CO MAT A. 355 



are almost always equally dangerous as in the eases of complete 

 apoplexy ; and particularly, 



1. In all the cases of hemiplegia succeeding to a paroxysm 

 of complete apoplexy. 



2. In all the cases coming upon persons of the temperament 

 mentioned in MXCV., and after the same antecedents as those 

 of apoplexy (MXCVL) ; and, 



3. In all the cases coming on with symptoms of apoplexy 

 from compression. 



MCLVI. It is, therefore, in the cases MCLIV. only, that sti- 

 mulants are properly admissible. And, even in the two first of 

 these cases, in which a plethoric state of the blood-vessels of the 

 brain may have brought on the disease, in which a disposition to 

 that state may still continue, and in w'hich even some degree of 

 congestion may still remain, the use of stimulants must be an 

 ambiguous remedy ; so that perhaps it is in the third of these 

 cases only that stimulants are clearly indicated and admissible. 



MCLVII. These doubts with respect to the use of stimu- 

 lants, may perhaps be overlooked or disregarded by those who 

 allege that stimulants have been employed with advantage even 

 in those cases (MCLV.), in which I have said they ought to be 

 avoided. 



MCLVII I. To compromise this contrariety of opinion, I 

 must observe, that even in the cases of hemiplegia depending 

 upon compression, although the origin of the nerves be so 

 much compressed as to prevent so full a flow of the nervous 

 power as is necessary to muscular motion, yet it appears from 

 the power of sense still remaining, that the nerves are, to a 

 certain degree, still pervious ; and, therefore, it is possible that 

 stimulants applied, may excite the energy of the brain so much, 

 as in some measure to force open the compressed nerves, and to 

 show some return of motion in paralytic muscles. Nay, further, 

 it may be allowed, that, if these stimulants be such as act more 

 upon the nervous than upon the sanguiferous system, they may 

 possibly be employed without any very hurtful consequence. 



MCLIX. But still it will be obvious, that, although certain 

 stimulants act chiefly upon the nervous system, yet they also 

 act always in some measure upon the sanguiferous ; so that, 

 when they happen to have the latter effect in any considerable 



z 2 



