Facial Neuralgia. Lafosse and Zundel describe as cases of this kind those in which periodically the horse’s eyes are fixed and shining, the ears drawn back and depressed as in vice, the head at intervals bent on the neck, with plaintive neighing, rubbing the head on the stall and pawing. Those cases of twitching of the head or rapid jerking of the ears in horses, when they have been driven for some distance, and which are relieved by wearing a close net over the nostril or by section of the trifacial nerve at the infra-orbital foramen, manifestly partake of this character.
Cervico-Occipital Neuralgia. Lafosse speaks of this as often mistaken for torticolis, the head being turned to the affected side during the paroxysms. In man this is often a result of cold draughts on the back of the head, and associated with tender points on the course of the nerve, between the mastoid and the median line.
Dorso-intercostal neuralgia causes pain in deep inspiration, and lumbo-abdominal neuralgia develops tenderness in the loins, in one testicle, or in one lip of the vulva according to Lafosse. Diagnosis between such cases and neuritis, spinal disease, and other obscure nervous affections must be very problematical.
Sciatic Neuralgia. This is described by Zundel as causing jerking and lameness in the affected limb, sometimes aggravated and sometimes improved by work and associated with muscular weakness or paresis. Sciatica in man is, however, rarely a simple neuralgia, but partakes rather of the nature of a neuritis, and there is no good reason for supposing that the disease of this nerve in the lower animals is other than an inflammatory condition.
Leclainche after consideration of the testimony adduced, is of the opinion that we still lack absolute evidence of uncomplicated neuralgia in the domestic animals.
Treatment. For toxic cases elimination of the poison is the first consideration. For lead carefully graduated doses of iodide of potassium to carry off the offending agent without increasing its poisonous action must be continued as long as the metal is passed by the urine. It may be followed by a course of strychnia, by electricity, massage and blisters. Gouty subjects may be treated with salicylate of soda, alkalies, or colchicum. The victims of Bright’s disease must be treated for the kidney affection.
Where there has been trouble of the digestive organs, intestinal antiseptics (salol, sodium salicylate, bismuth-salicylate, beta-naphthol) and small doses of arsenious acid will sometimes benefit.
In anæmic conditions a course of tonics (cod liver oil, iron, quinine, nux vomica) are indicated, and, to improve the local blood supply, nitro-glycerine. A rich stimulating ration, currying, an open air life, and sunshine (in summer a run at grass) are called for.
In man with a suspicion of traumatic origin, W. H. Thomson strongly advocates a persevering use of the hot water douche to the parts first affected, the hypodermic use of morphia and atropia, and in case of local anæmia nitro-glycerine every three hours. Where there is a suspicion of inflammation he successfully employs absolute rest, with opium narcotism so as to abolish the pain, for twenty days if necessary. Aconite, antipyrin, acetanilid, phenacetin, exaglin, and gelsemium have their advocates, and may benefit in individual cases. A course of arsenic is often successful, and phosphorus and ergot have each proved of value.