Peripheral resection of fifth nerve : three cases with microscopic examination of the portions of the nerves removed and report on the later condition of patients / by W.W. Keen and Wm. G. Spiller.

  • Keen, William W. (William Williams), 1837-1932.
Date:
[1900]
Catalogue details

Licence: In copyright

Credit: Peripheral resection of fifth nerve : three cases with microscopic examination of the portions of the nerves removed and report on the later condition of patients / by W.W. Keen and Wm. G. Spiller. 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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    dividing the nerve toward the apex of the orbit. On Jan. 9, 1899, she again reported at Dr. Mitchell’s clinic. She had suffered no pain after the operation, for eleven months, then had a recurrence for two months, accom- panying la grippe. In the last two weeks she had had another recurrence, but the pain was neither severe nor constant. Case 2.—Resection of the infraorbital and inferior dental nerves for tic douloureux after ineffectual treat- ment by massive doses of strychnin. Mrs. M., Princeton, N. J., aged 62, first consulted me Dec. 1, 1898, at the instance of Dr. James H. Wikoff. Twenty years ago she had a very serious hemorrhage from a uterine myoma, and a sister died after a hyster- ectomy for the same trouble. For ten years she had been a great sufferer from hemorrhoids, attended with profuse hemorrhages. She also has a femoral hernia. Ten or fifteen years ago, without assignable cause, a sud- den partial palsy of the left side came on, but yielded to treatment. For some time she has had a slight rise of temperature toward evening, and has been more or less of an invalid. The uterine myoma still persists, but has given her no trouble of late. Three years ago, without assignable cause, she began to have excessive pain in the groove between the nose and right cheek. It has now extended over the whole of the cheek and the lower jaw and also to the ear. The pain is the char- acteristic pain of tic douloureux and is caused by eating, conversation, etc. Desiring, first, to test the effect of strychnin, which in several cases had enabled me to avoid operation, I com- menced with 1/20 gr. t. d., adding one pill to the daily dose, so that the first dav she would take three pills; the second, four; the third, five; etc. When she reached six pills a day, she was to add one pill every other day until she had reached % gr. a day or until the pain had ceased. Up to the time when she was taking 7/20 gr. a day, no relief from the pain had been experienced, nor had any strychnin symptoms developed. Ordinarily I have found these symptoms develop slightly at first, so as to give warning, but in this case the onset was sud- den. Stooping down to pick up something from the floor, her legs were suddenly violently extended and her body was thrown some ten feet across the room. She