NERVES, PERIPHERAL, DISEASES OF.—The general conditions of disease to which any or all of the peripheral nerves are liable are: 1. Circulatory dis orders. 2. Inflammation. 3. Degenera tion. 4. Functional disorders. 5. Neo plasms.
Circulatory Disorders.
The circulatory disorders of any im portance are: (a) Annaia. (b) Hyper wrnia.
(a) ANJEMIA.—This is a frequent ac companiment of general ancemic states, and is also seen as a result of obstruction of the blood-vessels of the nerves from atheroma or other cause, and also oc curs with the vasomotor neuroses. The condition is of chiefly theoretical in terest, since a positive diagnosis is al ways difficult and frequently impossible, the symptoms being various and oft times vague and lacking in characteristic features. Anwinia is doubtless in some instances a cause of neuritic pains and neuralgias, and some of the pains and par2esthesias accompanying the ather omatous arterial changes of old age are doubtless due to this condition. Almost any of the ill-defined peripheral motor and sensory abnormalities of the nerves may at times be presumptively traced to anmnia.
Treatment.—The successful treatment of the condition is based upon a recog nition of its primary cause, and is di rected toward the removal of this cause, together with the use of general tonics and hygienic measures calculated to im prove nutrition and circulatory activity. In the aged and feeble, with diseased arteries, all remedial measures may prove disappointing.
(b) HYPER-EMIA.— This condition also is only recognizable with difficulty, although the symptoms are somewhat more definite and characteristic than are those of anaemia of the nerves. The most commonly observed symptoms are mus cular weakness, tenderness or pressure along the course of the nerve; pain, dart ing, stabbing, or neuralgic in character; together with sensory perversions. A true neuralgia may have as its basis hypenemia of the nerves. The symp toms are, it will be seen, much the same as those of an early stage of neuritis.
Eliology.—The causes of hypermia
of the nerves are: adjacent inflamma tions, inecha,nical injuries, exposure to cold; bacterial, alkaloidal, metallic, and other poisons; rheumatism. gout, and other diathetic diseases; in short, the causes which, when intensified or pro longed, cause neuritis.
Treatment.—The best results in treat ment are obtained from cold applica t 1.-. tt lies, cupping„ and counter irrl tat le n. Massage and hydrot 11 era p4 intasures are beneficial in chronic c:Fts. Of internal remedies, potassium it thtle and preparations containing iron :,ve the best results.
Neuritis.
inflammation of the nerves is, in most instantes, associated with more or less de,venerative change in the nerve-fibrils of the affected nerves. When the mor bid prociss involves the nerve-sheaths and connective-tissue structures in par ticular we have an "interstitial neuritis," and the changes are chiefly inflammatory in nature. When the disease locates itsclf in the nerve-fibrils it gives rise to -parenchymatous neuritis": a condition partaking. more of the character of a degeneration than of a true inflamma tion. In practice these two morbid states are usually combined—"diffuse neuritis"; so that, as indicated above, the so-called "neuritis" embodies both inflammatory and degenerative changes. There are many named varieties of neu ritis, based upon etiological differences, intensity of the disease, its distribution, etc., and much confusion resulting therefrom. The practically important varieties are the following:— (a) Traumatic neuritis. resulting from direct mechanical injury to the nerve, as from blows, wounds, pressure, etc.
(b) Neuritis from exposure to cold, sometimes improperly called "rheu matic." (c) Neuritis caused by extension of disease from adjacent parts (tubercu losis, syphilis, bone disease, etc.).
(d) Forms of neuritis resulting from preence of bacterial poisons in the blood, exemplified in the neuritis accom panying or following typhoid fever, ma laria. variola, syphilis. diphtheria, etc.