and, moreover, he had quite his own share of that heart-eating canker, care. For the heartburn he was in the habit of swallowing large quantities of the bicarbonate of soda. Now it is well known that antacids, although they may palliate fits of indigestion, cannot cure them; and, moreover, the constant use of an antacid like soda never fails to bring on a state of debility and poverty of blood. In the present case the pains in the limb were almost constant, combined with stiffness of the muscles, which necessitated the use of a staff in walking. At about three or four o’clock every morning there were paroxysms of the most terrible agony, during which the patient would leave his bed because, he said, “it wasn’t level,” and, rolled in a rug, lie at full length on the floor, bathed in pain-induced perspiration. It was no wonder he was glad to take that dangerous narcotic, hydrate of chloral, to give him quiet nights. But this only reduced his system more and more, and gave the enemy a stronger hold thereon. When I saw him he had been suffering thus for two months, and was indeed in a pitiable plight. But giving up both the chloral and the soda, going for change of air, using some simple tonic, and being careful in his diet, worked wonders for him. The sciatica left him in one week, and in six weeks he was well and hearty.
One of the most distressing things in connection with neuralgia is the length of time it sometimes lasts, and its habit of returning periodically, without giving, perhaps, any warning of its approach. The depression, too, of the nervous system which it effects is very great; even the mind to some extent suffers; the patient becomes timid and irritable, while at times even the muscles waste. The sufferer, if the complaint continues long, seems positively to age under it. That he soon recovers strength and spirits when the enemy has been driven from his stronghold, is only a proof of the recuperative power of nature in our systems, so long as youth or middle age is on our side.
Some ancient physician has said that no one thinks of taking care of his health until death stares him in the face. There is one exception, however: people very rarely die directly from neuralgia, unless it be that dreadful form of it called angina pectoris, or heart-cramp; but so great is the pain and torture from tic douloureux or sciatica, that sufferers therefrom are glad and willing to do anything that may present some hopes of relief.
The patient, then, who wishes to recover from this disease must first try to find out the cause of it, in his or her particular case. Is the digestion good? are the teeth good? is the health below par? are the spirits buoyant or the reverse? is the kind of life led that which seems to conduce to health and longevity?—these are questions which he had better put to himself and think well over
before commencing any treatment except the simple means of local relief which I shall presently mention; for, depend upon it, whatsoever tends to place the system below par opens the door for the cruel foe’s entrance. And the converse is likewise true.
If you, then, suffer from tic douloureux, see, first and foremost, that it does not arise from caries of the teeth. Only a dentist can find this out for you, for a tooth may be sound enough to appearance, and yet decayed within. Often the removal of one or two teeth will effect, in an hour, the complete cure of a case that has been going on for months.
The treatment for neuralgia may be fitly divided into the topical, or that which gives relief at once, without reference to permanent cure, and the constitutional, or that which tends to remove the cause and prevent any recurrence. I shall mention the former of these first. Probably that which gives the greatest relief is the subcutaneous injection of morphia; but as this tiny but comforting operation can only be performed by some one with skill, I pass it by, and tell you of the great good that may be done by twice a day smearing the track of the nerve with the aconitine ointment; only remember, it must not be applied to an abraded surface. When it can be borne, alternate douches of hot and cold water sometimes give relief, and rubbing or shampooing the parts for some length of time may result in good.
But if the pain is at its worst, and immediate relief is needed, the inhalation of or smelling at a vial of chloroform will act like a charm. Take first a little good Scotch whiskey, with from 20 to 40 drops of the spirit of ether in it; then have, not one sniff, but two or three good sniffs at the vial of chloroform. It will not make you insensible, but it will scare away the pain. I often do good by administering one large dose of quinine. I am rather chary of advising you, however, to try it, because ten or fifteen grains of this invaluable medicine may work injury if either head or heart is easily affected.
People often complain of what they call rheumatism in the jaw, where probably the whole of the teeth in one side, not one more than another, are affected. Now the drug called sal ammoniac (chloride of ammonium) is almost a specific for this kind of faceache. It strikes me I have recommended this before—probably in my paper on the teeth—however, it will bear repeating. The dose is half a dram three or four times a day, but if it doesn’t do good after the fourth or fifth dose, it may be stopped. It is well worth a trial, and is safe.
Neuralgia and rheumatism are at times mysteriously allied, and, did space permit, I could tell you of some very strange cures effected by the use of the dumb-bells—first, I think, recommended by Dr Arnott. When the pain comes on, the patient has recourse to