APOPLEXY. 107 



I ) re tend that they have suddenly lost their voice. We should suspect a 

 n if he could not speak, and yet could swallow and write well. The impostor 

 nearly always pretends to be absolutely dumb, and seldom knows enough about 

 his pretended complaint to see the necessity of uttering some word or word-like 

 syllable, as the true aphasic nearly always does. This reminds us of the case of 

 a soldier who, with the view of obtaining his discharge, pretended that he had 

 been suddenly struck dumb. He was taken to the doctor, who at once suspected 

 the real nature of the case. The man was told to try and say "Ah," it being 

 explained to him that he would have no difficulty, as it was "a purely laryngeal 

 sound, unconnected with the faculty of language." The effort was successful. He 

 then told to say " No," which, it was explained, was " a sound of similar 

 character." Not seeing the trap, he promptly replied as directed, " No." " Well, 

 my friend," said the doctor, " if you can say ' No ' you can say anything ; so good 

 day." 



Respecting the duration of an attack of aphasia we can say nothing definitely 

 it may last only a few hours, or many months. An attack, as a rule, indicates 

 no immediate danger, but at the same time a medical man should be called in 

 without delay. 



APOPLEXY. 



When a person falls down suddenly, and lies without sense or motion, except 

 that his pulse keeps beating and his breathing continues, he is said to have been 

 attacked with apoplexy, or to have had a " stroke." He appears to be in a deep 

 sleep, but it would be impossible to awaken him by the same means which would 

 rouse a healthy man. He is not in a simple faint, for his pulse beats perhaps 

 with unnatural force, and often his face, instead of being pale, is flushed, and his 

 breathing continues, although it may be laboured and noisy. The cause of this con- 

 dition is usually the rupture of a blood-vessel in the brain, and the consequent 

 pouring out of blood which ensues. Anything tending to produce congestion 

 of the head favours the occurrence of apoplexy. It often follows a fit of passion 

 or excitement, or some unusual act of exertion. 



We all recognise the fact that certain people are likely subjects to become 

 apoplectic. A seizure is most likely to occur in those whose parents suffered in 

 the same way ; in men and women of sedentary habits, accustomed to high living, 

 with protuberant bellies, large heads, florid features, and short thick necks; in 

 individuals above fifty, and those who are addicted to habits of intemperance. 

 Bright's disease of the kidney also favours the occurrence of an attack. It is 

 probable that in almost all cases in which a man has had a stroke, the blood- 

 vessels of the brain have been weakened or rendered brittle by degeneration. 



This dreadful visitation is seldom experienced without some warning, which, 

 properly interpreted, should put the patient on his guard. These are usually 

 fugitive attacks of congestion of the head, indicated by mental confusion and 

 dulness, a feeling of heat about the head, with coldness of the hands and feet, 

 and a diminished secretion of urine, with constipation. Among suspicious 

 signs may be enumerated headache and giddiness, experienced principally on 



