Neuralgia and the diseases that resemble it / by Francis E. Anstie.

  • Francis E. Anstie
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Neuralgia and the diseases that resemble it / by Francis E. Anstie. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    the dorsum of the foot; rarely on the sole of the foot or the back of the hand. It is very interesting to remark that these skin-lesions correspond very nearly, not only to those ohserved in the cases of nerve-injury reported by Mr. Paget,* in which actual neuralgia was i^resent (though the kind of pain is not exactly specified), bvxt also very nearly with the nutritive changes observed by Mr. Jonathan Hutchinson in a number of cases of surgical injuries of nerve*t The tendency of neu- ralgic pain accompanied by nutritive lesions of the skin and nails to seat itself in the hands and feet will be hereafter noted in connection with the subject of the pains of locomotor ataxy and of those produced by profound mercurial x)oisoning. And it will be seen in the section on Pathology, that very import- ant conclusions are suggested by the coincidence., Joined with the burning pains, and the altered skin-nutri- tion, in the cases of gunshot injury of nerves which we are considering, there is nearly always a marked alteration in the temperature of the parts, either in one direction or the other. In the great majority of instances of ordinary neuralgia after Vfounds, this alteration is a very considerable reduction of the temperatui^e of the parts supplied by tlie painful nerves; a change which corresponds with what appears in the vast ma- jority of all cases of division of sensitive nerves, whether pain be set up or not. But, in all examples of the burning pain af- ter injury, Messrs. Mitchell, Moorehouse, and Keen found the temperature of the painful parts notably elevated. It would appear that there is no form of neuralgia more dreadful, and scarcely any so hopeless, as this burning pain coming on as a sequel to severe nerve injuries. It exercises a profoundly depressing effect upon the whole nervous tone; the most robust men become timid ai:id broken down, and their condition is compared by the American writers to that of hys- terical women. There is another peculiar nutritive affection, first recognized as an occasional consequence of nerve injuries by Messrs. Mitchell, Moorehouse, and Keen, namely, an inflammation of joints, and, although we have no concern here with this symp- tom, it wall be referred to hereafter as throwing interesting light on certain questions of pathology. Certain lesions of se- cretion will also be specially referred to under the heading of Diagnosis. It. Neuralgias op Intra-nervous Origin.—As regards the constitutional conditions with which the several varieties of neuralgia that arise independently of external violence, or dis- ease of extra-nervous tissues, are respectively allied, the follow- ing preliminaiy subdivisions may be made: * lied Times and Gazette, ]Marcli 2G, 18G4. - f London IIosp. Reports, 1866.
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