Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
CASE III.--H. T., watchmaker's assistant, aged forty-two, suffered for
about three weeks with very severe remittent abdominal pain, entirely
unconnected with dyspepsia, constipation, or diarrhoea. It was
intermittent in character, but observation soon showed that the times at
which it came on were simply those at which the stomach had gone longest
without food, especially the early morning, and that nourishment never
failed to relieve it. The suffering was great, and the man failed
considerably in general health, notwithstanding that his appetite and
digestion were unimpaired. He had only been under my care about ten days
when he presented himself one day at the hospital, and stated that the
pains in the stomach had entirely left him, but that he suffered the
most frightful pains in and around the right eye. I found a well-marked
conjunctival congestion and lachrymation, but there were as yet no
tender points; the neuralgia was felt most severely in the globe of the
eye and in one tolerably straight line, darting up toward the vertex
from the brow. The iris seemed clear and free, and the cornea was not
cloudy. I gave the man a subcutaneous injection of one-sixth grain
acetate of morphia, for present ease, and ordered him muriate of iron
and small doses of strychnia three times a day. When he next appeared,
four days later, I was alarmed to perceive that unmistakable iritis had
fully developed itself, the iris was already turbid and discolored and
the pupil irregular, from a serious amount of adhesions. By this time
there were fully-developed tender points, supra-orbital and parietal;
besides this, pressure on the globe caused paroxysms of pain, in all the
branches of the ophthalmic division, but there was not much spontaneous
pain. I dropped atropine in the eye, applied blistering fluid to the
back of the neck, [the nape of the neck is the point most suitable for
blistering which is intended to affect the eye, and the ophthalmic
division of the fifth, generally,] and desired the man to come to see me
at my own house next day, intending to take him to an ophthalmic
surgeon. Unfortunately he failed to do this, and three days later, when
he came to see me at the hospital, the cornea was studded with
opacities, the pupil was almost closed with effused lymph, there was
violent ocular pain, and a great and increasing sense of tension. I
begged him to go without loss of time to the Eye Hospital, as my own
ophthalmic colleague was not at Westminster that day; and I have never
heard any more of the patient.
Public-domain text, read in full here on John Shaqi.
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