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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    limited to one or two small definite points, as if a nail or nails were bemg- driven into the skull. These x^oints correspond either to the supra-oi'bital or the parietal, or, as often happens, to both at once. But for the gi'eater limitation of the area of pain in clavus, that affection would have little to distinguish it from raigi'aine, for the former is also accompanied with nausea and vomitmg when the pain continues long enough; and in both instances it is obvious that there is a reflex irritation pro- pagated from the pamful nerve. The adjective hystericus is an improper and inadequate definition of the circumstances under which clavus arises. The truth is, that the subjects of it are chiefly females who are passing through the trying period of bodily development; but there is no evidence to show that uterine disorders give any special bias toward this complaint. Both migraine and clavus are often met with in persons who have long passed their youth; but their first attacks have nearly always occurred during the period of development. One circumstance in connection with well-marked clavus appears worth noting, as somewhat differentiatuig it from migraine. It is, I think, decidedly more frequently the imme- diate consequence of ansemia than thej'; but it does not ap- pear, from my experience, that the chlorotic form of anaemia is any more provocative of it than is aneemia from any other cause. Some of the worst cases of clavus, probably, that have ever been seen were developed in the old days of phlebotomy. It was then very common for a delicate gu'l, on complaint of some stitch of neui^lgia or muscular pain in the side, to be immediately bled to a large extent, with the idea of checking an imaginary commencing pleurisy. The treatment, so far from curing the pain and the dyspepsia (which it produced), often aggravated them; whereupon the signs of inflaunnation were thought to be still more manifest, and more blood was taken. Under such circumstances the most complete anaemia was develoi^ed, and very often the patient became a martyr to clavus in its severest fonns. One does not now very frequently meet with the victims of such mistaken practice; but I have seen one [since writing this I have seen another case (vide car- diac neuralgia, infra)'] very severe case of clavus produced by loss of blood (in a subject who was doubtless predisposed to neuralgic affections, to judge from his family history). The case was that of a boy who accidentally divided his radial. The middle period of life is not, according to my experience, fruitful in firet attacks of trigeminal neuralgia. But, when the neuralgic tendency has once declared itself, there are many cu^cumstances of middle adult life which tend to recall it. Over-exertion of the mind is one of the most frequent causes, especially when this is accompanied by anxiety and worry; indeed, the latter has a worse influence than the former. In women, the exhaustion of h^emorrliageal parturition, or of
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