Neuralgia of the inferior maxillary nerve / by John Lizars.

  • John Lizars
Date:
[1821]
Catalogue details

Licence: Public Domain Mark

Credit: Neuralgia of the inferior maxillary nerve / by John Lizars. Source: Wellcome Collection.

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    proposed to him the moxa or the knife, he entreated for the latter, as it would sooner decide the chance of relief. Accord¬ ingly, next day, in presence of Mr Allan, surgeon to the Infir¬ mary, and Dr Grant, house-surgeon to the same establishment, and several of Mr Allan’s and my own pupils, I divided the nerve as it emerges from the mental foramen of the inferior maxillary bone, by cutting the lining membrane of the mouth from the gums, precisely below the second molar tooth, an in¬ variable guide to the situation of the foramen. * The nerve, as it runs up to expand on the cheek, (for in this instance it had not yet branched into its twigs), being quite evi¬ dent, I cut away a portion about the fqurth of an inch. When the nerve was cut, he gave a leap, a sure criterion that it was divided. From the moment of division, he was no longer mo¬ lested with pain. The wound healed in a day or two, and he returned to the country, where he resumed his occupation as a ' labourer, and enjoyed excellent health, until one morning in December last he was suddenly awaked with the same torturing pains. Thus he had been freed from the disease for the space of twelve months. After enduring these excruciating tortures day and night for five weeks, and hourly becoming worse, the paroxysms recur¬ ring at shorter intervals, he came to town, and called on me on the 3d February last. The symptoms were nearly the same as formerly. They returned at shorter intervals, scarcely five mi¬ nutes intervening between the paroxysms. When I again pro¬ posed the cautery, he instantly entreated me to cut the nerve, for he had no faith in any thing but the knife; and, as the last operation was so trifling, compared with the pain he then and now endured, I appointed the next day, 4th February—When, in presence of Dr Duncan junior, Pro¬ fessor of Materia Medica, Mr Allan, surgeon to the Infirmary, Dr Campbell, lecturer on Midwifery, Dr Milligan and Dr Moore, I made an incision inside of the mouth, in a line with the inferior maxillary bone, precisely beneath the second molar tooth, separating the lining membrane of the mouth from the gums. My intention was to lay bare the nerve, and remove a piece as formerly; but in this I was disappointed by the old ci¬ catrix, which by its thickening had obscured the nerve, where I presumed it had formed a junction. The mental foramen * A straight line, drawn from the second molar tooth of the inferior maxilla to the base of the bone, will always indicate the mental foramen: and a straight line, drawn from the second molar tooth of the superior maxilla to the margin of the or- bk, will invariably bisect the infra-orbitary foramen.