(From Apoplexia 1057 to strike or knock down, or smite suddenly). The apoplexy. It is called sideratio,attonitus, stupor palperia, palpezia, gutta; when it is slight it is called parapoplexia.

Dr. Cullen ranks this genus of disease in the class neuroses, and the order comata. Gen. 42; which he defines a diminution commonly of all voluntary motion, attended with sleep, more or less sound, the motion of the heart and arteries still continuing; to which may be added an oppressed respiration, and frequently a snorting. Sauvages makes fifteen species. Nosolog. Method. Vol. 11.p. 815. Dr. Cullen reduces them to nine; Synopsis Nosol. Meth. Vol. II. p. 183; viz.

1st. Apoplexia sanguinea, with signs of an universal plethora, and chiefly fulness in the head. The varieties are the carus a frigore and spontaneus; cata-phora coma.

2d. Apoplexia serosa, which happens generally in aged and leucophlegmatic people; carus ab hydro-cephalo.

3d. Apoplexia hydhocephalica; see Hydroce-phalos.

4th. Apoplexia atrabilaria, observed in persons disposed to melancholy.

5th. Apoplexia traumatica; when the head is hurt by violent external force.

6th. Apoplexia venenata, from strong sedatives, whether externally applied, or internally taken. Carus ab insolatione, carus a frigore, etc.

7th. Apoplexia mentalis; carus a pathemate, from passions of the mind.

8th. Apoplexia cataleptica, in which the respiration is not stertorous; and though the limbs maintain any accidental position, yet they give way to external force applied to them.

9th. Apoplexia suffocata, which happens from any external suffocating power; as in cases of hanging and drowning. See Submersio, and Suffocatio.

Dr. Cullen considers the carus, cataphora, coma, haemorrhagia cerebri, catalepsis, cerebri affectio spasmo-dico-ecstatica, and the ecstasis, as apoplexies; the ty-phomania, and lethargus, as symptomatic apoplexies. There is often also a symptomatic apoplexy from, 1. Intermittent fever. 2. Continued fever. 3. Inflammation. 4. Exanthema. 5. Hysteria. 6. Epilepsy. 7. Gout. 8. Worms. 9. Ischury. 10. Scurvy. There are also many species of asphyxy which come properly under this head. See Asphyxia.

To the definition of apoplexy, he adds, that the abolition of the powers of sense and motion is in some degree only; meaning, that under the title of apoplexy are comprehended those diseases which, as differing from it chiefly in degree, cannot, with a view either to pathology or practice, be properly distinguished from it. Such are the diseases named above. Lomnius observes, that this disorder is generally preceded by sudden and acute pains in the head, vertigo, dimness of sight, grinding the teeth during sleep, a coldness of the whole body, especially the extremities; then, as though thunder struck, the patient falls down sometimes with shrieks; immediately after the eyes are shut, a snorting comes on, the difficulty of breathing is great, endangering suffocation; the breast ceases to heave, just as if it were bound in cords; sense and voluntary motion are entirely lost.

The following species of apoplexy should be carefully distinguished, as the mode of treatment greatly differs.

The first is the sanguineous apoplexy, in which we find a strong full pulse, a red and bloated visage, the patient's neck swelled, an oppressed loud respiration, with a little hoarseness. This species prevails amongst the robust, who have much blood, loaded with crassamentum. The second is the serous apoplexy, in which the symptoms are, in general, like those in the former species, except that the pulse is weaker, the countenance pale, or at least far less ruddy, and the breathing less oppressed. The third is the spasmodic-apoplexy; the same signs attend this as are usual in the second species; only it is sooner removed, and rarely degenerates into a palsy. The fourth is the Symptomatic, such as from flatus in the stomach, the gout, etc.

Of the sanguinary apoplexy, the predisposing cause-is a plethora, and this determined to the head by some remote cause, induces the proximate or immediate cause, a compression of the brain. Indeed the immediate cause may be brought on by different means: which] though differing in their nature, ultimately produce similar effects. The remote causes are, surfeits, indigestion, too long exposure to the sun, inordinate drinking, particularly about the age of sixty, hysteric affections, convulsions, serous collections in the brain, libidinous excess, particularly in old men, repulsion of acrid matter, suppression of urine, salivation suddeply interrupted by cold and other causes, blows and wounds of the head, poisons, noxious effluvia, or an hereditary disposition. If the causes be examined respecting their consequences, it will appear that they are either calculated to increase the volume of blood, or occasion a determination to the brain, or produce such effects there as will prevent the nerves from exercising their influence: of course they will produce apoplexy. The predisposing causes are, fulness of blood, short neck, indolence, and a lax fibre.

Dr. Cullen thinks that the proximate cause is, in general, whatever interrupts the motion of the nervous power, from the brain, or of the blood to it. In apoplexies from internal causes, he thinks the motion of the nervous power is interrupted by some compression on the origin of the nerves; and this compression is occasioned by an accumulation of blood in the vessels of the head. In apoplexies from external causes, the motion of the nervous power is interrupted by directly destroying its mobility; as when mephitic air, fumes from charcoal, etc. are admitted to the nerves. In reality, a compression of the brain from a fulness of the veins or arteries, or an immobility of the nervous power, will equally produce the disease.

From an attention to the symptoms of an apoplexy, and the appearances observed on dissecting those to whom it had proved fatal, the brain is very generally its seat. Wepfer, in his histories of those subjects, observes, that the vessels in their brains were often ruptured, or very turgid; at other times the ventricles of the brain were filled with a watery humour; or a portion of serum, or blood, was found between the brain and its membranes.