by it, ought to use a very spare and slender diet, avoidingall strong liquors, spiceries, and high-seasoned food. They oughtlikewise to guard against all violent passions, and to avoid the ex-tremes of heat and cold. The head should be shaved, and daily-washed with cold water. The feet ought to be kept warm, andnever suffered to continue long wet. •The body must be kept openeither by food or medicine, and a little blood may be let everyspring and fall. Exercise should by no means be neglected ; butit ought to be taken in moderation. Nothing has a more happyeffect in preventing an apoplexy than perpetual issues or setons ;great care, however, must be taken not to suffer them to dry up,without opening others in their stead. Apoplectic persons ought •never to go to rest with a full stomach, or to lie with their headslow, or to wear any thing too tight abovit their necks. When anattack of apoplexy is immediately threatened, blood-letting is theremedy most to be relied on, and the blood should be drawn eitherfrom the jugular vein or temporal artery, determining the extentpf blood to be taken away by the circumstances of the case, &c.When a lethargic disposition prevails, bleeding should also beadopted, particularly topical, from the temples, by means of leech-es, or from tiie nape of the neck by the scarificator and cupping ;