Often occurs secondarily to caries Rarely appears before puberty. of internal ear, and purulent discharge the result of scarlet fever, measles, etc., in childhood. Frequently follows a blow or Comparatively seldom caused by injury. blow, or other external injury or caries of bone. No true "points douloureux." If severe, soon presents, in most cases, the "points douloureux." Usually the pain does not Intermissions of pain complete, completely intermit. and of considerable length. Pain often excruciating from a Pain usually not very violent at very early period. first. Pain often limited in situation, Pain superficial; follows seems deep-seated, though, as distribution of recognizable often as not, it has no relation nerve-branches belonging to to the site of the abscess. the trigeminus or the great occipital. No well localized vaso-motor or Usually there are lachrymation, secretory complications. congestion of conjunctiva, or other vaso-motor and secretory complications, such as are described in Chapter III. Very rare in old age; then Severe and intractable neuralgia usually traumatic. is commonest in the degenerative period of life. Relief from stimulant narcotics Relief from opium, etc., is much very transitory. more considerable and permanent.