Plain Advice to the Neuralgic by a Family Doctor.[45]—Here, reader, are two facts, which are patent to every thinking medical man: first, this agonising complaint, called neuralgia, is very much more common or prevalent in our day than it was in the days of our forefathers; and secondly, those among us who are most apt to suffer from it are they who live in luxury, or who live too fast, and neglect to keep their bodies up to the proper health-pitch. The poor, too, are often afflicted in the same way, and those who are much confined in workshops, and badly ventilated factories. From this it is not difficult to perceive a lesson may be learned.
[45] The article entitled “Plain Advice to the Neuralgic,” which appeared in ‘Cassell’s Family Magazine,’ is so good that we reprint it verbatim.
Little need is there to describe the symptoms of neuralgia, whether it takes the form of tic douloureux or faceache, hemicrania or half headache (sometimes, but wrongly, called sun-pain), or sciatica, in which the pain follows the course of a nerve running down the back of the leg, even at times as far as the toes. The pain when fully established is of a terribly acute kind, and indescribable burning and shooting—torture, in fact. It generally comes on without any warning at all, in one sharp twinge, which soon recurs and keeps on increasing, till the poor patient is half distracted, and his pale anxious face is beaded with perspiration.
Of the three kinds of neuralgia, the most common by far is tic, or faceache. This pain seems to ‘come out,’ as I have heard patients describe it, from a spot between the ear and temple, and spread itself over one side of the face, adown the jaws along one side of the nose, and into the eye itself. The fits of pain seem at times induced by the most trifling causes, such as a sudden start, a loud, quick sound, as the slamming of a door, or the slightest draught of cold air, a mouthful of hot tea or cold water. Sometimes the patient will get ease if he keeps in bed, with the face entirely buried in warm soft flannel, but contact with the pillow will at once induce a paroxysm. Sleep banishes the pain entirely for the time, or perhaps altogether, if the slumber has been natural, and not induced by weakening, enervating narcotics.
Now let us see for a moment what are the usual causes of neuralgia. If we know these, it will assist us materially in laying down rules for the general treatment of the complaint.
And here let me premise that some cases are incurable, because they depend upon pressure by tumours of some kind at the root of the nerve, maybe a bit of bone growing into it. For remember the nerves are extremely sensitive if pressed upon directly. A kinder-hearted man than Professor L—, of Aberdeen, or ‘Sandie’ as he was familiarly termed, never lived; but he used to tell us students, “Gentlemen, in cutting down upon an artery, in one of the extremities, you will often find the artery, the vein, and the corresponding nerve lying in juxtaposition. You can easily tell the vein, but you may be puzzled to know which is nerve and which artery; give one of them, then, a slight pinch with the forceps—if it is the former, oh! won’t the patient holloa! but if he doesn’t holloa, go on, tie away.”
And I have often seen this put in practice with the very happiest results, so far as the operator was concerned. I merely mention this to prove to you that pressure on the root of a nerve may cause an incurable form of neuralgia. But do not think that I wish to frighten you! I therefore hasten to tell the perhaps afflicted reader, that these cases are very rare indeed, and that the large majority of those who suffer from the malady may be cured for the time, and the disease even prevented from returning.
I said that very often neuralgia gave no warning, but came on suddenly, but it more often comes on gradually, and is preceded by some derangement of the general health, such as indigestion. From this fact, again, the wise may take a hint.
I do not say that strong men with robust constitutions never take neuralgia, but all my experience, and that I believe of nearly all medical men, go to prove that it is more frequently an accompaniment of a weakened frame of body, with a nervous system below par. This may have been occasioned by bodily fatigue combined with want of sleep, anxiety of mind, worry, &c., or from debility from whatever cause. But I must not forget to say that indigestion is a frequent cause, and excess in eating and drinking combined with late hours in hot rooms. Another hint, please, reader. Foul air, especially living in malarious districts, will also bring on neuralgia, and in this case the attacks are generally of a periodical kind. The great majority, however, of the cases of neuralgia which come under the notice of the practitioner, are caused by decayed teeth. And this fact gives us hint number three.
Sciatica cases are at times exceedingly distressing. I shall just mention one, which I cured not long since; and we may learn something from it because the cure was so simple. A gentleman, thirty-two years of age he was, spare but wiry; from errors in diet, I elicited, he had become troubled with indigestion and heartburn, which lasted for months;