Observations on sciatica and other neuralgic affections : with a consideration of their frequent origin from a disordered state of the stomach ; interspersed with some novel views respecting the origin and prevention of gall-stones ... ; together with an account of the waters of Bagnères de Bigorre and Barége in their treatment / by Richard Carmichael.

Date:: 1838

Credit: Observations on sciatica and other neuralgic affections : with a consideration of their frequent origin from a disordered state of the stomach ; interspersed with some novel views respecting the origin and prevention of gall-stones ... ; together with an account of the waters of Bagnères de Bigorre and Barége in their treatment / by Richard Carmichael. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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various portions of the nervous system which possess dis- tinct functions, it will be then time enough to endeavour to ascertain the minute organic alterations which disease may induce. Many years since, in dissecting a subject, I found a portion of a needle, three quarters of an inch in length, im- bedded in the very centre of the sciatic nerve, where it passes behind the great trochanter; and yet there was no thickening of the nerve or its investment, nor any of the usual signs of the effects of previous inflammation. Hence we may conclude, that the nervous structure is but little subject to inflammation and its consequences. But this ad- mits of a doubt; for we often find that, after amputation, the most severe neuralgic pains occur in the stump, and in such instances the cut extremities of the nerves have been found indurated and enlarged, as may be seen by the preparations which I now present to you; but it ought to be observed, that these morbid alterations in structure are not always productive of pain. It is also said, that in those who have suffered severely from sciatica, the neurilemma of the sciatic nerve has been found thickened and enlarged. In one in- stance, that of a woman who died of tic douloureux in the Richmond Hospital about two years since, the Gasserian ganglion of the fifth pair of nerves was found hardened and enlarged to the size of a nutmeg, and exhibited a fibro-cel- lular or scirrhous appearance. The nerves could not be traced through the tumour, but were lost in its substance, as may be clearly seen by a close examination of the interesting preparation which I now lay before you. This poor woman had been several years afflicted with the disease,^ from th* tortures of which, neither opium in the largest doses, stramonium, nor any other narcotic, afforded the slightest palliation ; in fact she suffered more agony than any human being I ever saw afflicted with any disease. To so great a degree] was she worn down by pain,' that for some months

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