Ap'oplexy (Gr. apoplēxia—from plēso, 'I strike'—'disablement from a stroke'), a term used in medicine, from early times, of any sudden and unaccountable loss of consciousness, and still popularly employed in much the same way. It is generally applied, however, by modern medical writers to rupture of a blood-vessel, with hemorrhage in the brain or its membranes, whether with or without unconsciousness. This sense will be adhered to in the following description. Most unfortunately, it has also been used of hemorrhages into the tissue of any organ in the body—e.g. pulmonary apoplexy.
In consequence of these ambiguities, there is at present a tendency to abandon the word in favour of more precise terms.
Apoplexy is commonly a disease of advanced life, being very rarely met with below the age of forty. The most important causes which predispose to apoplexy are Atheroma and minute Neurisms (q.v.) in the brain (see ARTERIES, Diseases of), and chronic Bright's Disease (q.v.). At one time much more importance was attached than now to a thick-set, short-necked habit of body in this connection. Men are more liable to apoplexy than women. A severe apoplectic fit or shock may come on suddenly or gradually; in either case the patient loses sensation, motion, and consciousness, and lies with flushed face, full slow pulse, and noisy 'stertorous' breathing. If death occur, a clot of blood may be found in the substance or upon the surface of the brain, with the ruptured artery from which it has escaped. If the shock be not fatal, the patient gradually recovers consciousness; and it is found then, if not before, that there is Paralysis (q.v.), partial or complete, of one side of the body. In the course of days or weeks this may pass off; but rarely disappears completely. Mental enfeeblement, as well as bodily, may result. Less severe shocks of apoplexy often occur, with no unconsciousness, but only paralysis, partial or complete, of one side of the body. The approach of apoplexy is often heralded by premonitory symptoms—e.g. temporary confusion of thought or loss of memory, giddiness, headache, difficulty of speech, weakness in a limb, double vision; and when these occur, prompt medical treatment, especially attention to regular action of the bowels, may occasionally avert the threatened apoplexy. When a shock of apoplexy has occurred, the patient must be kept lying perfectly quiet, with head raised, and cold applied to it. Medicines which tend to check hemorrhage, as ergot, should be administered. Purgatives may be given; and bleeding, especially from the temporal artery or external jugular vein, is sometimes valuable. Alcohol is dangerous, and should on no account be used unless by express direction of a medical man. A person who has had one shock of apoplexy is always liable to a recurrence.
Embolism of the cerebral arteries (see ARTERIES, Diseases of) closely resembles apoplexy; as do fits, called apoplectiform attacks, met with in other brain diseases—e.g. tumours, general paralysis. The condition of a patient suffering from Epilepsy (q.v.), uræmia (see KIDNEYS, Diseases of), or narcotic poisoning—e.g. by opium or alcohol—may be very like that described as characteristic of apoplectic unconsciousness, and very difficult to distinguish from it. Hence the great importance of caution in dealing with a person found unconscious, lest he be treated, to his imminent peril, as merely drunk, when really suffering from severe apoplexy.
Heat-Apoplexy is another name for Sunstroke (q.v.).