Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
disposition to neuralgia is uncommonly strong.
A sufficiently complete explanation of my theory as to the pathology and
etiology of neuralgia has now been given, although the subject might be
elaborated at far greater length; and I hope it will be apparent to the
reader that the view now advocated is at once important, and also
vouched for by strong evidence. I claim for it that the whole argument
shall be taken together, for it is a case of cumulative proof; every
link must be weighed and tested, before the remarkable strength of the
chain can be felt. And it may fairly be said that, if the proof of a
definite kind of material change in a definite organ, as the essential
factor in neuralgia, has been established upon reasonable grounds, an
important step has been taken toward removing a serious opprobrium and
difficulty in practical medicine. Although the true neuralgias are not
among the most frequent of human diseases, they form a class of enormous
practical importance, for they are sufficiently common to be sure to
occur in considerable numbers in the practice of every medical man, and,
both from the suffering which they inflict, and the rebelliousness which
they often show to treatment, they are among the gravest sources of
anxiety which the practitioner is likely to encounter. There are
probably few disorders which so often occasion mortification and loss of
professional credit to the physician. The helplessness which men, who do
not enjoy special opportunities of seeing those diseases with frequency,
so often show in dealing with them, is largely caused by the extreme
timidity and vagueness with which the standard treatises on medicine
deal with the question of their pathology; and a very unfair advantage
has thus been given to the specialists, who, by the mere force of
opportunity, and continual blind "pegging away" in an entirely empiric
manner, have acquired a certain rude skill in the treatment of these
maladies which enables them to outshine practitioners who often have far
more in them of the veritable _homme instruit_ as regards general
scientific education and habits of mind. It will be evident, as a mere
abstract proposition, that the enunciation of a reasonable pathology of
the disease, and the sweeping away of a mass of unmeaning phrases about
"mysterious functional affections" and the like, must be a distinct gain
to practitioners of plain common-sense and good general knowledge, to
whom neuralgia is merely one of a vast number of different diseases
among which their attention and study are divided. And I hope that, in
the further remarks on Diagnosis, Prognosis, and Treatment, yet to be
made, the value of clear pathological ideas of disease will be brought
more practically and clearly into view. [The reader will find, at the
end of Part I. of this volume, a note which contains a brief discussion
on the "Erschopfung" theory of Jaccoud, and the doctrines of Dr.
Public-domain text, read in full here on John Shaqi.
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