Poisons introduced into the body from with out may also produce inflammations of nerve. Arsenic and lead and phosphorus do this, as well as others. Alcohol is an extremely common cause, and outbreaks of multiple neuritis have been described among beer-drinkers, due to the presence of arsenic in beer, the arsenic being, quite unknown to the brewers, present in an artificial sugar used in the brewing.
The treatment of a condition, which might be due to any one of so many different causes, must obviously depend upon the unravelling of the cause. It will be sufficient to note here that rest., and, if it be a limb that is mainly involved, protection by enveloping in wool, and elevation on a pillow, with the application of warm poultices or fomentations, are the chief means of treatment. In painful conditions, also, the use of a mixture of antipyrin and bromide of potassium, recommended for fever on p. 512, with the addition of 1 grain citrate of caffein to each dose, will give great relief.
Neuralgia is nerve pain ; and it may affect any nerve, occurring sometimes in the trunk of the nerve, but often being felt in the parts in which the affected nerve ends, even though the cause may be acting on the nerve at its origin. It is liable to produce spots painful to touch over the place where a nerve issues from an opening in a bone, or pierces some tissue, to reach the surface.
The causes are numerous— injury to the nerves, or irritation due to some inflammatory action. For example, neuralgia is often due to the irritation set up by a diseased tooth. Gen eral bad health is a fruitful source of neuralgia. Depressed health, poverty of blood, or altered conditions of the blood, such as are found in rheumatism and gout, and occasioned by mal aria, ought at the very first to be considered in the search for the cause.
Symptoms. — The pain varies in character, being stabbing, tearing, grinding, gnawing, burning, cutting, or tingling, and so on ; and it is often, indeed usually, in paroxysms or darts, being subject, even when continuous, to sudden aggravations of an unbearable sort. During these aggravations the person may be com pletely unmanned. He presses over the painful place with his hands, his face may flush up, and a profuse perspiration break out, and sudden twitchings of muscles may accompany the spasm of pain.
Frequently the pain recurs at certain periods of the day. It is in such cases quinine is likely
to have its best effect.
The treatment of neuralgia consists first of all in removing, if possible, the cause, the source of irritation, in rectifying the condition of health which lays the person open to it. Treat rheumatism, gout, bloodlessness, &c., if any of these exist, in the appropriate way. Nourish ing food, salt-water bathing followed by brisk friction of the skin, exercise, early hours, avoid ance of fatigue overwork and anxiety, regula tion of the bowels, and abstinence from stimu lants and bad habits, in fact, all means that restore a good tone to the bodily system, will aid in overcoming neuralgic affections. Secondly, medicines may be given directly for the disease ; chief of these is quinine, in at least 5 - grain doses, and quinine, combined with iron, arsenic also for adults (3 drops to 6 of Fowler's liquor), or phosphorus in the form of the pill mem ' mended for headache. A combination of the utmost value, specially in neuralgic headache, is 5 grains of quinine, with 20 grains of salicylate of soda, given twice in the twenty - four hours. Other treatment will be mentioned in discussing forms of neuralgia.
Tic Doloureux is neuralgia of the fifth nerve (see p. 151). It occurs on one side of the face, produced, it may be, by a diseased tooth, b3 inflammation in the ear passage, by exposure to cold, by dyspepsia, or other causes. It may affect the whole side of the face, or only parts of the face. When it affects only a certain region of the face, it is usually one of three parts. The fifth nerve has three divisions: one, after pass ing through the orbit, comes out to the surface, under the skin, near the inner end of the eye brow, and spreads over the forehead. When this branch is affected the pain spreads from the spot over the forehead. The second branch comes to the surface just below the lower eye lid, and the pain from it spreads over the cheek and upper lip, the side of the nose, and round the under side of the eye. Neuralgia of these branches is readily accompanied by swell ing of the face about the eyes, redness of the eyelids, and watering of the eyes. The third branch runs in the substance of the lower jaw, supplying the teeth, and comes out of the bone by an opening in the middle line in front.