The cure of Apoplexy consists first in removing the exciting cause of the disease, should this still remain applied, and afterwards in endeavouring to relieve the congestion of the vessels. This last is attempted by large bleedings, which are thought to be more effectual when the vessels near the head are opened, such as the jugular vein or the temporal artery ; we may also take blood from the cutaneous vessels by the scarifieator or by leeches, and afterwards apply large blisters to the neck ; along with these drastic purgatives are to be given, so as to procure a free evacuation from the bowels. Where the disease appears to have been im mediately produced by repletion of the stomach, or by any noxious substance received into it, an emetic will be proper, hut in other cases vomiting is thought to be rather injurious, or at least dots not seem to have any claim to be considered as a remedy of general applica tion. When depletion has been carried as far as has been thought necessary, or as the state of the patient will justify, little efficient treatment remains to be em ployed ; stimulants must at first be used with great caution, as any degree of over-excitement might bring back the original complaint ; the longer the disease has continued the more freely they may be given; but it must at the same time be confessed, that we can have less expectation of benefit from them. Upon the whole, if the complaint be not relieved, either by the efforts of nature, or by the operation of our remedies, soon after its first invasion, we are not to hope for much advan tage from any thing that can be done in future, but must confine ourselves to relieving particular symptoms, ant] soothing the helpless condition of the patient, by an attention to a variety of minute circumstances, for which no general rules can be prescribed.
Paralysis may be regarded as a partial Apoplexy, and is, in most instances, the sequel of that disease, when it does not terminate fatally. The two diseases originate from the same causes, and commence nearly with the same symptoms, in the most severe kind of Palsy ; but besides these, we have partial Paralysis, sometimes of a single limb, or even of a single muscle, which proceeds entirely from some local injury of the nerves of the part. We have also another variety of Palsy, in which the affection is general, but less violent, where there is no sudden seizure, and where the loss of sensation and motion is not complete in any one part, but where there is a degree of weakness over the whole body, and espe cially in the voluntary muscles, accompanied by tremor, partial convulsions, numbness, and frequently by a ge neral wasting of the part. This kind of Paralysis is the consequence of the excessive use of opium, or a too free indulgence in ardent spirits, and is occasionally observed to come on in old age without any assignable exciting cause. In the more severe cases of Palsy, and in those that are left after an apoplectic attack, we usually find that exactly one half of the body is affected, constituting the variety of llemiplegia ; and upon dis section we find, in most of these cases, that the injury to the brain is on the opposite side to that of the paralytic limbs, a fact which has been much employed by those who have speculated upon the pathology of the nervous system. Another variety of Palsy is Paraplegia, where the diseased is separated from the sound part of the body by a transverse section ; this proceeds, in almost all cases, from an injury to the spine, and of course the extent of the disease depends upon the part in which the spine is affected.
Where the Paralysis occurs in its violent form, or is the sequel of Apoplexy, its treatment must, in every re 9cct, coincide with what was recommended above for this complaint: we must begin with copious depletion of We have placed this disease in the genus Dyscinesia, although it is in fact a species of dropsy, because both its symptoms and its treatment connect it more with the primary diseases of the nervous system, than with those of any other part of the animal economy. The the sanguiferous system, then administer active purga tives, apply blisters, and gradually have recourse to sti mulants. But, in many cases, the accession of Palsy does not indicate that state of the blood-vessels, which leads us to suppose that bleeding is necessary ; and although, perhaps, purgatives arc always proper, we place our chief reliance upon the stimulating plan, after we have done all that lies in our power to remove the exciting cause. The stimulants that have been employed in Palsy, both general and local, are very numerous ; the choice must depend upon circumstances connected with the nature of the constitution of the patient and the part affected. They consist both of various articles of the materia mcdica, and of diffetent mechanical appli cations ; among the former, we may enumerate ether, and spirituous compounds, lytta, oleum terebinthinze, am monia, sinapis, the warn] essential oils, and the whole class of vesicants, and rubifacients. Among the more efficacious of the mechanical applications, is friction in various forms, hot fomentations, electricity, and gal vanism, a remedy which, however, has not answered the high expectations that were formed respecting it ; the natural thermal springs are had recourse to with benefit in the later stages of Palsy.
It would be incompatible with our object to point out the means employed for removing the various local causes of Palsy ; but there is one that is connected with diseases of the spine, which forms so important an object of our attention, as to require being distinct ly noticed. When the disease occurs spontaneously, it has been conceived to originate from a scrofulous ten dency in the constitution, and it must therefore be combated by all those means which are supposed to be useful iu counteracting this tendency. Practitioners, however, are but too well aware of the little benefit that is to be derived from the most approved of these means, and generally all that lies in our power is to endeavour to remove the local complaint, and this has been usually attempted by the application of caustic issues near the part affected. A new plan of treatment has been lately proposed, in which, instead of issues, the patient is strictly confined, for a great length of time, to the horizontal posture. When we consider the nature of the affection, and especially when we perceive the ravages which it commits in the structure of the bones, we can scarcely imagine how mere rest, although a powerful adjunct, can alone perform a cure, and we are led to conjecture, that in those cases where this plan has been successful, the symptoms depended simply upon weakness, or a loss of voluntary power, arising from a nervous affection, but without any struc tural disease. In Palsy of long continuance, where the original cause of the disease is removed, and where the structure of the part is irremediably injured, it has been found of great impottance for the patient to use as much voluntary exertion as possible in the affected muscles, and in this way the healthy action has been restored in parts which were previously almost quite useless.