Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
It is undoubtedly very difficult, sometimes, to elicit the truth, even
in cases where we may entertain considerable suspicion that alcoholic
excesses are the real cause of the pains which the patient calls
neuralgic; more especially where the patient is aware that he or she is
taking an amount of alcohol which is seriously damaging to health. And
it is therefore necessary to look out for every possible additional help
to our diagnosis. Besides the cardinal features of the disease--the
insomnia, loss of appetite, foul breath, haggard countenance, and pains
encircling the limbs near the joints rather than running longitudinally
down the extremities there are certain moral characteristics of the
patient that often tells a significant tale. The drinker, especially if
a woman, is shifty, voluble, and full of plausible theories to account
for this and the other phenomenon. It will be well to try the effects of
a somewhat sudden though not uncourteous remark, to the effect that the
diet should be strictly unstimulating. If this be introduced with some
abruptness, in the course of a conversation not apparently leading to
it, the patient's manner will not unfrequently betray the truth; while,
if our suspicions are groundless, we shall also probably perceive that,
in the unconscious, or frankly surprised, expression of the countenance.
We may sometimes derive crowning proof of the existence of alcoholic
excess by cautious questions which at least reveal the fact that the
patient suffers from spectral hallucinations; this is a far commoner
occurrence in chronic alcoholism than is generally supposed; it needs to
be inquired for with great tact, but, when established beyond doubt, and
joined to insomnia and the peculiar foul breath, is of itself sufficient
to establish a positive diagnosis of alcoholic poisoning.
Public-domain text, read in full here on John Shaqi.
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