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trengthen the ftomach, with laxatives at proper ditances, are particularly indicated.

Laftly, In all decays exercife and frictions, according to the patient's ftrength, ought to be conftantly ufed change of air is generally of fervice, and fometimes a long fea-voyage. Patients labouring under diforders of the lungs in this country, are very juftly fent to Lisbon or Naples. But riding on horfeback, if practicable; if not, in a coach, or a litter at least ; or fome other manner of moving the body, is always proper.

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Oft difeafes of the head have a great affinity

Mot with each other, and commonly proceed from

repletion. Of thefe the principal is the apoplexy, which is fometimes owing to an over-vifcid blood, circulating too flowly, and almost stagnating in the arteries of the head and this vifcid blood, being perpetually urged forward by the force of the heart, bursts its veffels; and lodging on the brain, and compreffing the nerves fubfervient to the motions of the body, obftructs their ducts, and prevents the influx of their native juice. But it is more frequently caufed, without any confiderable rupture of the veffels, by a watery and red humour tranfuding from the blood,

VOL. III.

F

blood, or by the juice, oozing out of the circumjacent glands, which loads the membranes of the brain, fills its ventricles, and ftops the courfe of the animal fpirits. The former of thefe may be called the fanguineous apoplexy, the latter the pituitofe. To that Hippocrates gives the epithet of strong, and pronounces it incurable; and to this he gives that of light or weak, and yet fays it is difficult to be cured *. A great number of hiftories of both forts may be read in Wepfer and Bellini has moft rationally accounted for all the fymptoms in this and the like diftempers .

I fhall not dwell on external caufes, fuch as blows, falls, and fractures of the fcull occafioned by them; because they indicate no peculiar treatment, but what depends on furgery.

The fanguineous kind requires plentiful and fre quent bleeding, both from the arm and jugular veins; but purging is more requifite in the pituitofe. Opening the occipital veins, propofed by Morgagni #, is likewife of confiderable benefit, as I have experien ced in feveral very dangerous cafes. For as these veins have a communication within the brain with both the lateral finuffes; by opening thefe veins, part of the blood, which they would have conveyed into the finuffes, is taken off; and the quantity of blood in the finuffes being thus fomewhat diminished, its motion through them is more eafily performed. And therefore cupping in the nape and fides of the neck,

* Aphor. fect. ii. 42. + Obferv. anatom. ex cadaveribus eorum quos fuftulit apoplexia, Amftel. 1731. De morbis capitis. || Adverfar. anat. vi. animad. 83,

with pretty deep scarifications, to give a free paffage to the blood, is always ukful.

Upon the fame account alfo it is, that drawing blood from the temporal arteries, which some authors recommend, is of fervice, if it can be of any. As to the fafety of this operation, Galen indeed afferts, that he faw an artery, even in the arm, opened without any great inconvenience *. But yet the quantity of blood, taken away by opening the temporal artery, is fo inconfiderable, that much benefit cannot be expected from that practice. Wherefore it would be better to follow the advice which Aretæus gives in an inveterate headach, of opening the two arteries behind the ears +; because they will discharge more blood, that would have run into the head, than the temporal arteries can.

Blifters are likewife to be laid on the head and all the limbs; and cathartics are necessary, taken both by the mouth, and by way of clyfter but they must be acrid and powerfully stimulating; because the nervous fibres are become very torpid.

The lethargy and carus are lighter fpecies of the apoplexy.

SECTION II.

The Palfy.

THE apoplexy, when it is not mortal, very fre

quently terminates in a palfy, which is the crifis

of the difeafe and this palfy generally feizes but one

* Method. medendi, !ib. v. cap. 7. diuturn. curat. lib. i. cap. 2.

F 2

+ De morb.

fide

fide of the body. And what the above-cited Morgagni obferves after Valfalva, that on diffection of the bodies of apoplectics, who had been seized with a hemiplegia, he always found the cause of the disease in the oppofite fide of the brain *, I have formerly found true, more than once, in St Thomas's hofpi

tal.

There is now no longer any room for blood-letting, or draftic purges; it will be fufficient to give warm and moderate cathartics now and then, fuch as the tinctura facra. And as the difeafe is now become chronical, instead of blifters, it will be requifite to make iffues in proper places, efpecially in the nape of the neck, and above the fcapulæ, either with the actual cautery, or with cauftic medicines. Hippocrates advifes to apply the actual cautery in eight places at leaft, and specifies them †.

The cure is to be chiefly profecuted with aromatic ftrengtheners and fteel. And befides, it is of fervice to stimulate the skin of the paralytic part: which is extremely well effected by the green ointment, mixed with a feventh or eighth part of the ftrong fpirit of vitriol and when the part begins to be rubefied, this liniment is to be removed, and the part anointed with ointment of elder. Cold bathing is Cold bathing is very beneficial in perfons not too

far advanced in years; but

hot bathing is prejudicial to all paralytics. And I have known fome cafes of paralytics, fent to Bath by a mistaken notion of their physicians, who, upon coming out of the bath, were feized with a return of the apoplexy, which carried them off.

* Adverfar. anat. vi. animadv. 84. + De morbis, lib. ii. fect. 12.

Wherefore

:

Wherefore I take this occafion to publish fome remarks which I have made on these waters. Their chief virtue feems to me to confift in a certain mineral heat, whereby they warm and cherish the ftomach and inteftines; and therefore they are chiefly ferviceable to thofe who have ruined their appetite and digeftive faculty by drinking wine, or other fpirituous liquors which is well known to be the cause of a number of evils. But they are very prejudicial to all whofe inward parts, as the brain, lungs, liver, or kidneys, are too hot. And for the fame reafon, though they may be agreeable to, and mend the ftomach; yet if the use of them be continued too long, they more frequently hurt this organ; that very warmth, which was beneficial at firft, by immoderate perfeverance becoming prejudicial, by over-relaxing the fibres. A circumftance, which I have feveral times obferved more particularly in patients, whofe diseases were owing to a fault in the nervous fluid.

This disease never is acute, is often tedious, and in old people almost incurable; and the patient for the most part drags a miferable life. For the vigour of his mind together with his memory are loft, or vaftly impaired; he totters and shakes, and is become a difmal fight; as if no longer a man, but an animal half dead.

St Vitus's Dance.

THIS odd disease, both in fymptoms and name, is of the paralytic kind, and is cured by frequent cold

bathing

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