Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
It is a marked peculiarity of hypochondriasis that it is far more common
in men than in women; a relation which is precisely the opposite to that
which rules in neuralgia. Hypochondriasis is also pre-eminently a
disease of adult middle life; it is scarcely ever seen in youth, except
as the result of excessive masturbation acting on a temperament
hereditarily predisposed to insanity.
The results of treatment frequently assist our diagnosis in difficult
cases. Almost any medicine will relieve the pains of the hypochondriac
for a time, and it is generally far easier to do him good, temporarily,
than it is to relieve a neuralgic patient; but, _en revanche_, every
remedy is apt to lose its affect after a little while. The only chance
of producing permanent benefit in hypochondriasis is by the judicious
combination of remedies that remove symptoms (especially dyspepsia,
flatulence, etc.), which mischievously engage the patient's mind, with
general tonics, and, above all, which such alterations in the patient's
habits of daily life as take him out of himself and compel him to
interest himself in the affairs of the world around him. And, after all,
our best efforts will frequently lead to nothing but disappointment.
It is notoriously the fact that hypochondriasis especially affects the
rich and idle classes; but it would be a great mistake to suppose that
it never attacks the poor or the hard-worked: only, in the latter
instances, it apparently needs, for it development, the existence of
strong family tendencies to neurotic disease, and especially to
insanity. Among the numerous debilitated persons who attend the
out-patient rooms of our hospitals we every now and then encounter as
typical a case of hypochondriasis as could be found even among the rich
and gloomy old bachelors who haunt some of our London clubs. I have one
such patient under my care now, who has been a repeated visitor at the
Westminster Hospital during many years: he has had pseudo-neuralgic
pains nearly everywhere at different times; but his most complaint has
been of pain in the groin and scrotum of the right side. The existence
of what seemed, at first, like the tender points of lumbo-abdominal
neuralgia, at one time led me to believe it was a case of that
affection; but I was soon undeceived by finding that the tenderness did
not remain constant to the same points, but shifted about. This man has
professed, by turns, to derive benefit from nearly all the drugs in the
Pharmacopoeia; but the only remedies that have done him good, for
more than a day or two at a time, have been valerian and assafoetida,
with the prolonged use of cod-liver oil. He will never be really cured;
and I suspect that the secret of his maladies is an inveterate habit of
masturbation acting on a nervous system hereditarily predisposed to
hypochondriasis.
Public-domain text, read in full here on John Shaqi.
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