Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
The second variety of sciatica occurs for the most part in middle-aged
or old persons who have long been subject to excessive muscular
exertion, or have been much exposed to damp and cold, or who have been
subject to the combined influence of both these kinds of evil influence.
One must also include, I think, in this group a considerable number of
cases where the age is not so advanced, but the patient has been
obliged, by the nature of his business, to maintain the sitting posture
daily, for hours together, exercising pressure on the nerve; this is
especially liable to happen in these persons.
The sufferers from this variety of sciatica are mostly, as already said,
of middle age or more; but this statement must be understood to be made
in the comparative sense, which refers rather to the vital status of the
individual than to the mere lapse of years. Many of these people have
hair which is prematurely gray, and in some the existence of rigid
arteries, together with arcus senilis, completes the picture of organic
involution, or senile degeneration. In particular cases, where
depressing influences have been at work for a long time, or unusually
active, these appearances rectify the false impression we should
otherwise derive from learning the mere nominal age of the person; this
is especially often the case with regard to patients who have for a long
time drunk to excess. The prematurely and permanently gray hair (it will
be seen hereafter that permanency of grayness is an important point),
together with well-marked inelasticity of arteries, very often tells a
tale which is most useful in informing us, not only of the vital status
of the patient, but of the kind of sciatica under which he labors; and
also influences our prognosis seriously. There is otherwise a somewhat
deceptive air about the appearance of many of these degenerative cases;
for instance, a ruddy complexion is not uncommon, nor the retention of
considerable, or even great, muscular strength. It is probable that
these appearances deceived Valleix and many others, or they could hardly
have failed, as they have, to observe the frequency of the degenerative
type among the most numerous group of sciatic patients, namely, those
between thirty and fifty years of age. These persons are not truly
"robust," although at a hasty glance they might at first seem to be so.
It would be a serious mistake to omit the search for the important vital
evidences which have been referred to, since these therapeutic and
prognostic indications are of the highest value.
Public-domain text, read in full here on John Shaqi.
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