COMATA. 341 



degree of apoplexy, lead me to think, that also the apoplexy 

 proceeding from retrocedent or atonic gout is of the same kind, 

 or that it depends upon an immobility of the nervous power, ra- 

 ther than upon compression. 



MCXIX. It may indeed happen, that, as the apoplectic and 

 gouty predispositions do often concur in the same person; so it may 

 consequently happen, that the apoplexy coming upon gouty persons 

 may sometimes depend upon compression ; and dissections may, 

 accordingly, discover, that the circumstances of such a cause had 

 preceded. But in many cases of apoplexy following a retroced- 

 ent or atonic gout, no such antecedent or concomitant circum- 

 stances, as commonly occur in cases of compression, do distinct- 

 ly or clearly appear ; while others present themselves, which 

 point out an affection of the nervous power alone. 



MCXX. With respect, however, to the circumstances which 

 may appear upon the dissection of persons dead of apoplexy, 

 there may be some fallacy in judging, from those circumstances, 

 of the cause of the disease. Whatever takes off or diminishes the 

 mobility of the nervous power, may very much retard the motion 

 of the blood in the vessels of the brain ; and that perhaps to the 

 degree of increasing exhalation, or even of occasioning rupture 

 and effusion : so that, in such cases, the marks of compression may 

 appear upon dissection, though the disease had truly depended 

 on causes destroying the mobility of the nervous power. This 

 seems to be illustrated and confirmed from what occurs in many 

 cases of epilepsy. In some of these, after a repetition of fits, 

 recovered from in the usual manner, a fatuity is induced, which 

 commonly depends upon a watery inundation of the brain : And, 

 in other cases of epilepsy, when fits have been often repeated 

 without any permanent consequence, there happens at length a 

 fatal paroxysm ; and, upon dissection, it appears that an effu- 

 sion of blood had happened. This, I think, is to be considered 

 as a cause of death, not as a cause of the disease : for in such 

 cases, I suppose that the disease had diminished the action of 

 the vessels of the brain, and thereby given occasion to a stag- 

 nation, which produced the appearances mentioned. And I ap- 

 prehend the same reasoning will apply to the cases of retroced- 

 ent gout, which, by destroying the energy of the brain, may oc- 

 casion such a stagnation as will produce rupture, effusion, and 



