Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
The view which I am strongly convinced alone explains the beneficial
action of blisters is that which supposes them to act as true stimulants
of nerve-function. In order that this effect shall be produced, it will
be necessary that the skin-irritation be either produced at some
distance from the seat of the greatest pain, or that, if applied in that
spot, it shall be comparatively mild in degree. And accordingly, I have
been led, in my observations to apply the blister at some distance from
the focus of pain. An indifferent point, however, will not do--there
must be an intelligible channel of nervous communication between the
irritated portion of skin and the painful nerve. This object is
accomplished by placing the blister as close as may be to the
intervertebral foramen from which the painful nerve issues; the effect
of this is probably a stimulation of the superficial posterior branches,
which is carried inward to the central nucleus of the nerve. I must say
that the results which I have derived from this plan of treatment have
been far more satisfactory than those which I used to obtain when I
habitually applied the vesication as near as might be to the focus of
peripheral pain; and I think that this result tallies well with the idea
that the essential mischief in neuralgia consists in an enfeebled
vitality of the central end of the posterior root. An exceedingly
interesting confirmation of this idea as to its _modus operandi_ has
been afforded me by the fact that not merely neuralgic pain, but also
trophic and inflammatory complications attending it, have been sensibly
relieved, in several cases that I have seen, by this mode of reflex
stimulation. This has been particularly the case in herpes zoster, where
the process of inflammation and vesiculation has been very promptly
checked by the application of a tolerably powerful blister by the side
of the spine at the proper level; and I am gratified to mention that Dr.
J. K. Spender, of Bath, pointed out this fact[39] at a time when he had
only seen my statement that the pain could be relieved in this way. In
the case of the trigeminus, the same kind of reflex stimulation is most
effectively obtained by applying the blister over the branches of the
cervico-occipital, at the nape of the neck; and it is remarkable what
powerful effects are sometimes thus produced, even in cases that wear
the most unpromising aspect. For example, in the desperate epileptiform
tic of old age, I have more than once seen a complete cessation of
suffering, which lasted for a very long time--so long, in fact, as to
make me hope against hope that it might never return. I do not now
entertain any such expectations from this remedy; still, its value is
very great.
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