In the serous apoplexy, the symptoms are nearly the same, only the pulse is not so strong, the countenance is less florid, and the breathing less difficult. Bleeding is not so necessary here as in the former case. It may however generally be performed once with safety and advantage, but should not be repeated. The patient should be placed in the same posture as directed above, and should have blistering-plasters applied, and receive opening clysters in the same manner. Purges here are likewise necessary, and the patient may drink strong balm-tea. If he be inclined to sweat, it ought to be promoted by drinking small wine-whey, or an infusion of carduus benedictus. A plentiful sweat kept up for a considerable time has often carried off a serous apoplexy.
When apoplectic symptoms proceed from opium, or other narcotic substances taken into the stomach, vomits are necessary. The patient is generally relieved as soon as he has discharged the poison in this way.
Persons of an apoplectic make, or those who have been attacked by it, ought to use a very spare and slender diet, avoiding all strong liquors, spiceries, and high-seasoned food. They ought likewise to guard against all violent passions, and to avoid the extremes of heat and cold. The head should be shaved, and daily washed with cold water. The feet ought to be kept warm, and never suffered to continue long wet. The body must be kept open either by food or medicine, and a little blood may be let every spring and fall. Exercise should by no means be neglected; but it ought to be taken in moderation. Nothing has a more happy effect 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 heads low, or wear any thing too tight about their necks.
CHAP. XLII.
OF COSTIVENESS, AND OTHER AFFECTIONS OF THE STOMACH AND BOWELS.
We do not here mean to treat of those astrictions of the bowels which are the symptoms of diseases, as of the colic, the iliac passion, &c. but only to take notice of that infrequency of stools which sometimes happens, and which in some particular constitutions may occasion diseases.
Costiveness may proceed from drinking rough red wines, or other astringent liquors; too much exercise, especially on horseback. It may likewise proceed from a long use of cold insipid food, which does not sufficiently stimulate the intestines. Sometimes it is owing to the bile not descending to the intestines, as in the jaundice; and at other times it proceeds from diseases of the intestines themselves, as a palsy, spasms, torpor, tumours, a cold dry state of the intestines, &c.
Excessive costiveness is apt to occasion pains of the head, vomiting, colics, and other complaints of the bowels. It is peculiarly hurtful to hypochondriac and hysteric persons, as it generates wind and other grievous symptoms. Some people however can bear costiveness to a great degree. I know persons who enjoy pretty good health, yet do not go to stool above once a-week, and others not above once a fortnight. Indeed I have heard of some who do not go above once a month.
Persons who are generally costive should live upon a moistening and laxative diet, as roasted or boiled apples, pears, stewed prunes, raisins, gruels with currants, butter, honey, sugar, and such like. Broths with spinage, leeks, and other soft pot-herbs, are likewise proper. Rye-bread, or that which is made of a mixture of wheat and rye together, ought to be eaten. No person troubled with costiveness should eat white bread alone, especially that which is made of fine flour. The best bread for keeping the body soluble is what in some parts of England they call meslin. It is made of a mixture of wheat and rye, and is very agreeable to those who are accustomed to it.
Costiveness is increased by keeping the body too warm, and by every thing that promotes the perspiration; as wearing flannel, lying too long a-bed, &c. Intense thought, and a sedentary life, are likewise hurtful. All the secretions and excretions are promoted by moderate exercise without doors, and by a gay, cheerful, sprightly temper of mind.
The drink should be of an opening quality. All ardent spirits, austere and astringent wines, as port, claret, &c. ought to be avoided. Malt-liquor that is fine, and of a moderate strength, is very proper. Butter-milk, whey, and other watery liquors, are likewise proper, and may be drank in turns, as the patient’s inclination directs.