Surgical measures, such as nerve stretching, splitting the sheath, etc., may be tried as a last resort. The diet should be liberal and the general bodily state improved as much as possible by tonics and hygienic measures. In the later stages of the malady electricity and massage should be used systematically, as they shorten the period of convales cence.
In seiatiea patient should be confined to bed and the leg immobilized by a long hip-splint. Hot-water bags are to be kept continuously under the thigh from the sciatic notelf to the popliteal space. Once a day galvanism is used for five minutes, the negative electrode being ap plied to the sole of the foot, which it should equal in size, and the positive one equally large, placed under the hip as the patient reclines. Fifteen-grain doses of phenacetin are administered for the acute pain in the beginning, or, if necessary, an hypodermic of morphine may be given. Grme Hammond (Post graduate, Sept., '94).
Good results obtained in sciatica and intercostal neuralgia from painting a mixture of equal parts of guaiacol and glyeerole over the course of the nerves. Ferrand (Jour. des Prat., No. 30, '94).
Three obstinate cases of sciatica suc cessfully treated with trinitrin pre scribed in the following form:— Solution of trinitrin diluted to zh drachm.
Tincture of capsicum, 1 'A drachms. Mint-water, 3 drachms.
AI. Sig.: Three drops to be taken 3 times daily. Mikhalkine (Revue de Then 116dico-chir., Feb. 15, '95).
Cases of good results from use of salo phen in sciatica. From 45 to 75 grains were given a day. Unpleasant effects were either wholly wanting or very transitory. Luigi Cappellari (Gazz. degli Osp., No. 35, '96).
One hundred and thirteen cases of re bellious sciatica in which compression resulted in recovery. Patient lies on his face, with his legs extended and resting easily one against the other. The most painful spot is selected: the region where the nerve proceeds from the large sciatic opening. On its trunk both thumbs arc applied and it is compressed with the greatest possible force; at the same time slight lateral movements are made without changing the point of pressure or moderating its intensity. This takes from fifteen to twenty seconds, and is followed by an interval of twenty min utes' rest, when the procedure is re peated. After a second application pa
tient is able to walk, and for several hours, or even a day, he may be free from pain.
In order to obtain complete recovery, this procedure should be practiced about six times a day every two days, until definite suppression of neuralgia is ob tained. M. Negro (Bull. 1116c1., Jan., '96).
Nitroglycerin, in doses of I minim of the 1-per-cent. alcoholic solution and in creasing up to 5 minims three times daily, s.uecessfully given to seven pa tients suffering with sciatica. In the acute cases they recovered in from ten days to a month; in the chronic eases they improved notably and gained daily. Only discomforts arising from the use of this drug were congestive headaches and flushing of the face sometimes fol lowing the first dose of the medicine, while in others they did not supervene until the maximum doses were adminis tered. To counteract these effects the bromides may be used. If after a period of administration of ten days no percep tible effects have been obtained, it should be abandoned. Treatment of amemie conditions, diathesis, and local causes must be considered and carried out in conjunction with the special treatment. W. C. Krauss (N. Y. Med. Jour., Feb.
29, '96).
In sciatica deep injections of glycero phosphate of soda recommended very highly. One to two cubic centimetres of a 25-per-cent. solution are to be in jected deeply into the muscle as near as may be to the nerve. Of 63 eases treated in this manner, 41 were cured, 18 ameliorated, while in only 4 was the treatment a failure. Constitutional treatment is not to be neglected when the neuralgia is a symptomatic one. Albert Robin (Bull. G6n. de May 30, '97).
Deep injections of antlpyri»e into the muscle in the region of the sciatic nerve promptly relieves sciatica. A long needle is employed, and the injection made at a point nearly in id way bet ween and a little below a line drawn from the tuberosity of the ischium to the great troehanter, the antipyrine solution being slowly injected at a vertical depth of about half the length of Ilic needle. Kinn (Sem. 316(1., XViii, p. '98).