Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
have latterly heard very bad accounts from him; still, there has been
nothing to throw doubt on the neuralgic character of the disease.
In reflecting upon the anatomy of the nervous branches to the dura
mater, I have formed the opinion that there are two situations, one
anterior and the other posterior, in which intracranial neuralgia may
occur; the former at the giving off of Arnold's recurrent branch from
the ophthalmic division, near the sella turcica, the other in the
peripheral twigs of this same branch, distributed to the tentorium
cerebelli.
_Pharyngeal Neuralgia._--A rather common and extremely troublesome form
of neuralgia is that which attacks the pharynx. It is very much more
common in women than in men, and especially in hysterical persons. The
pain commonly commences in a not very acute manner; it may be felt for
some days, or even weeks, as a dull aching, coming and going pretty much
in accordance with the patient's state of fatigue, or of reinvigoration
after meals, etc. Some trivial circumstance, such as a slightly extra
degree of exhaustion, or the influence of some depressing emotion, will
then change the type to that of decided neuralgia, which may become
extremely severe. Nothing is more annoying, and even distressing, than
the suffering itself, besides which there are abnormal sensations in the
throat which almost irresistibly compel the patient to believe that
there are severe inflammation and ulceration, and that the throat is in
danger of being closed up. Although the pain is usually one-sided, it
sometimes affects both sides, and is felt also at the back of the
pharynx. The act of swallowing being painful, there is the greater
suspicion of inflammation or ulceration, but careful observation shows
that a large bolus of food is swallowed with as little, if not less,
pain than a small mouthful of solids or even liquids.
Pharyngeal neuralgia must, I think, be considered mainly an affection of
the glosso-pharyngeal nerve; the evidence for this is found in the
distribution of the pain. A slight degree of the neuralgia will only
involve some one or two points in or behind the tonsil; but, when the
pain is strongly developed, it will be found to radiate into the tongue,
in one direction, and into the neck (following the course of the
carotid) in another, besides spreading well into the region occupied by
the pharyngeal plexus. One disagreeable reflex effect of severe
pharyngeal neuralgia consists in involuntary movements of the muscles of
deglutition, another is seen in the copious outpouring of thick mucus
similar to that which collects in the pharynx and oesophagus when a
foreign substance has become impacted.
Public-domain text, read in full here on John Shaqi.
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