Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
will recall the fact that they were often "bilious" in their youth;
which "biliousness" turns out to have been regularly preceded by
one-sided headache, and to have been severe in proportion to the
severity and duration of that previous headache.
I ask the reader to dwell with fixed attention on this fact of the
exclusiveness, or almost exclusiveness, with which the neuralgias of
the anterior part of the head are represented during the period of
bodily development, and especially in the years just succeeding puberty,
by migraine or by clavus. When this fact has thoroughly entered the
mind, we can hardly help joining with it that other and most important
fact already noticed, of the close connection between the predisposition
to migraine and the predisposition to epilepsy, and reflecting further
on the strong tendency which epilepsy likewise shows to infest the
earlier years of sexual life. In view of these things, it is difficult
to avoid the inference that both the epileptic and the neuralgic
affections of this critical period of life are the expression of a
morbid condition of the medulla oblongata, in which the sensory root of
the trigeminus has its origin; and further, that this morbid condition
(tending to explosive and atactic manifestations of nerve-force) must
have its basis in defective nutrition. For, be it remembered, the epoch
of sexual development is one in which an enormous addition is being made
to the expenditure of vital energy; besides the continuous processes of
the growth of the tissues and organs generally, the sexual apparatus,
with its nervous supply, is making by its development heavy demands upon
the nutritive powers of the organism; and, it is scarcely possible but
that portions of the nervous centres, not directly connected with it,
should proportionally suffer in their nutrition, probably through
defective blood-supply. When we add to this the abnormal strain that is
being put on the brain, in many cases, by a forcing plan of mental
education, we shall perceive a source not merely of exhaustive
expenditure of nervous power, but of secondary irritation of centres
like the medulla oblongata, that are probably already somewhat lowered
in power of vital resistance, and proportionably irritable. Let us
suppose, then, that to all these unfavorable conditions there was added
the circumstance that the structure of the medulla oblongata, or of
parts of it, was congenitally weak and imperfect; then surely it would
be scarcely possible for these loci minimæ resistentiæ to escape being
thrown into that state of weak and disorderly commotion which eminently
favors pain in the sensory, and convulsion in the motor apparatus.
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