COMATA. 349 



time, the sense remained entire in that arm, and the state of 

 the circulation continued as natural. With this he had an 

 affection of the arm of the other side, which was a total loss of 

 sense with a perfectly entire motion : it was attended with an- 

 other circumstance, viz. a cessation of the circulation in that 

 arm which had lost the sense. It appeared to me, that the 

 two symptoms, of loss of sense and loss of motion, depended 

 upon quite different causes. 11 



MCXLIII. 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 (MCXL.). 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. 



MCXLIV. The hemiplegia (MCXL.) 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 

 (MXC V.), and is preceded by the same symptoms (MXCVIII.) 

 that have been taken notice of with respect to apoplexy. 



MCXLV. 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 measure relieved ; but in so far as commonly there still 

 remain the symptoms of the loss of memory, and of some de- 

 gree of fatuity, these, I think, show, that the organ of intellect, 

 or the common origin of the nerves, is still considerably affected. 



MCXLVI. Thus, the hemiplegia, from its evident connexion 

 with, and near relation to, apoplexy, may be properly consider- 

 ed as depending upon like causes ; and, consequently, either 



