Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
The most common seat of cervico-brachial neuralgia has been, in my
experience, the ulnar nerve, the superior and inferior points above
mentioned being the foci of greatest intensity; an axillary point has
also been developed in one or two cases which I have seen. Rarely,
however, does the neuralgia remain limited to the ulnar nerve; in the
majority of cases it soon spreads to other nerves which emanate from the
brachial plexus. A very common seat of neuralgia is also the shoulder,
the affected nerves being the cutaneous branches of the circumflex. I am
inclined to think, also, that affections of the musculo-spiral, and of
the radial near the wrist, are rather common, and have found them very
obstinate and difficult to deal with. One case has recently been under
my care in which the foci of greatest intensity of the pain were an
external humeral and a radial point; but besides these there was an
exquisitely painful scapular point. In another case the pain commenced
in an external humeral and a radial point, but subsequently the shoulder
branches of the circumflex became involved. A most plentiful crop of
herpes was an intercurrent phenomenon in this case, or rather, was
plainly dependent on the same cause which produced the neuralgia.
Median cephalic neuralgia is an affection which used to be comparatively
common in the days when phlebotomy was in fashion, the nerves being
occasionally wounded in the operation. I have only seen it in connection
with this cause, that is to say, as an independent affection. One such
case has been under my care. But a slight degree of it is not uncommon,
as a secondary symptom, in neuralgia affecting other nerves. The
traumatic form is excessively obstinate and intractable.
In the neuralgias of the arm we begin to recognize the etiological
characteristic which distinguishes most of the neuralgic affections of
the limbs, namely, the frequency with which they are aggravated, and
especially with which they are kept up and revived when apparently dying
out, the muscular movements. In the case above referred to, of neuralgia
of the subscapular, musculo-spiral (cutaneous branches), and radial, the
act of playing on the piano for half an hour immediately revived the
pains, in their fullest force, when convalescence had apparently been
almost established.
Public-domain text, read in full here on John Shaqi.
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