Causes.—They are many. (1.) The poison that comes from infectious diseases such as typhoid fever, diphtheria, smallpox, leprosy, la grippe, etc. (2) From poisons such as alcohol, lead, arsenic; phosphorus, mercury, coal gas, etc. (3) From anemia, cancer, tuberculosis, syphilis, septicemia, diabetes. (4) From cold, over-exertion, etc.
Symptoms.—Acute febrile multiple neuritis. A typical case: This comes on from exposure to cold, over-exertion, or in some cases spontaneously. There are chills, headaches, pains in the back, limbs and joints, and the case may be called rheumatism. Loss of appetite, coated tongue, constipation, and other symptoms of stomach and bowel trouble. The temperature rises rapidly, and may go to 103 to 104 degrees. The limbs and back ache, but intense pain in the nerves are not always constant. The pain is usually sharp, severe, and located in the limbs, and is worse from moving and pressure. There are tingling feelings in the hands, feet and body, and a feeling as if ants or insects were crawling over them, and there is also increased sensitiveness of the nerve trunks or entire limb. There is loss of muscular power, first marked, perhaps, in the legs, and it extends upwards and reaches the arms. Sometimes it first begins in the arms. In typical cases the extending muscles of the wrist and ankles drop. (Wristdrop and foot-drop). In severe cases there is a general loss of muscular power, producing a flabby paralysis. This may extend to the muscles that control speaking, swallowing and hearing resulting in impairment of these functions. The muscles soften and waste away rapidly. Disorders of nutrition are frequent, like watery swelling (oedema), glossy looking skin, sweating, hives, etc.
[NERVOUS SYSTEM 279]
Recovery.—The course of the disease varies considerably. In mild cases the symptoms disappear very soon. In the worst form the patient may die in a week or ten days. As a rule, in moderately severe cases after persisting for five or six weeks, the condition remains about the same for a few months, and then improvement slowly begins and recovery takes place in six to twelve months. In neuritis from alcohol drinking there is a rapid onset as a rule, with delirium and delusions. The result is usually favorable and after persisting for weeks or months improvement gradually begins, the muscles regain their power, and even in the most desperate cases recovery may follow. The mental symptoms are very severe in alcoholic cases. Delirium is common. It takes much longer for such cases to regain what they call their normal condition.
Neuritis following diphtheria and other infectious diseases. The outlook in cases from these diseases is usually favorable, and except in diphtheria, fatal cases are uncommon. It is most common from diphtheria. Recovery, in neuritis from diphtheria, takes place in about three months, but some cases are fatal.
Neuritis from lead.—The first symptoms are those of intestinal colic, lead line on the gums, "dropped-wrist." The recovery is quite gradual and the poison may be cast out in three to four months.
In Neuritis from Arsenic.—We have disturbance of the stomach and bowels first, then the legs and arms are about equally affected, weakened; may recover in two to six months.
Treatment for acute kind.—The first thing to do is to rest in bed and control the pain and acute symptoms. Hot applications help to relieve the suffering. Patient must be kept comfortably and constantly warm and quiet. Hot applications of lead water and laudanum.
Medicines.—It may be necessary to use morphine to control the pain. Remedies such as antipyrine or aspirin are often used. A physician must be called. When the disease is caused by arsenic and lead and alcohol, of course you must remove the cause before you can hope for any improvement.
Caution.—Any one can readily understand from reading this description that the thing to do is to be careful not to needlessly expose yourself to taking cold. One subject to rheumatism or neuritis, even in small degree, should take care not only not to take cold but not to overdo in laboring; cold, wet and over-exertion cause the majority of the acute attacks. But some are caused by diseases, such as diphtheria, typhoid fever, etc., and a great many cases of neuritis following these and other infectious diseases can be avoided if proper care is taken during and after these diseases. Such care can easily be taken. Keep your rooms warm and comfortable, and the patient in bed or in a comfortable room until all danger is past. How often I have heard a doctor blamed for such results when in most cases it is the patient's or nurse's fault. Certain results will follow certain diseases and only proper care can keep such results from following. Dropsy frequently follows even a light case of scarlet fever. Why? Simply because, on account of being a light case, the child is left to roam at will about the rooms and catches cold, takes la grippe. If people would only take care of themselves this disease would not leave so many lifelong victims. I have seen men and women who have just recovered from this disease stand on the street corners on a cold, damp day, and talk an hour, and the next day they wondered how they could possibly have taken cold. We cannot disobey the laws of nature safely. Persons who are subject to neuritis or rheumatism should be especially careful on cold, damp, wet days and of over-exertion.