SHINGLES. The popular name for the variety of herpes (q.v.) known as herpes zoster, from its tendency to extend in girdle fashion around the waist, i.e., one or both sides of the chest. The rash of shingles in itself is but moderately painful, but the importance of the condition lies in the hyperaesthesia of the skin in neighboring parts supplied by the same nerve. This hyperaesthesia is such that the slightest touch causes a burn ing pain resembling that occasioned by touching a raw and highly sensitive surface. Associated with the pain due to the eruption are muscular and joint pains (possibly resulting from the enforced immobilization of the part) and these, in the form of cramps, may be even more severe than the superficial pain. As a result of such paroxysms of pain, sleep is interfered with, often to an important extent, and the patient looks tired and worried. Never theless, he is not ill as with an acute infective illness, though the temperature may be raised a little at times. Paroxysms of pain
are often determined by extraneous causes, e.g., in the case of herpes of the thigh by a full rectum, hunger, insufficient or exces sive warmth. The real importance of the disease lies in the fact that the pain is often so severe that there is a danger that re course may be made to morphia for its relief. In view of the dura tion of the associated neuralgic pain, the danger of inducing the morphia habit is very great, and use of morphia and other opiates must be avoided at all costs. Though distressing, the disease is never fatal, in spite of the popular belief that such is the case if the shingles extend right round the body. There is a relation between shingles and chicken-pox, for the two are apt to be asso ciated in the same community and may even occur in the same individual simultaneously.