Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
Neuralgia of the testis (as an independent affection and not a mere
extension of lumbo-abdominal neuralgia) is fortunately a much less
common malady than the corresponding affection of the ovary; as might
indeed be expected, from the much less degree of functional perturbation
to which, in ordinary physiological circumstances, the former organ is
exposed than the latter. Except from actual growths within the testis,
of which it was a mere symptom, I have never seen neuralgia of the
testis save from one of three causes. In one remarkable example it was
produced as a reflex effect of severe herpes preputialis. Secondly, it is
sometimes observed as a symptom of calculus descending the ureter. And,
thirdly, I have seen it several times undoubtedly produced by excessive
self abuse.
The occurrence of testicular neuralgia, in one case of epilepsy, as to
the cause of which I had been previously much puzzled, led to the
discovery of the real origin of the fits. I should observe here that I
do not believe that self-abuse is ever more than an immediately exciting
cause of epilepsy, a predisposition to the disease having previously
existed in all cases. In the patient just referred to, there was a
family history of epilepsy, but it was difficult to explain the exciting
cause until this was suggested by the occurrence of neuralgic pain in
the testicle. The patient relinquished his habit, and both the pain and
the epilepsy ceased, and, for some twelve months during which I had him
under observation, had not recurred at all. A medical friend has
informed me of an instance in which the same habit had produced a
neuralgia of the testis so severe as to strongly tempt the patient to
castrate himself, and he would probably have done so but that he was too
much of a coward with regard to physical pain. The attacks of pain were
so severe as frequently to produce vomiting and the greatest
prostration.
_Hepatic Neuralgia._--It must be allowed that the evidence even for the
existence of neuralgia of the liver is at present in an unsatisfactory
state. At the same time, there are carefully-recorded cases, by
Trousseau and other[7] writers of unquestionable authority, which leave
no doubt in my mind, corroborated as they are by a certain amount of
experience of my own, that such a form of neuralgia really exists. I
must, of course, be understood to refer to something altogether
different from the spasmodic pain which is produced by the difficult
passage of a gall-stone toward the bowel. I have now seen several cases
in which, as it appeared to me, there was sufficient evidence of
neuralgic pain seated in the liver itself, and not dependent either on
gall-stone or any so-called organic diseases of the viscus.
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