Clinical observations on functional nervous disorders.

  • Jones, C. Handfield (Charles Handfield), 1819-1890.
Date:
1864
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Licence: Public Domain Mark

Credit: Clinical observations on functional nervous disorders. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    empirical habit of applying sedative remedies as near as possible to the seat (apparent) of pain. But, of course, we cannot affirm in any case of pain involving the trunk of a nerve that the morbid action may not be central: the law of eccentric phenomena holds true so far as that central disorder may certainly give rise to peripheral sensation. The only certain means of dis- tinguishing the site of the pain causing action is division of the affected nerve. If this arrests the neuralgia, we know the disorder is seated peripherally; if it fail to do so, we know that we have to seek more centrally. In a very large number of cases, I fear, it must remain problematical where the real seat of the disorder is. If—the pain being specially referred to some inter- mediate spot—injection of opium subcutaneously at that part should give decidedly more relief than the same dose at a distance, it would afford ground for believing that the cause of the neuralgia was localized in that spot. In the ordinary way of rubbing sedative lini- ments on the cutaneous surface covering the seat of pain, we have no means whatever of proving a local action on the suffering nerve, but rather the reverse. For take the case of the sciatic, where pain is acutely felt at the back of the thigh, and notably between the ischiatic tuberosity and the great trochanter: if this be relieved by sedative applications to the covering tegument, we are sure that the chief action of the remedy must be on cutaneous ramifications of the gluteal, lesser sciatic, and branches of the external cutaneous and other nerves on the front of the leg. These will convey impressions to the spinal centre not far from the part where the roots of the sciatic are implanted; so that if the neuralgia were of central origin, it is very conceivable that the morbid action