fectual means of rousing apoplectics of this kind seems to be throwing cold water on several parts of the body, or washing the body all over with it.

5, Although the poison producing apoplexy happens to be so powerful as very soon to occasion the appearances of death above mentioned; yet, if this state has not continued long, the patient may often be recoverable; and the recovery is to be attempted by the same means that are directed to be employed for the recovery of drowned persons, and which are now commonly known.

CHAP. IV.

OF PALSY.

1140. PALSY is a disease consisting in a loss of the power of voluntary motion, but affecting certain parts of the body only, and by this it is distinguished from apoplexy (1094). One of the most frequent forms of palsy is when it affects the whole of the muscles on one side of the body; and then the disease is named a Hemiplegia.

1141. The loss of the power of voluntary mo. tion may be owing either to a morbid affection of the muscles or organs of motion, by which they

are rendered unfit for motion; or to an interruption of the influx of the nervous power into them, which is always necessary to the motions of those that are under the power of the will. The disease, from the first of these causes, as consisting in an organic and local affection, we refer entirely to the class of local diseases. I am here to consider that disease only which depends upon the interrupted influx of the nervous power; and it is to this disease alone I would give the appellation of Palsy. A disease depending on an interrupted influx of the nervous power, may indeed often appear as merely a local affection; but, as it depends on an affection of the most general powers of the system, it cannot be properly separated from the systematic affections.

1142. In palsy, the loss of motion is often accompanied with a loss of sense; but as this is not constantly the case, and as therefore the loss of sense is not an essential symptom of palsy, I have not taken it into my definition (1140); and I shall not think it necessary to take any further notice of it in this treatise; because, in so far as it is in any case a part of the paralytic affection, it must depend upon the same causes, and will be cured also by the very same remedies as the loss of motion.

1143. The palsy, then, or loss of motion, which

is to be treated of here, may be distinguished as of two kinds; one of them depending upon an affection of the origin of the nerves in the brain, and the other depending upon an affection of the nerves in some part of their course between the brain and the organs of motion. Of the latter, as appearing in a very partial affection, I am not to speak particularly here; I shall only treat of the more general paralytic affections, and especially of the hemiplegia (1140). At the same time, I expect that what I shall say upon this subject will readily apply to both the pathology and practice in the cases of affections more limited,

1144. The hemiplegia (1140) usually begins with, or follows a paroxysm of apoplexy; and when the hemiplegia, after subsisting for some time, becomes fatal, it is commonly by passing again into the state of apoplexy. The relaxation, therefore, or affinity between the two diseases, is sufficiently evident; and is further strongly confirmed by this, that the hemiplegia comes upon persons of the same constitution (1095), and is preceded by the same symptoms (1098), that have been taken notice of with respect to apoplexy.

1145. When a fit of apoplexy has gone off; and there remains a state of palsy appearing as a partial affection only, it might perhaps be supposed that the origin of the nerves is in a great mea

sure relieved; but in so far as commonly there still remain the symptoms of the loss of memory, and of some degree of fatuity, these, I think, shew, that the organ of intellect, or the common origin of the nerves, is still considerably affected.

1146. Thus, the hemiplegia, from its evident connection with, and near relation to, apoplexy, may be properly considered as depending upon like causes; and consequently, either upon a compression preventing the flow of the nervous power from the brain into the organs of motion, or upon the application of narcotic or other powers (1115), rendering the nervous power unfit to flow in the usual and proper manner.

1147. We begin with considering the cases depending upon compression.

The compression occasioning hemiplegia may be of the same kind, and of all the different kinds that produce apoplexy; and therefore, either from tumor, over-distention, or effusion. The existence of tumor giving compression may often be better discerned in the case of palsy, than in that of apoplexy, as its effects often appear at first in a very partial affection.

1148. The other modes of compression, that is, of over-distention and effusion, may, and commonly do, take place, in hemiplegia; and, when

they do, their operation here differs from that pro ducing apoplexy, by its effects being partial, and on one side of the body only.

It may seem difficult to conceive that an overdistention can take place in the vessels on one side of the brain only; but it may be understood: And, in the case of a palsy, which is both partial and transitory, it is perhaps the only condition of the vessels of the brain that can be supposed. In a hemiplegia, indeed, which subsists for any length of time, there is probably always an effusion, either sanguine or serous: but it is likely that even the latter must be supported by a remaining congestion in the blood-vessels.

1149. That a sanguine effusion can happen without becoming very soon general, and thereby occasioning apoplexy and death, may also seem doubtful but dissections prove, that, in fact, it does happen, occasioning palsy only; though, it is true, that this more commonly depends upon an effusion of serous fluid, and of this only.

1150. Can a palsy occasioned by a compression remain, though the compression be removed?

1151. From what has been said 1144, it will be obvious that the hemiplegia may be prevented by all the several means proposed (1125 et seq.) for the prevention of apoplexy.