6. As soon as the Height and Violence of the Pulse abates; when his Breathing becomes less oppressed and difficult, and his Countenance less inflamed, he should take the Decoction [Nº. 23]; or, if it cannot be got ready in Time, he should take three Quarters of an Ounce of Cream of Tartar, and drink Whey plentifully after it. This Medicine succeeded extremely well with me in a Case, where I could not readily procure any other.
7. He should avoid all strong Liquor, Wine, distilled Spirit, whether inwardly or by outward Application, and should even be prevented from [36] smelling them.
8. The Patient should be stirred, moved, or even touched, as little as it is possible: in a Word every Thing must be avoided that can give him the least Agitation. This Advice, I am sensible, is directly contrary to the common Practice; notwithstanding which it is founded in Reason, approved by Experience, and absolutely necessary. In Fact, the whole Evil results from the Blood being forced up with too much Force, and in too great a Quantity, to the Brain; which being thence in a State of Compression, prevents every Movement and every Influence of the Nerves. In Order, therefore, to re-establish these Movements, the Brain must be unloaded, by diminishing the Force of the Blood. But strong Liquors, Wines, Spirits, volatile Salts, all Agitation and Frictions augment it, and by that very Means increase the Load, the Embarrassment of the Brain, and thus heighten the Disease itself. On the contrary, every Thing that calms the Circulation, contributes to recall Sensation and voluntary Motion the sooner.
9. Strong Ligatures should be made about the Thighs under the Ham: By this Means the Blood is prevented in its Ascent from the Legs, and less is carried up to the Head.
If the Patient seems gradually, and in Proportion as he takes proper Medicines, to advance into a less violent State, there may be some Hopes. But if he rather grows worse after his earliest Evacuations, the Case is desperate.
§ 148. When Nature and Art effect his Recovery, his Senses return: though there frequently remains a little Delirium or Wandering for some Time; and almost always a paralytic Defect, more or less, of the Tongue, the Arm, the Leg, and the Muscles of the same Side of the Face. This Palsy sometimes goes off gradually, by the Help of cooling Purges from Time to Time, and a Diet that is but very moderately and lightly nourishing. All hot Medicines are extremely hurtful in this Case, and may pave the Way to a repeated Attack. A Vomit might be even fatal, and has been more than once so. It should be absolutely forbidden; nor should we even promote, by Draughts of warm Water, the Efforts of the Patient to vomit. They do not any ways depend on any Humour or Mass in the Stomach; but on the Oppression and Embarrassment of the Brain: and the more considerable such Efforts are, the more such Oppression is increased: by Reason that as long as they continue, the Blood cannot return from the Head, by which Means the Brain remains overcharged.
§ 149. The other Species of Apoplexy is attended with the like Symptoms, excepting the Pulse not being so high nor strong; the Countenance being also less red, sometimes even pale; the Breathing seems less oppressed; and sometimes the Sick have a greater Facility to vomit, and discharge more upwards.
As this Kind of the Disease attacks Persons who abound less in Blood; who are less strong, and less heated or inflamed, Bleeding is not often at all necessary: at least the Repetition of it is scarcely ever so: and should the Pulse have but a small Fulness, and not the least unnatural Hardness, Bleeding might even be pernicious.
1. The Patient however should be placed as was directed in the former Mode of this Disease; though it seems not equally necessary here.
2. He should receive a Glyster, but without Oil, with double the Quantity of Salt, and a Bit of Soap of the Size of a small Egg; or with four or five Sprigs of Hedge Hyssop. It may be repeated twice a Day.