Text book of veterinary medicine, Volume 3 (of 5)Law, James
Science
Text book of veterinary medicine, Volume 3 (of 5)
Law, James
Veterinary medicine
This is characterized by pain paroxysmal, intermittent or remittent
situated in the course of given nerves. It must be a pure neurosis and
unaccompanied by any specific structural lesion like inflammation,
degeneration, atrophy, hypertrophy, tumor or the like. It is therefore
manifested subjectively and cannot be easily identified in the lower
animals. Nevertheless, Lafosse, Zundel, Genée, and others have recorded
cases, their conclusion being deduced from symptoms which were held to
indicate nervous suffering in the absence of any structural lesion
whatever. _A priori_ one can with difficulty escape the conviction that
neuralgia must exist in the lower animals as in man, and the only
drawback to its recognition is the difficulty of diagnosis.
The first step in such diagnosis must usually be the presence of
lameness, stiffness or indisposition to free movement of some particular
muscle or group of muscles deriving their innervation from a particular
nerve. Or there may be a particular position habitually assumed such as
semi-closed eyelids, drawn back ears, laterally inclined neck which
strongly suggests nervous suffering. Next, there must be the exclusion
of any appreciable structural cause and especially of inflammation. The
three prominent features of the pain of inflammation is that it is
aggravated by pressure, it is heightened by movement, and it is
accompanied by some decided alteration of the function of the part. If
there are at the same time exudation and swelling, inflammation is all
the more certainly indicated. In a neuralgic pain on the contrary
pressure does not increase the pain: it may even alleviate it: movement
of the part may be rather satisfactory to the patient than painful; and
the disturbance of function, contractile, secretory, trophic, is not
perceptible. There is no local exudation nor swelling to account for the
nervous disorder.
The liability to confound the affection with a neuritis more centrally
situated, but the pain of which is referred to the periphery of the
nerve, is to be obviated by a tracing of the nerve along its course to
the nerve centre so as to identify any centre of tenderness, and also by
the implication of all the peripheral branches coming off ectal of that
point.
Again, rheumatism may be easily confounded with neuralgia, but here the
affected nerve and muscle and even the skin over it is liable to be very
tender to the touch or pinch, and if at all acute some hyperthermia is
present. Like rheumatism, neuralgia shows a tendency to shift from place
to place.
Pains due to pressure on the nerves by tumors, aneurisms, and other
swellings, are constant, whereas neuralgic pains are marked by
remissions and aggravations and even by intervals of complete relief.
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