cause[33] of "hyperæsthesia"), as is, in fact, very frequently the case. He also thinks the distinction between paroxysmal and lancinating pains too indefinite to serve as a sufficiently reliable basis of diagnosis, especially considering the endless _nuances_ of the form which the pain is apt to take. I agree with Eulenburg upon this point; and am convinced, from my own observations, that such a distinction as that between lancinating and paroxysmal pains is illusory, [I have taken some pains to investigate the character of the pains, not only in neuralgia, but in locomotor ataxy. It is true that the lancinating character predominates, on the whole, in the latter disease; but there are great differences in different individuals, and even in the same patient at various times, which plainly depend on subjective influences. Compare for instance, Dr. Headlam Greenhow's report on an ataxic patient, with a report on the same man by Dr. Buzzard and myself. ("Trans. Clin. Soc.," vol. i., 1868, pp. 152-162.)] the two kinds being frequently found alternate in the same case. The only useful distinction, in my opinion, is Benedikt's first one: he is probably right in saying that, where such an affection as an inflamed joint forms the source of peripheral irritation that immediately provokes a neuralgia, the pain is apt to be unusually continuous. The extent to which the pain of neuralgia spreads into different termini of the same nerve has been made the basis of distinctions as to the seat of the original mischief. For example, it has been said that pain in the mental branch of the third division of the trigeminus, which does not invade the auriculo-temporal branch, can hardly depend on an irritation operating on the trunk of the inferior dental; it must be distinctly peripheral, or else it must act upon limited portions of the central origin of the fifth nerve. But the fact seems rather to be that, whether the neuralgia was excited by lesions at the periphery, in the nerve-trunk, or in the centre, it is equally possible that either a small or a large part of the peripheral expanse of the nerve may become the seat of the pain: this almost necessarily follows from the entire independence of individual fibres in nerves.