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A33733 A physico-medical essay concerning the late frequency of apoplexies together with a general method of their prevention and cure : in a letter to a physician / by William Cole. Cole, William, 1635-1716.; Kimberley, Samuel. 1689 (1689) Wing C5043; ESTC R23720 53,543 201

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substances of it which are apt to secede upon these parts of the Brain to which they reach from the impetuous protrusion from the heart and the vessels being here tenderest as all vessels not only are at their extremities but especially when they runn deepest and proportionally farthest because then they are smallest 't is no wonder that a congestion should soon be made where this is But yet if we consider their comparatively small number to those in the Cortical and how they must be better fenced and supported by their being distributed through a more compact substance as the corpus callosum is there seems less danger of either a congestion or extravasation in this region the strength of the tone of any part mainly conducing to the ready transmission of the perluent liquor And that this happens most usually in the cortical region three of the four instances alledged by Wepfer seem to evince in which I conceive it is easy to gather that they were the extime parts of the Brain that were most disaffected and therefore there seems reason to suppose must be primarily so But from hence Secondly The Nature of the distemper may be deduced And it seems to me probable that it consists indeed in the defect of that matter which should be supplyed to the nerves for the exercise of the animal functions but occasioned from the vitiated organization of the parts and vessels of the Brain from whence a due secretion which I have heretofore Tr. de secretione animali endeavoured to make probable to be here performed by a simple colature in the Cortical glandules of the nervous liquor out of the bloud cannot be made but that either from the forementioned distention of the sanguiferous vessels the secretory ducts cannot readily admit the matter to be separated the confusion of the masse emergent upon such a congestion prohibiting a regular secession or else the grosser substance of the bloud not moved as 't was wont being brought to the beginnings of the nerves must needs obstruct them and so cause an immediate cessation of motion in all parts below as well as by disturbing the regular motion of the spirits in the Brain hinder the exertion not only of the Intellectual but also sensitive faculties For though Intellection and possibly Sence belong only to the Soul as such which is a substance distinct in it self from the Body yet the exercises of it so long as the soul continues united to the body cannot be had but by its mediation our bodies being very fitly resembled to Hydraulick Engines whose structure disposes them to exhibit a great number of various phaenomena when filled with a due liquor and set on work by a mover distinct from them whether within or without 't is not material which as they whilst in order very regularly perform all the motions their fabrick directs to so if they happen to be either accidentally broken or disordered in any part or else the liquor they carry comes to be so gross as to obstruct them or corrosive or otherwise vitiated as to make its way through them must either undergo a total loss of their motion or at least a very great disorder in the several performances that the organical design requires Agreeably to which the Bloud appears to be the principal liquor for the motion of this curious engine of our body as being universally and uncessantly carried through all parts of it Not to make a comparison betwixt this and the Nervous juice which though it may be designed for more noble and perhaps much more extensive proximate uses than the gross masse of the bloud yet must be owned on the account of its small quantity and slow motion to be not fit for this design otherwise than to spiritualize and give an instinct to that and the Heart that impels it adde that 't is made out of the bloud Now if through the fault of its pipes the arteries and veines it make its way out of them it must of necessity extremely disaffect the parts in which this happens especially when they are designed for the nobler sort of uses Indeed Life as well from arguments of Reason as the Divine Oracles which tho' they teach many things above yet none against Reason and I conceive ought to be construed literally when the analogy of reason and nature countenances it though many things in them are owned to be spoken according to mens common apprehensions holy scripture being designed not to teach Philo but Theosophy seems to consist originally and therefore principally in the motion of the Bloud its first indicia being from the punctum saliens for which therefore so exquisite pipes are made to distribute it to all parts of the body and return it back again to its first source for reiterated motions and those so adapted to the secretory parts for the separating of substances from it for several uses that as all vital actions must needs be placidly performed whilst they are thus duly disposed so if any of them happen to be broken or opened at least in any considerable measure whereby this vital stream gets forth of its boundaries that due and regular motion thence ceasing Life must too But this must most effectually come to pass if this disturbance of the motion of the bloud chance to be in the Brain where the Soul sits by the consent of almost all inthroned and from whence she gives laws to all the Body so that if this her Royal seate happen to be overwhelmed with such a deluge and her intercourse with the rest of the body which her Empire over it requires intercepted 't is no wonder she leaves her province and mansion thus become so unfit for her residence But I must beg your pardon for these allegorical excursions which yet the luxuriancy of the subject readily affords This fault in the due Organization of the Brain consists either in an Obstruction of the passages or a Solution of the continuity either of which may easily occasion any of the symptoms For the former 't is impossible but that since there is a necessity of a due proportion between the cavity of the vessels and the liquors as well here as in innumerable instances every where to be met with to the performing of regular motions if any obstruction happen the Liquors must either move more sparingly than is requisite or be congested there or else the course of them must be diverted into other channels and so natures designation to be discerned by the known effects must be altered from any of which occasions as there must happen a defect of spirits to actuate the Brain and nerves and that proportionally to the greatness of the obstruction so if this happen sodainly and be total 't is evident that there must follow both a total and sodaine abolition of the animal functions In the latter the Bloud flowing out of its vessels must in so tender a part as the Brain quickly overflow a great part of
considerable numbers of its particles at once and so undergo a strong impression which may easily enough be conceived to be propagated to the Brain partly by disturbing their regular tonick motion which must from their tensity be continued up to their original partly by the ingress of too many of the lancinating particles of it into them which besides the fixing or dissipating the animal spirits which I conceive to be much of the nature of volatill salts may disorder the tone of these nerves first and then by the continuance of the impulse of those behind which have the same ground to attempt an entrance that of the Brain it self which being more tender than the nerves must therefore when the cause of the disaffection reaches it be proportionally injured A second way I conceive is at the ears whose outer cavity going deep seems to be in part contrived for warming the Air that it may not by its Coldness disaffect those exquisitely sensible auditory nerves and the membranes upon whose due tone and tensity as the sence of hearing seems mainly to depend so must it be much impaired if so unusual impressions are made upon it by intensly Cold Air and besides those nerves being thence so disaffected must by their contractions conveigh the like motions up to the Brain and so disturbe and weaken it And I formerly knew a very Learned person who had a total and irremediable deafness that was caused as he told me by a journey taken in a very keene frost over the Mountains in Wales to which I remember not whether any Apoplectick distemper succeeded but the instance at least evidences the great effect of intense Cold upon the nerves which had it lasted long 't is to me probable that by being propagated up to the Brain it might have produced either that or other nerval distempers Another way whereby I conceive the Cold Air may be injurious to the Brain is at the extremities of the nerves in all parts of the skin which having as must be owned I presume apertures there may possibly admit some such subtil and lancinating substances as I have supposed to be constantly but in frosty seasons more copiously carried in the Air and being once admitted may on the same ground as I have urged in relation to the olfactory Nerves by consecution come to affect the Brain it self But though their tracts are very long and small and so there cannot be a proportionable influence as in those yet their great numbers and the consideration that they are on every side pressed upon by the Air may perhaps be thought to Compensate for that defect But this pressure of the Air on the surface of our Bodies which I distinguish from that on the olfactory nerves on this consideration that in one case 't is uniform depending only on the weight of the Atmosphere or such general motions in it as make it act uniformly on all parts of the surface of them which by their make and private motions determine it not otherwise in the other some part of it is moved with a greater violence from the dilatation of the parts designed for Respiration whose cavity therefore being to be filled in proportion to that dilatation it must happen that that portion of Air that does it must have brisker agitation than the rest of its masse and make impressions accordingly this pressure I say may prove chiefly injurious to the Brain by its acting on the Nerves in the Eares Because they being terminated at a cavity which is still kept warmer than the rest by the steames continually exuding from every side of it and for some time somwhat detained there must therefore be more open and consequently more liable to injuries if an extraordinary occasion happen such as I am instancing in to make an impression on them And this must happen rather to tender Bodies and those who accustom themselves to keep much within doores than to the more robust whose employments expose them much to the Air at all seasons both on the score of the comparative flaccidity of all parts in them and the defect of a due digestion in their bloud and other liquors through want of due exercise which must dispose them to be put into confusion when violent causes come to excite it and experience shewes that such persons of all others are most obnoxious to the alterations of the Air. So that the manner of this action seems to consist in the penetration made by the Nitrous particles principally of the Aire upon the Fibres of the Brain for that as well as all other solid parts must consist of Fibres which thereby undergo some however small solution of continuity and either the little cavities of those Fibres for I think the Aeconomy of our Bodies can hardly be mechanically made out without supposing them all to be Vessels though our sensories cannot determine it become straitned or their sides perforated on the account of either of which they cannot duly either receive or retain and consequently not regularly transmit the substances destined to each part which is to be respectively supplyed by them In that continuity due confirmation repletion of them I suppose the Tone of the parts to consist and therefore when any thing perverts any of these requisites to it as in our present case all the consequences emergent from the impulse of the bloud or other liquors disturbed in their motion may be expected Now such an Atony happening to be in so very tender a part as the Brain cannot therefore easily be rectifyed but may continue much longer than if it happen to other parts whose Fibres being stronger and functions fewer must on both scores caeteris paribus sooner and more easily return to their natural constitution And not only the reason of the thing but dayly experience shews it that whereas most other parts of our Bodies having once received any injurious impression as by falls blows c. do after fit remedies used return to their due tone quickly the cause once removed the Brain on the contrary long retaines its weakness if once injured though for the present releived in some degree as for instance those that have had an Apoplectick fit once doe many times on whatsoever light occasion either find a return of it or at least undergoe a considerable weakness of their intellectual faculties not to be corrected but by a long and constant regularity if it be at all and the like is observable concerning those who have been seized by Vertiginous and Hypochondriacal distempers which I take to be properly Nerval and to spring from the Brain or its liquor disaffected from which few happen to be perfectly freed their imagination indeed being disturbed disposing them to be too immorigerous So that I conceive it may be inferred that if the Ambient Air come to have a great degree of Coldness especially if it continue long both the forementioned disposition of the Bloud to supply matter for Apoplexies must be
But from which of them 't is requisite we enquire To consider first the Passive qualities of the Air Dryness and Moysture it may perhaps seem probable that they may in order to produce this as well as some other distempers indispose the Brain the former by hardning the tone of the sanguiferous vessels in general and consequently contracting their tubes and so causing an acceleration of the motion of the Bloud through them which must if propelled with the same force at its original runne more swiftly through vessels when thus straitned than whilst having their usual dilatation whereby it may be presumed that when cast forth of the arteries into the interstices between them and the veins at their extremities it may make its way into the more yielding substances it is any where to pass through and the Brain being confessedly more so than any other part of the Body is therefore most likely to be affected on such occasion the latter which is countenanced by the great Hippocrates Sect. 3. Aph. 16. by intenerating the Brain so much beyond its usual constitution that it may thence become more than naturally susceptible of the always briskly circulating Bloud Next as to the most efficacious of the Active ones Heat it may perhaps be urged that the Bloud though otherwise well enough constituted being much heated and rarifyed by that excess of the Ambient might be inclined to make its way out of the vessels in the Brain especially on the account of its forementioned tenderness But besides that experience warrants none of these suppositions perhaps it can hardly be made out 1 st That so great a dryness as must effect this can be introduced into our Bodies which are continually irrigated not only by the circulating Bloud but other secondary liquors 2 dly That a great excess of moisture in the Air should produce Apoplexies unless those more rare ones as I suppose they are from the Serum and that generally after other distempers which have weakned the crasis of the Bloud as well as the tone of the Brain since such a dyscrasy impressed on the Bloud seems to make it more torpid by clogging the spirits in it and so less apt to inundations and besides relaxes the vessels as well as the substance of the Brain and so favors its ready passage along them and 3 dly That the excess of outward heat should cause this eruption since by it the solid parts may be as well presumed to be invigorated to resist as the Bloud excited to attempt it besides that the transpiration that is occasioned by this heat may sufficiently compensate for the accelerated motion of the Bloud its quantity which may in that case be principally dangerous being thence diminished It remains then to attribute this frequency of Apoplexies to the Coldness of the Air as the most adequate occasion which when it happens to be intensly so may I conceive be made out to give a probable reason of it That Cold is a great enemy to the Brain is both the general sense and confirmed by the authority of Hippocrates Sect. 5. Aph. 18. and all Physitians since and therefore we may possibly inferr that the great Architect fenced this part with so strong a wall scarce more to protect it from other injuries than this to which 't would otherwise be exposed But how Cold affects it so injuriously may require a little explication In order to it give me leave Sr to consider without pretending to discuss it so minutely as men of more Philosophical heads and better accomplished in such speculations might the nature of Cold as being requisite to be known in some measure to the understanding its relative effects Which attempt indeed might appear very presumptuous after that the exquisite Mr. Boyle has not thought fit to determine in the matter but that you may perhaps find that the short deductions I make however unartificially are either taken from or I conceive reducible to what he has delivered and so farr from being positively asserted that they are only submitted to the censure of your and others better judgments To which purpose three or four general considerations seem not unfit so farr as belongs to our present disquisition to be taken notice of to give an account of its manner of affecting us In the first place then it may be considered that though neither Cold nor Heat nor any of the rest of the sensible qualities have any real Being but only in relation to our perception insomuch that were there no sensitive Beings there could be no such things yet they must be founded on somthing that does really exist as all accidents besides are So that though they cannot be reckoned amongst the general affections of matter as motion though they depend upon it or its contrary Rest Bulk Figure c. are which would still be where matter is tho' there were no sensitive Beings yet are consequent upon it but determined by these and associated to somwhat that has perception Secondly That 't is evident our sensories are affected by Cold that is have some impression made on them Now nothing can affect but by approaching to that which it does so affect and to approach requiring motion it must follow that motion must go to constitute the nature of Cold. Which though it may seem not so evident since Cold is reckoned contrary to Heat and this consisting obviously in motion it may be urged that should in Rest Yet it may be returned that tho' it be necessarily to be inferred there is motion where there is Heat yet not always that there is Heat where motion so that 't is not motion simply but considered with some adjunct viz. motion in such or such a degree and with relation to sensitive Beings that constitutes Heat and consequently that 't is not to be inferred that Cold consists in absolute Rest because contrary to Heat but in a different degree of motion though other mechanical affections must concurr to determine it which recedes on one hand from a middle degree of it in our sensory as that which makes Heat does on the other Which too may be evinced from hence that each of them having a great latitude of degrees must be founded in what admits of degrees which motion does but Rest not Thirdly that motion here being not to be considered abstractedly but together with the subjects of it and as occasioned by and produced in some Bodies we may take notice that as 't is evident the Bodies without us which excite our sensation are moved so our organs which are designed to receive the impressions of these extraneous objects and transmit them to the Soul can hardly be presumed to do it any more indeed than prove a fit mansion for her without having their particles whether consistent or fluid for both are necessary to their construction in motion and not only so but endued with a determinate degree of it This degree ought not to be violent for so the
constituting particles neither could be brought into such a frame as we find they are nor persist in it but they especially the most subtil which are the Souls immediate instruments in the organ would soon undergo new textures or be dissipated As on the other hand it must not be very languid since in that case they being in great numbers and some touching still in their motion upon others which have a different determination would soon be intangled in one another or otherwise stopped But it must be such a middle one as may keep up a due crasis in both the fluid and consistent substances that make up the organ for the performing the functions appointed Fourthly that these motions considered as I said in their subject thus regulated being congenial to us seem not properly objects of our perception at least are not taken notice of since 't is by means of them that the Soul receives those impressions that cause a perception of others but rather instruments of transmission of those others from without which recede from these degrees or are otherwise circumstantiated tho' indeed even these when becoming either too quick or too slow they deffect from their due proportion may by affecting the Soul differently from what they use to do so excite her as that she may take notice of them too as well as those of exterior objects which thus sollicite them Fifthly that therefore these mean motions being what belong to the organs duly constituted are the standard from whence wee are to take our measures of all others so that when any objects from without come against and so affect our sensories with a greater degree of motion than what naturally belongs to them we forme one kind of notion of them when with a lesser degree a very different one and give them likewise denominations according to that degree of motion with which they act upon our sensory From the consideration of these particulars we may I conceive deduce that the nature of Cold consists in a check though not a total stop of that degree of motion which belongs naturally to the parts of and fluid substances in those of our sensories which concern the sense of Touching duly constituted as on the contrary Heat without some reflection on which Cold can hardly be understood in an acceleration of such their motions Which differences being by means of these organs transmitted to the Soul and so affecting her she forming a comparison between them denominates one Heat and the other Cold. But though motion must have the first consideration in producing this effect upon us yet 't is farther to be noted that the Bulk and Figures both of the Bodies that cause this check and those upon which 't is impressed must concurr to it it being evident that not only some are themselves more fit and easy to be moved than others according as they are bigger or less of this or that figure but also to accelerate or retard the motions of others that impinge against them As to acceleration wherein Heat consists minute Bodies of almost any figures that are irregular if they are not apt to cohere may occasion that though some more than others especially those that are most angular since with their angles striking against those among which they move they must be presumed to exert a proportionally greater force than blunt or glabrous ones can which on that score are easy to be distorted But as to retardation which makes the nature of Cold that we may restrain our discourse to that it may be occasioned on several accounts For first either the affecting Bodies may by a correspondency of their sides so apply themselves to those to which they come that transferring their surplusage of motion to them they may adhere to them and with them constitute bigger masses and acquire other figures than before they had Or Secondly by altering the due contexture of the vessels which is necessary to regular motions they may thence occasion a stop of the substances which used to be carryed in them and so though they are otherwise disposed to accelerate motion on the account of their figures as I said before yet thus accidentally they come to retard it Or Thirdly if they happen to be of such a figure and texture as to be flexible and thereby to wrap themselves about those they occurr to they may by thus inviscating them hinder their motion Or Fourthly and which may possibly in the present case be the most effectual means of occasioning this check they may so interpose themselves between the moved particles in the organ as to intercept their former motions whereby also they fill the spaces necessary for continuing those motions This seems most agreeably to be done by Conical ones which by their angle are fitted to enter but being blunt and bigger at the other extremity must when they come into porosities which are a little straiter than that necessarily fix there and both the more abate the motion of the forementioned agitated matter and also be more firmly impacted in the parts unto which they thus arrive by their contraction upon the score of the lancination occasioned by the sharp angle of these particles first entring the solid parts that are sensile being all the Body over contractile as being I suppose nothing else but either propagations of nerves or the roots of them And when it happens that many such conical substances come to act at once upon the organs the effect must be the more considerable But perhaps Sr you may think these speculations too nice and general and indeed impertinent to the present consideration since they are not our senses that are in Apoplexies primarily affected those persons that are violently seyzed loosing immediately upon the stroke the use of them but only influentially from the Brain which it self is thought to be void of sense actually which supposition yet may perhaps be lyable to some exceptions though the source of it to all the Body beside And therefore when they invade more gradually and those that are affected are conscious of great pain in the head it may be supposed that the morbifick matter affects the membranes of the Brain as well as the substance and so causes that symptom So that if the predisposition to the disease be from Cold affecting a part of our Body not sensible you may ask to what purpose all this notion of our perception is introduced However give me leave to say that since Cold would not properly be Cold as I have urged without perception which though it produce all the effects it does on Bodies not endued with sence on a purely mechanical account viz. from schematismes of matter in motion determined by the fitness of some to act on others according as they appel to one another yet as it relates to us who are endued with sense and to whom it belongs to define things cannot be well understood without reflection on that it seems not altogether alien to
be said of almost any thing else whether food or Physick And I presume no wise man will conclude from a few instances of the disagreeableness of any thing to some men when vast numbers of them on the contrary side may be brought to warrant its use that it ought universally to be avoided or branded with a note of infamy My sense of it is that in those persons with whom 't is found to agree 't is a very good drainer of humors and so may supply the place of Fontanels or at least that fewer of these may be necessary to those who abound with moysture For by its irritating and occasionally from the great afflux of the Saliva enlarging the secretory ducts in the glaudules about the Mouth as 't is evident there must be a great discharge so a great diversion from the Brain tho' I own the greatest part of the matter comes not immediately from thence but out of the Bloud in which case 't is advisable that the persons that take it should drink but moderately least otherwise they do themselves more hurt by the supply than they can receive benefit by the discharge of moysture from this or any other evacuations But there seems another reason why Tobacco may be useful to those who are disposed to Apoplexies under the supposition of its agreeableness viz. that by reason of the vellication the smoke of it impresses on the nerves in the Mouth it makes them contract themselves and so by consecution the whole Brain comes to be analogously affected So that if the Brain happen to be more lax than ordinary and thereby disposed to receive an afflux of Bloud or Serum as I take it to be especially after a person has had and escaped one Fit as well indeed as in many other cases of preceding nerval indispositions I see nothing but it may prove a very useful administration toward restoring the tone of it and 't is known to be very advantageous to many Hysterical persons of which though perhaps other reasons may be assigned as the altering the texture of the Fermentative particles by the association of those of the smoke to them as they chance to be admitted and so those of other figures and bulks may hence emerge or else the determination of the nerves to other motions by the action of this smoke impressed on the mammillary processes or other nerves about the Mouth or parts adiacent yet this seems to me none of the least probable that by corroborating the tone of the Brain it prevents the admission of those too elastical or otherwise heterogeneous particles into the tubes of the nerves which are the cause of the symptoms Also the frequent use of Volatile Salts may conduce much to a prevention under the limitations alledged for the use of Coffee such as are spirits of Sal Armoniac Harts-horne Soot c. which are but such Salts diluted as being I conceive so congenerous to those called Animal Spirits that they must needs excite them in us when too torpid or supply them when wanting unless the constitution of the Nerves be too dry or apt to be irritated by them And their effects have in many instances of nerval distempers found been so remarkable that they are now adays become of very familiar use though somtimes likewise abused But there are two specious administrations much cryed up and used by many which deserve to be taken notice of viz. Apoplectick Balsams whose principal use is to be smelt to composed of perfumes Aromaticks and other ingredients reputed Cephalicks and Snush Concerning the former of which give me leave to say I think them so farr from being useful for prevention that they most ordinarily prove very prejudicial For by reason of their grateful smell and the great activity of their odorous particles but without any troublesom irritation some of them may easily enough be presumed to be admitted into the Brain at the extremities of the olfactory nerves with the Air in inspiration and being once so are so farr from assisting it to contract it self that they much relax and expand it and consequently dispose it to admit an afflux of bloud especially when before fitted as I have said to be congested in or make its way forth of its vessels in the Brain And their influence seems to me to be very great likewise upon the fluid substances in the Brain which have all some lentor and therefore these admitted substances by reason of their activity may easily exagitate them whereby the passages must come to be enlarged and so become capable of an afflux or congestion I own indeed that in some cases of Headache they may be and have proved a very effectual remedy as perhaps when the matter that causes it may be acrimonious but not in the degree or kind to produce convulsive symptoms all sorts of aculeated particles being not fit to produce one effect which the soft particles of these may by their adhesion so blunt or sheathe that their lancination must therefore immediately be taken off But as these cases are but rare so also there ought to be a distinction made between the administration of medecines upon an emergency and their common use when no cause requires it which last the present caution refers too for then there is reason to suspect they meeting with no hostile particles may too much relax and open the pores of the Brain and so give occasion to the suggested inconveniences If the experiment of convulsive symptoms which imply contractions ordinarily excited by these medicines in those who are disposed to Hysterick fitts be urged against this notion which supposes the distemper under consideration to proceed from a laxity I answer first that it seems probable that these convulsive symptoms proceed from a kind of Explosion according to the sense of Dr. Willis which must first inferr an Expansion of them and then a contraction when the due requisites to it concurr for Secondly the Aromatick particles though of themselves very soft and agreeably entring at the pores of the nerves yet finding after their admission heterogeneous and fermentative substances in the Braines of some persons may be very much inclined from their congress first to agitate and then in return be agitated by them from whence the Brain being vellicated is forced into contractions to expel them upon which lucta too such corpuscles must in probability be formed as may prove very vellicating on a second score and so continue these fitts as being uncapable to be sodainly expelled Whereas when they happen to be applyed to persons not abounding with such fermentative particles they may only relax the tone of the Brain and so dispose to Apoplexies on the forementioned account On the same score I conceive Snush especially made as 't is usually with Aromaticks and Perfumes and so mild either on the account of its ingredients or from frequent use as not to cause Sternutation to be prejudicial instead of being advantageous to the health
of those that immoderately use it and more perhaps then the Apoplectick Balsoms because both the matter of it is more gross and thence apt to lye longer about the extremity of the Olfactory nerves and so continually to affect them and also the custome of many is as I have often observed ever and anon to be supplying more whereby the pores of those nerves are kept continually open And I must suspect that should any Pestilential Season invade which God avert such persons as much accustome themselves to these pouders would caeteris paribus be in more danger of receiving infection than others since from the symptoms delivered by Authors the pestilence appears to seyze the Brain particularly and the sodain fate recorded of those that without any preceding indisposition have whilst that raged fallen down dead in the streets seems not so easily accountable for any other occasion than that the pestilential Miasmes are admitted at those nerves since all other ways to the Brain the source of sense and motion and indeed of all the actions of life is the most likely seate of this sodain prostration 'T is true it may be urged that many which use it receive no apparent injury and indeed some are of so firm a constitution of the Brain as well as of the whole Body that comparatively great occasions of sickness will have little or no influence on them whereas others are affected by very small ones But I think the objection may as well be urged as on another score I a little before intimated by those who having long indulged themselves in immoderate drinking have yet lived to a great age when 't is obvious that many more much shorten their Lives by it But though not Apoplexies yet Vertigoes and other distempers which shew the Brain debilitated may hence perhaps arise Secondly as to the Cure of an Apoplexy It consists according to my notion before alledged of the Cause chiefly in copious Phlebotomy since nothing else seems capable of dislodging at least sodainly and this distemper of all others requires a Sodain remedy the morbifick matter For the distention both of the Sanguiferous vessels and habit of the parts being by a good depletion taken off sodainly the Fibres which constitute both must be presumed to contract themselves by their Tonick motion but especially those in the habit the Elastical pressure of the Ambient as concurring ordinarily So in this case especially when the resistance within is abated So that when what is nearest the Heart runs into it with some impetuosity the rest both finding roome enough in the Veines and being urged on not only by the arterial bloud behind rushing into the veins the faster when it has more roome but also by the Systaltick motion now the distention is taken off must leave its former recesses and be restored to circulation Which action is quickly propagated to the Brain and that put into Analogous contractions But this may be presumed most effectually to happen whilst the Vessels are only distended before the bloud hath made its way forth into the habit of the Brain which if it once hath at least in any considerable quantity the distemper seems scarce at all remediable either by this or any other administrations both on the account of the forementioned difficulty if not impossibility of its getting out of those recesses into the veines again and also the yeildingness of the Brain to the Pulsifick protrusion of the bloud behind This Phlebotomy I conceive ought to be administred to Thirty Fourty Fifty or Sixty or perhaps more ounces at a time some persons requiring more to be taken away some less according as the congestion and obstruction happens to be greater or less and the quantity of bloud to abound in the Body if the Pulse which should be tryed during the bleeding fail not Otherwise considering the great quantity we have in our Bodies 't will not satisfy the indication And by such an evacuation viz. to at least Sixty ounces at once D. Gibbons of Oxon a person whom you as well as I know to be besides his great parts and general Learning of that sagacity and judgment in Physick that his example must much justify the practise cured an Apoplexy there some time since thought deplorable as if you question the relation from me you may be satisfied both from himself and his Chirurgeon and also several others that were present And were it proper for me I could alledge Analogous instances of such profuse if you will call them so evacuations of that kind in my own observation attempted with great advantage to my Patients And if the first bleeding secure not the Patient it ought after a few hours to be repeated and so if need be several times there being much more danger from the disease than loss of bloud which has usually been observed to have been spent as I a little before noted upon wounds or Spontaneous Haemorhages in much greater quantity without loss of Life and the consequent weakness has soon been corrected by a due regimen of diet or perhaps some other assistances Nay even Old Age ought not to supersede this remedy however the assertion be like to be censured for very bold by many who more consult their own fears than the reason of the thing For besides that such antient persons who are inclined to Apoplexies generally abound enough with bloud theirs is more apt to grow viscous from their decay in some degree of spirits and their inability to a sufficiently brisk action requisite to spiritualize and keep it in a due crasis so that when apt to distend or get out of its vessels it ought to be taken away in good quantities both in regard the decayed strength of the part affected is not proportionally to what it formerly was sufficient to manage it and return it into its proper vessels or its usual circulation in them and also because if it be in them once grown viscous 't is scarce possible it can be corrected for the forementioned reasons and therefore according to the sense of the deservedly famous Botallus ought to be taken away that better from the supervening nourishment may be substituted in the roome of it the sanguifying power though upon a considerable abatement of the quantity being in the rest sufficient even in the eldest persons to transmute the appelling Chyle which from its previous preparations we feeding on nothing but vegetable or animal substances which must be highly digested and exalted to be brought to either of those estates and those farther exalted generally either by Elixation assation or fermentation wants little of the perfection of Bloud even before its admission into the mass of it as if prejudices were laid aside might be collected from instances which now and then occurr of old people who by wounds or haemorhages loose great quantities of it and yet recover nay many times increase the vigor they had before these accidents and I see no reason why what