Sect. 145.
very Person has some Idea of the Disease termed an Apoplexy, which is a sudden Privation or Loss of all Sense, and of all voluntary Motion; the Pulse at the same Time being kept up, but Respiration or Breathing, being oppressed. I shall treat of this Disease only in a brief Manner, as it is not common in our Country Villages; and as I have expatiated on it in a different Manner in a Letter to Dr. Haller, published in 1761.
§ 146. This Disease is generally distinguished into two Kinds, the sanguineous and serous Apoplexy. Each of them results from an Overfulness of the Blood Vessels of the Brain, which presses upon, and prevents or impairs the Functions of the Nerves. The whole Difference between these two Species consists in this, that the sanguineous Apoplexy prevails among strong robust Persons, who have a rich, heavy, thick and inflammable Blood, and that in a large Quantity; in which Circumstance it becomes a genuine inflammatory Distemper. The serous, or humoral Apoplexy invades Persons of a less robust Constitution; whose Blood is more dilute or watery; and rather viscid, or lightly gelatinous, than heavy or rich; whole Vessels are in a more relaxed State; and who abound more in other Humours than in red Blood.
§ 147. When the first kind of this Disease exists in its most violent Degree, it is then sometimes termed, an apoplectic Stroke, or thundering Apoplexy, which kills in a Moment or instantaneously, and admits of no Remedies. When the Assault is less violent, and we find the Patient with a strong, full and raised Pulse, his Visage red and bloated, and his Neck swelled up; with an oppressed and loud hoarse Respiration; being sensible of nothing, and capable of no other Motions, except some Efforts to vomit, the Case is not always equally desperate. We must therefore immediately,
1. Entirely uncover the Patient's Head, covering the rest of his Body but very lightly; procure him instantly very fresh free Air, and leave his Neck quite unbound and open.
2. His Head should be placed as high as may be, with his Feet hanging down.
3. He must lose from twelve to fifteen Ounces of Blood, from a free open Orifice in the Arm: the Strength or Violence with which the Blood sallies out, should determine the Surgeon to take a few Ounces more or less. It should be repeated to the third or fourth Time, within the Space of three or four Hours; if the Symptoms seem to require it, either in the Arm, or in the Foot.
4. A Glyster should be given of a Decoction of the first emollient opening Herbs that can be got, with four Spoonfuls of Oil, one Spoonful of Salt: and this should be repeated every three Hours.
5. If it is possible, he should be made to swallow Water plentifully, in each Pot of which three Drams of Nitre are to be dissolved.