Of lethargy, coma, carus, cataphora.
These denote different degrees of profound deep sleep without delirium. Authors have often confounded them with the febrile class, especially the “lusus naturæ” of remittents. To this irresistible torpor and drowsiness, even at meals or in conversation, many corpulent and fat persons are subject. We also read in authors of some extraordinary instances of profound long protracted sleep, from which it was impossible effectually to rouze the person. The vertigo has also been distinguished into simplex, scotomia, caduca. In this disease all objects, although at rest, seem to whirl round; sometimes with headach, flushing of the face, noise in the ears; and if not supported, the patient often falls down. It is commonly fugacious, and momentary; seldom above a minute; and in some diseases is symptomatick. The prognostick may be deduced from that of apoplexy.
Of the predisposing and occasional causes of apoplexy, lethargy, coma, carus, cataphora, and vertigo: hereditary; short neck; plethora, general or partial, sanguine or serous, especially sanguineous plethora in the vessels of the brain; tight neckcloaths; pressure on the descending aorta, cava; serous or sanguineous exudations or extravasations in the brain; compression of the medullary substance, or of the origin of the nerves; suppression of habitual evacuations or hemorrhages, nasal or hemorrhoidal; habitual venesection neglected; old ulcers dried up; full and long continued inspiration loading the vessels of the head; blood forced on the brain by violent efforts of coughing, vomiting, fecal expulsion, exercise, venery, stooping the head; salivation suddenly suppressed by cold; foul stomach, gluttony, surfeits, luxurious living, and sedentary life; fatness, corpulency; intoxication, sottish potations; violent passions of mind irascible or stimulating, and also depressing, as anger, ambition, chronic melancholy and cares; intense meditation and study; intemperate lust in old age; noxious vapour from liquors in fermentation, from charcoal, quicklime, and new-plastered walls; particular effluvia and odours concentrated in large quantity; crowded rooms filled with animal steams from the lungs; thunder; sometimes epidemick state of the air and elements, or perhaps celestial influences not yet explained; intense cold; warm baths; blood rarified and expanded; insolation; some narcotick poisons, as opium, hyoscyamus, cicuta, laurus, belladonna, and some fungi: obstructed circulation through the lungs and heart, from asthma, polypi, ossifications of the large blood vessels or valves, and particularly of the right ventricle; external injuries of the head; concussion, fractures. The most frequent cause is, accumulation and congestion of blood in the brain: but sometimes, on dissection, no disease is discernible; and effusions in the brain do not always inflict apoplexy.