110 THE TREATMENT OP DISEASES. 



sible by the police should be placed in a cell until an examination has been made 

 by the doctor. It frequently appears at the inquest that what was supposed to be 

 drunkenness was in reality apoplexy. Even putting aside the question of treat- 

 ment, the feelings of the relatives surely deserve some consideration, for it must 

 be no small aggravation of their grief to find that one whom they loved and 

 cherished was locked up on a charge of drunkenness. 



An apoplectic seizure may terminate in any one of three different ways. Either 

 it gradually passes off, leaving the patient apparently none the worse for the stroke ; 

 or it terminates in incomplete recovery, the mind being impaired and some parts of 

 the body paralysed ; or it ends in death. In any individual case it is very difficult 

 to say what the result will be. An attack of this kind is always replete with 

 danger, the severity of which may to some extent be estimated by the depth of the 

 insensibility, the degree of prostration, and the difficulty in swallowing. There is a 

 very common opinion that a person suffers from three different attacks of apoplexy, 

 the .first being mild, the second resulting in paralysis, and the third terminating 

 fatally. This is not literally true, but undoubtedly the danger greatly increases 

 with every successive attack. In fatal cases death very rarely occurs immediately, 

 as it may do from heart disease, or the rupture of an aneurism, or a broken neck. 

 There is almost always an interval of some hours, so that there is time to send for 

 the friends or relatives, unless they live at a great distance. In favourable cases, 

 even when partial recovery has taken place, there is still a fear, especially during 

 the first fortnight, that there may be a recurrence of the bleeding in the brain, or 

 that the clot will set up inflammation. "When the symptoms gradually diminish 

 there is, in the first place, a recoveiy of mental power. For a time this may be 

 imperfect, so that the patient is childish, his memory is impaired, and he experiences 

 a difficulty in expressing his wants in appropriate language. This soon passes off, 

 there being simultaneously an improvement .in the condition of the limbs, the 

 capability of movement appearing first in the arm and then in the leg of the 

 paralysed side. 



"What are you to do when a person is suddenly struck down with apoplexy ? Li 

 the first place, send for the doctor and say what is the matter. Undo the things 

 about the neck, especially the shirt-collar and necktie. Have the windows opened, 

 so as to admit plenty of fresh air and cool the room. Place the patient in an easy- 

 chair, and let him remain in a half -recumbent position, or put him on the bed or 

 on the floor, with his head well supported. The less he is moved the better, but 

 take care to see that the head is raised. Sponge the head with the coldest water 

 you can get, and send for ice. When the ice comes, put it in a bag and apply it to 

 the head, cutting short the hair if long. It is necessary to have the bowels opened, 

 and as the patient cannot swallow put three drops of croton oil right at the back of 

 the tongue, when it will run down. You will have no difficulty in doing this, and 

 can use the end of a pen or a little brush if necessary. Apply mustard-poultices 

 to the calves of the legs. Keep the patient absolutely quiet. This is all that is to 

 be done ; in fact, the danger is of doing too much rather than of not enough. After 

 what we have said, we need hardly remind you of the absolute necessity of making 

 sure that the patient is in reality suffering from apoplexy and not from opium- 



