Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
The dose to be employed is an exceedingly important matter, and one as
to which practitioners are still very often injudicious. We ought never
to commence with a larger dose than one-sixth of a grain; but very often
as little as one-twelfth of a grain will give effective relief, and in
not very severe cases it is well worth while to try this smaller
quantity. When no larger quantity than one-sixth of a grain is employed
we commonly observe no narcotic effects, _i. e._, there is no
contraction of pupil, no heavy stupor, and, although the patient very
often falls asleep, on waking he does not experience headache, nor is
his tongue foul. I cannot too strongly express the opinion that it is
advisable by all means to content ourselves with this degree of the
action of hypodermic morphia, unless it fails to produce a decided
impression on the pain. But in very severe cases our small doses will
fail; and then, rather than allow the patient to continue having severe
paroxysms unchecked, we must frankly admit the necessity of using a
narcotic dose from one-quarter to one-half of a grain, according to
circumstances. Whatever actual dose be employed, it is important not to
repeat it with unnecessary frequency; once a day in the milder, and
twice a day in the more severe cases, will be all that is advisable,
save in very exceptional cases: the point being to administer it as
quickly as possible after the commencement of an exacerbation. If by
these means we can prevent the patient having any severe pains during a
period of several days, we often give time to the affected nerve to
recover itself so completely, especially with the aid of other measures
to be presently mentioned, that the tendency to neuralgia is completely
broken through, and we can drop the injections, either at once or by
rapid diminution of the dose, and thereafter treat the case merely with
tonics, and with the precautionary measures to be dwelt upon under the
heading of Prophylaxis. But, if we have been driven to the use of
distinctly narcotic doses, and these do not very speedily break the
chain of neuralgic recurrence, it will not do to continue to rely upon
hypodermic morphia; it will be best to try some of the local remedies
(blistering, galvanism) with it. If this combination fails, we should
then try the effect of atropine, the sulphate of which, hypodermically
injected, fully represents for all useful purposes the mydriatic class
of narcotics.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account