Neuralgia and the diseases that resemble it / by Francis E. Anstie.

  • Anstie, Francis Edmund, 1833-1874.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Neuralgia and the diseases that resemble it / by Francis E. Anstie. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    believe, a certain mobility of the vaso-motor nervous system and of the cardiac motor nerves; but I insist less on this than on the above-named features, because a more extended experi- ence is necessary to establish the fact with certainty. Within my own experience it has always seemed to be the case that persons who are liable to neuralgia are specially prone to sud- den changes of vascular tension, under emotional and other influences which operate strongly on the nervous system. The observation of this fact has been made accidentally, with- out any previous bias on my part, in the course of a large number of experiments made upon individuals free from man- ifest disease at the time, with Marey's sphygmograph. Neuralgic attacks are always intermittent, or at the least remittent, in every stage of the disease. The manner in which neviralgic pain commences is charac- teristic and important. There is always a degree of sudden- ness in its outset. When produced by a violent shock, it may, and often does, spring into full development and seveinty at once, of which, perhaps, the most striking example is the sud- den and violent neuralgic pain of the eyebrow which some per- sons experience from swallowing a lump of undissolved ice Usually, however, the first warning is a sudden, not very severe, and altogether transient dart of pain. The patient has probably been suft'ering from some degree of general fatigue and malaise, and the skin of the affected part has been some- what numb, when a sudden slight stitch of pam darts into the nerve at some point which corresponds to one of the foci here- after to be particularized. It ceases immediately, but in a few seconds or minutes returns; and these darts of iDain recur more and more frequently, till at last they blend themselves together in such a manner that the patient suffei's continuous and vio- lent j)ain for a minute or so, then experiences a short intermis- sion, and then the pain returns again, and so on. These inter- mittent spasms of pain go on recui'ring for one or several hours; then the intermissions become longer, the pain slighter, and at last the attack wears itself out. Such is generally the history of first attacks, especially in subjects who a,re not past the midtUe age, nor particularly debilitated from any special cause. A point of interest in connection with the natural history of the neuralgic access is the condition of the circulation. The commencement of pain is generally preceded by paleness of skin and sensations of chiHiness. At the commencement of the painful paroxysm, sphygmographic observation shows that the arterial tension is much increased, owing, in all prob- ability, to spasm of the small vessels. This condition is grad- ually replaced by an opposite state, the pulse becoming large, soft, and bounding, though very unresisting, and giving a sphygmographic trace which exhibits marked dicrotism. Sim-