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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    in similar circumstances with the addition of_ excessive or too long- continued exertions of these muscles. Hj'steric tender- ness also sometimes bears a considerable resemblance, superfic- ially, to true intercostal neuralgia, in cases where the genuine disease does not exist. A less common but very remarkable variety of intercostal neuralgia than that just mentioned, is the kind of ijaiu which at- tends a good many cases of herpes zoster, or shingles. It is only of recent years that any essential connection between zos- ter and neuralgia has been suspected. The occurrence of neu- ralgia as a sequel to zoster had indeed been mentioned by Eayer, Eecamier, and Piorry, but the essential nature of the connection between the two diseases was evidently not sus- pected by Lecadre, when, as late as 1855, he published his val- uable essay on intercostal neuralgia. M. Notta was one of the first to present connected observations on the subject. But it was much more fully discussed in a paper published by M. Ba- rensprung, in 1861. [Ann. der Charite-Krakenhauser zer Ber- lin, ix., 2, p. 40. Brit, and For. Med.Rev., January, 1862.] This author showed the absolute universality with which unilateral herpes, wherever developed, closely followed the course of some superficial sensory nerve, and gave reasons, which will be dis- cussed hereafter, for sui:)ioosirig that the disease originates in the ganglia of the posterior roots, and that the irritation spreads thence to the posterior roots in the cord, causing reflex neural- gia. We shall have more to say on this matter. Meantime, it seems to be established, by multiplied researches, that, though unilateral herpes may and of len does occur without neuralgia, and neuralgia without herpes, the concurrence of the two is due to a mere extension of the original disease which is a nervous one. In young persons, zoster is not att-ended with severe neu- ralgia, but a curious half-paretic condition of the skin, in which numbness is mixed v.dth formication, or with a sensation as of boiling water under the skin, precedes the outbreak of the eruption by some hours, or by a day or two. Painless herpes is commonest in youth. I remember, for instance, that, in an attack of shingles which I suffered about the age of eleven, there was at no stage any acute pain; only, in the pre-eruptive period, for a short time, I had the curious sensations referred to above: and the same thing has occurred in all the patients below puberty that I have seen, if they complained at all. From the age of puberty to the end of life, the tendency of herpes to be complicated with neuralgia becomes progressively stronger. The course of events varies much in different cases, however. In adult and later life the symptoms usually commence with a more or less violent attack of neuralgic pain, which is suc- ceeded, and generally, though not always, displaced by the herpetic eruption. The latter runs its course, and after its dis
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