AP′OPLEXY

(-plĕks-e). Syn. Apoplex′ia , Apoplex′is , L. (from απο-πλησσω, I astound, or strike down, Gr.); Apoplexie , Fr.; Schlagflu , Ger. A disease so named on account of the suddenne and violence of its attacks. Symp. Sudden suspension or lo of the powers of sense and motion; the heart continuing to beat and the lungs to act, but generally with difficulty. During the fit the patient usually lies in a state resembling sleep, or the stupor induced by drunkenne . In some cases there is paralysis of one side of the body, and convulsions of the other. In the sanguineous or sthenic variety, or the one which is most common, the pulse is hard and full, the countenance flushed and bloated, and the breathing stertorous; in the serous or asthenic variety, the pulse is feeble, the skin cold, and the countenance pale. “The presence of convulsions is indicative of great danger.” (Dr Cheyne.) In both cases the patient is generally found lying on his back, in a state of complete insensibility, which defies every effort to arouse him; the eyelids almost cover the eyes, which are fixed and devoid of intelligence, whilst the pupils scarcely change their dimensions under the varying influence of light and darkne ; the lips are usually purple or very dark; and both the lips and nostrils have generally a slight trembling movement communicated to them by the deep and laborious breathing of the patient. Treat. In this disease, more than perhaps any other, medical aid should be immediately sought. In the mean time the patient should be placed in an easy posture, in a well-ventilated apartment, and in the sanguineous or sthenic variety, in as erect a position as po ible; but in the asthenic variety, when the face is pale, with the head and shoulders only moderately elevated. The neckcloth should be removed, and the clothes loosened, and the head and neck laid bare. Crowding round the patient should be particularly avoided, and a free exposure to fresh air secured in every po ible way. When medical aid cannot be immediately procured, blood should be freely taken (say 15 to 20 fl. oz., or more) from the arm, by any person competent to do so; unle the face be pale, and the pulse feeble, when cupping at the back of the neck, or leeches behind the ears, should be substituted for ordinary bleeding. Cold water should be dashed on the head, the legs placed in pretty warm water, and blisters or mustard poultices applied between the shoulders. In the mean time 8 or 10 gr. of calomel may be administered, and its action subsequently promoted by the use of saline purgatives and stimulating clysters. When there is a difficulty of swallowing, a couple of drops of croton oil may be applied to the tongue; or it may be poured on sugar, before placing it in the mouth. Indeed, this mode of relieving the bowels should be adopted in all extreme cases, as soon as po ible. Emetics should be carefully avoided. The only exception to this rule is, when the stomach is distended by a heavy undigested meal; when an emetic is hazarded as the le of two evils. Nasal stimulants, as smelling salts or aromatic vinegar, should also be avoided. If the bleeding has not afforded some relief, it may be repeated in from 3 to 5 hours. When these means prove succe ful, the remainder of the treatment may consist in the administration of mild purgatives and diaphoretics, and the avoidance of stimulating food or drinks, and of other like exciting agents. Prev., . The premonitory symptoms of apoplexy are giddine , pain and swimming in the head, lo of memory, faltering in speech or using one word for another, diminished sensibility either of body or mind, or both, drowsine , noises in the ears, specks floating before the eyes, nightmare, frightful dreams, laborious respiration, heavy yet unrefreshing sleep, an inclination to sigh without any moral cause, cramp in the legs at night when there is no irritation of the bowels to account for them, . . When any of these symptoms occur (especially in “free livers”) aperient medicines and a light diet should be at once had recourse to, and wine, beer, and spirits avoided as the most dangerous poisons. If the symptoms increase or continue, active purgation, a still lower diet, and even bleeding may be had recourse to. Pure air, early rising, regular habits, gentle muscular exercise, and loose, easy clothing, are powerful preventives of apoplexy. By attending to the admonitions of nature, and adopting the simple means which are within the reach of all, it is indisputable that many fatal cases of apoplexy might have been avoided, and a still larger number le ened in severity. Robust, plethoric persons, with short thick necks, are universally accounted the most liable to apoplexy. In them the fit generally comes on without warning; and when once attacked with this malady they are especially liable to its recurrence. But it must be recollected that the po e or of no particular constitution or temperaments, to whatever cla it may belong, enjoys immunity from the attacks of apoplexy—a disease more fatal among English men than the natives of other countries. Obs. A lo of consciousne exists alike in apoplexy, epilepsy, narcotism from opium and opiates, complete intoxication, and common fainting. These may be distinguished by observing that—in EPILEPSY there are almost always convulsions, and more or le rigidity of the limbs, with (generally) foaming at the mouth and gnashing or grinding of the teeth, and frequently, the utterance of noises often not unlike the barking of a dog; whilst stertor and laborious breathing, as a rule, are calm, and perspiring, and the respiration is tranquil and without stertor; whilst the patient can, in almost all cases, be temporarily aroused to consciousne and kept awake by being made to walk between two attendants; the odour of opium or laudanum is also frequently perceptible in the breath or ejected matter:—in the insensibility of INTOXICATION the pulse is usually feeble, and the patient may be temporarily roused by violent shouting in the ear, or by the application of nasal stimulants, particularly the common smelling-bottle (if strong); and the breath, and ejected matter (if any), smells of liquor:—in ordinary FAINTING the face and lips are pale, the breathing quiet, the pulse scarcely perceptible, the limbs mobile, and the fit lasts only a few minutes. Treatment for Horses. Give in the first place a strong stimulant internally, and apply mustard embrocations to the belly and spine. Bleed, should the pulse be small and indistinct.— In the parturient apoplexy of cows. Bleed in the very earliest stage; give salts and croton; diluents; no solid food; let the body and legs be rubbed and clothed; use catheter; apply ice and refrigerants to head and neck; give frequent clysters of linseed gruel; remove milk every hour, and apply rubefacients to the spine.