Medical and surgical monographs / by Andral [and others] with occasional comments by the editor of the library and others.

Date:
1838
Catalogue details

Licence: Public Domain Mark

Credit: Medical and surgical monographs / by Andral [and others] with occasional comments by the editor of the library and others. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    leads to an important rule of practice; but in other cases, as far as my own experience has yet gone, it teaches us but httle as to the origin of the disease, or the remedies by which it is to be cured. What I am now about to mention renders it probable that the kind of pain depends (at the least) as much on the particular structure of the part to which it is referred, as on the particular cause which produces it. It has been stated, by Sir Henry Halford, that the tic douloureux in the face arises from the irritation of the nerves, occasioned by a portion of dead or carious bone, and I have no doubt that it is so in some instances. I have seen one, if not two cases, which confirm Sir Henry Halford's observation. But I also can entertain no doubt that it may arise from other causes. In one case, which I saw with Mr. Green and Mr. Freeman, the existence of epileptic fits, a ptosis of one eyelid, and some other symptoms, led us to believe that the pain in the face was the con- sequence of some disease in the brain. The patient died, and the appearances on dissection afforded ample proof of the correctness of the opinion which we had been led to form during the patient's life-time. In other instances it appears to be merely the conse- quence of a disordered condition of the digestive organs. But I am not aware that in these different cases there is any essential difference in the symptoms of the disease, or that it is possible for us, judging merely from the kind of pain, to pronounce that it arises from this or that cause, or that it is to be cured by this or that remedy. Although there is no part of the body which may not, at one time or another, be the seat of these nervous affections, it would appear that some parts are more liable to them than others. They are met with less frequently in the viscera, which are supplied by the great sympathetic nerves, than in other parts. Nervous pains are more severe, and perhaps, on the whole, more common, in those parts which receive their nerves from the fifth pair—as the face, the eye, the tongue—than in any other individual part. Muscular spasms are common in the muscles of the neck, especially in the sterno-cleido-mastoideus. I am inclined to believe, also, that they occur more frequently in the upper limb than in the lower. It is not uncommon to see one hand and arm in a state of constant tremulous motion, there being no other indication of disease. I have seen several cases in which a muscular spasm of the upper limb has shown itself in the following manner. The patient ex- periences no inconvenience from it until he uses the limb; for example, until he sits down to write. Then, when he has gone so far as to have written a few letters, some of the muscles act invo- luntarily, and jerk the hand in a direction contrary to that which was intended ; so that, instead of completing the word which was begun, the pen makes a long scratch on the paper. A lady complained of pain in the head, and her mouth was drawn to one side; and hence she was supposed to sutler from paralysis of the muscles of one side of the lace. However, when I was consulted respecting her, I observed that there were nearly