344 PRACTICE OF PHYSIC. 



MCXXVIII. In the case of a plethoric state of the system, 

 it might be supposed that blood-letting would be the most 

 effectual means of diminishing the plethora, and of preventing 

 its consequences : and, when an attack of apoplexy is immedi- 

 ately threatened, blood-letting is certainly the remedy to be 

 depended upon ; and blood should be taken largely, if it can 

 be done, from the jugular vein, or temporal artery. But when 

 no threatening turgescence appears, the obviating plethora is 

 not judiciously attempted by blood-letting, as we have en- 

 deavoured to demonstrate above (DCCLXXXVIL). In 

 doubtful circumstances, leeches applied to the temples, or scari- 

 fications of the hind-head, may be more safe than general 

 bleedings. 



MCXXIX. When there are manifest symptoms of a ple- 

 thoric state in the vessels of the head, a seton, or pea-issue, 

 near the head, may be very useful in obviating any turgescence 

 of the blood. 



MCXXX. These are the means to be employed for prevent- 

 ing the apoplexy which might arise from a plethoric state of the 

 vessels of the brain ; and if, at the same time, great care is 

 taken to avoid the exciting causes (MXCVIII.) these means 

 will be generally successful. 



In the cases proceeding from other causes (MCXV.), as 

 their application is so immediately succeeded by the disease, 

 they hardly allow any opportunity for prevention. 



MCXXXI. For the Cure of apoplexies from internal causes, 

 and which I suppose to be chiefly those from compression, the 

 usual violence and fatality of it require that the proper reme- 

 dies be immediately and largely employed. 



The patient is to be kept as much as possible in somewhat of 

 an erect posture, and in cool air ; and, therefore, neither in a 

 warm chamber, nor covered with bed-clothes, nor surrounded 

 with a crowd of people. 



MCXXXI I. In all cases of a full habit, and where the dis- 

 ease has been preceded by marks of a plethoric state, blood-let- 

 ting is to be immediately employed, and very largely. In my 

 opinion, it will be most effectual when the blood is taken from 

 the jugular vein ; but, if that cannot be properly done, it may 

 be taken from the arm. The opening of the temporal artery, 



