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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    stylo-mastoid foramen, and, thirdly, the infra-orbitary, inde¬ pendent of what is urged against the two first operations by Dr Haighton and Mr Swan, rather than suffer this poor wretch to endure such misery* On examining the mouth, great pain was given by touching the coronoid process of the lower jaw bone, as well as the gum all along the right side. The next day, the 26xh, I tried to divide the nerve, by intro¬ ducing from the inside of the mouth a sharp-pointed curved bistoury along the inside of the coronoid process of the inferior maxillary bone, between it and the pterygoideus internus mus¬ cle to the foramen ; then lateralizing the instrument outwards, and cutting towards me, with the expectation of hooking the nerve. In this I experienced considerable difficulty, from the superior maxilla shutting up, as it were, the space. He felt at one time excessive pain, indicating the division of the nerve. He was easier during the afternoon, but passed nearly as bad a night as formerly. The following day, The 27th, the pain was confined to the seat of the extracted tooth; this, therefore, was cauterized. As the operation of yes¬ terday had caused considerable tumefaction, so as to prevent any examination of the wound, we put him on a course of car¬ bonate of iron, which he took to the extent of two ounces daily. This he continued to the 4th of March, without receiving the least benefit. To-day I prevailed on him to allow the application of the moxa, which was accordingly done; but he could scarcely suffer it. 15th March.— He was relieved a little during the afternoon of the day the moxa was applied; but the following day his suf¬ ferings were as severe as ever. The tumefaction of the muscles in the neighbourhood of the wound last inflicted, having now subsided, and the sore formed by the moxa healed, I again at¬ tempted to divide the nerve as it enters the foramen; but in place of the bistoury, 1 made first a perpendicular incision with a scalpel close to the coronoid process, and then introduced a round shaped gum lancet between the process and the internal pterygoid muscle, and scarified the bone at the foramen. When the lancet reached the seat of the nerve, the pain he experienced was intolerable; and it was with difficulty he could sit till I cut the nerve completely. From this moment there was a sudden and satisfactory termination to all his sufferings, similar to what had occurred after the first operation in December 1819; and from this time he has continued well. The other day I saw him toiling in the field with apparently great enjoyment of life.