Two cases of neurectomy for severe neuralgia / by F.T. Paul.

  • Paul, F. T. (Frank Thomas), 1851-1941.
Date:
[1891]
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of neurectomy for severe neuralgia / by F.T. Paul. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    glass of whisky and water at bedtime occasionally induced some sleep. The pain was scorching, almost like a lightning stroke, much aggravated by moving of the jaw, swallowing, and at times the mere touch of a hair of the beard caused the most acute pain.” When I first saw this gentlemen he had for some time past been suffering such intense agony that it had been impossible for him to attend to business. Food caused so much pain on touching the gums, that he could scarcely be induced to take his meals, though all nourishment was given liquid, and even the movement of his jaws in talking started paroxysms, so that he would frequently have to write his replies to my questions. At this time the pain was most severe over the left upper jaw, especially the gums. The attacks presented the usual char- acters of flushing of the part, lachrymation, and muscular con- traction, though not of a marked spasmodic kind. We decided, as a preliminary operation, to have his remaining teeth ex- tracted, which was accordingly done very carefully under chloro- form by Mr Royston. The teeth were all sound externally; but on cracking them open, minute odontomes were found in the pulp cavity of several. This ojDeration gave unfortunately no relief. I next, with the assistance of Drs Hawkes and J. D. Hayward, cut down upon and excised the infra-orbital nerve after violently stretching it. For three days the patient suf- fered worse than ever; then relief came, and he was for months entirely free from severe neuralgic pain. He returned to his business, and was able to enjoy life; but gradually sensations of the old trouble in the left side of the lower jaw, which was really one of the earliest parts affected, warned him that his cure was only partial. Fearing lest this pain would shortly assume the terrible character of his past experience, he asked us at once to deal with the nerve of the lower jaw in the same manner as the upper. Accordingly, late in the autumn I trephined the left ramus of the jaw over the inferior dental foramen, and excised half an inch of the nerve without previously stretching it. This was