NEURALGIA, a word of modern origin (derived from rei]por, a " nerve," and" pain " ), first employed by Chaussier to designate a certain class of Aiseases of which the characteristic symptom is a most acute pain following the course of a nerve in one or more of its ramifications, subject to paroxysms and intermissions, in most cases unattended by either heat, redness, or swelling, and often without any apparent lesion at alL Although from the nature and causes of the affection we have every reason to believe that neuralgia must have existed in all ages, still (historically speaking) it may be called a modern disease, as the first distinct description of it that we possess is that published by Andrd, a surgeon of Versailles, in 1750, in his Observ. Prat. stir les Maladies de l'Urethre.' He, however, bad only met with one species, namely, Neuralf,ia Paciei, which ho called " tic douloureux," • a name which, in popular language, it still retains; but since his time the same disease (subject only to certain local modifications) has been observed in various other parts of the body, and it is probable that every sensatienary nerve is liable to the same morbid condition. Chausaier has enumerated nine species (of which the- three first are merely varieties of the neuralgia faciei), namely : 1. Neuralgia frontalis, which is seated in the frontal division of the first or ophthalmic branch of the fifth pair of cerebral nerves. The pain begins at the supra orbital foramen, and extends to the forehead, the upper eyelid, the eyebrow, the atruncuLs lachrymalis, the inner canthun of the eye, and sometimes to the whole of that side of the face. 2. Neuralgia sub or/lite/is, which occupies the superior maxillary nerve, or second division of the fifth pair. The pain begins at the infra-orbital foramen, and extends to the check, the upper lip, the she nasi, the lower eye lid, and the teeth of the upper jaw. 3. Neuralgia maxillaris, which is seated in the inferior maxillary nerve, or third division of the fifth pair. The pain commences at the mental foramen, and either extends to the chin and lip, or else to the teeth of the lower jaw, the tongue, and the temple. 4. Neuralgia I lio-serotalis, which occupies the ilio-scrotal nerve, or external division of the musculo-cutancons branches given off by the lumbar plexus, and derived from the first lumber nerve. The pain commences at the crista ilii, follows the spermatic cord, and extends to the scrotum and the testicle. 5. Neuralgia femoro-poplitealis, which is seated in the great sciatic nerve. The pain begins over the
sacrum, or about the great trochanter, follows the course of the nerve down the posterior part of the thigh to the popliteal space, and thence extends along the peroneal nerve, or external division of the great sciatic, to the outside of the foot. C. Neuralgia which occupies the crural nerve, given off by the lumbar plexus, and derived from the second, third, and fourth lumbar nerve& The pain commences at the erural arch, extends along the anterior and internal part of the thigh, and sometimes follows the 'course of the internal saphenous nerve, one of the deep-seated branches of the crural, to the inner ankle and the dorsum of the foot. 7. Neuralgia planlaris, which is seated in the external and internal plantar branches of the posterior tibial nerve, or internal division of the great sciatic. The pain begins at the heel, shoots across the sole of the foot, cud extends sometimes up the calf of the leg towards the knee. 8. Neuralgia culato-digaalis, which occupies the uln:ae nerve, given off by the brachial plexus, and derived front the fifth, sixth, seventh, and eighth cervical nerves. The pain sometimes commences at the upper part of the arm, and follows the course of the nerve along the ulnar border of the fore-arm to its termination in the inside of the middle, the ring, and the little fingers ; sometimes only part of the nerve is affected, and the pain is confine] to the humerus, or commences at the elbow. 9. " Nerralgics Anennales doulenrs ordinairement chroniques, dont le siege vatic h l'infini." Several of those have been particularly described, and constitute so many additional distinct species :-1. Otaigia (described by M. hard), which is seated in the cords tympani, a portion of the vidian nerve, or posterior branch of Meckere ganglion and which is characterised by an acute pain following the course of this nerve. 2. Neuralgia cerriealis is of rare occurrence : M. Bosquillou has observed two cases after opening the external jugular vein, in consequence of wounding the superficial branches of the cervical plexus formed by the anterior branches of the second, third, and fourth cervical nerves; and 31. Jolly has met with another after the application of leeches to the side of the neck. 3. Neuralgia intercostalis (first described by Siehold, and afterwards by Corvisart) occupies either a portion or the whole of one of the intercostal nerves, generally in the lower part of the thorax.