This title was formerly applied only to nervous pains in the face and head, but is now used to designate nervous pains in any part of the body. The pain is of every possible degree and variety of character; but is generally severe, and more or less darting and lancinating. It is sometimes described as piercing, tearing, screwing, pulsating, aching, burning, tingling, etc. Sometimes it attacks a single tooth; comes on suddenly like an electric shock; as suddenly ceases, and as suddenly returns; sometimes in the same tooth, at others, on the opposite side of the jaw. The pain may either be confined to the course of a single nerve and its branches, or it may be spread without reference to such limits, and sometimes it darts rapidly from one point to another, between which there is no immediate nervous communication.

In some instances there is extreme tenderness of the part; but more frequently strong pressure, instead of being painful, affords relief, and sometimes, in these very cases, a slight touch,' or the flapping of a handkerchief will bring on a violent attack; while sometimes gentle friction will give relief, where strong pressure could not be borne. With the pain there is frequently spasmodic twitching of the neighbouring muscles, and sometimes strong spasm. The head is more frequently the seat of neuralgia than any other part of the body. In the scalp it may be confined to one limited spot, or it may extend over half its surface. In the latter case, it is denominated hemicrania. The affection which goes by that name is sometimes connected with the stomach, as one of the forms of sick headache; but it is often, and perhaps more frequently, nothing more than neuralgia of the scalp. When of this character it is exceedingly painful, and sometimes of considerable duration. In the face, the disease in its most violent forms has been called Tic Douloureux. It may effect certain regions of the face in particular; as the neighbourhood of the eye, the temples, the cheek, lips, and nose and the jaws. It is not unfre-quent in and about the eye, producing redness of the lids and of the eyeball, swelling of the external parts, and a flow of tears. Sometimes the eyeball is particularly affected, and there is excessive sensibility, so that the least ray of light produces exquisite pain. This painful sensibility of the eye may be acute and temporary, or chronic; and, in the latter case, sometimes continues for many years. Neuralgia may attack any part of the body. Persons who have had limbs amputated are very liable to suffer from neuralgic pains at the end of the stump. In the female breast the pain is sometimes very violent. The causes of neuralgia are various: sometimes it originates from a disordered state of the digestive organs; sometimes from an exposure to alternations of heat and cold; and sometimes from extreme sensitiveness, or from loss of tone in the nerves affected. Very obstinate cases of neuralgia have sometimes been traced to tumours or other disease within the cranium. Neuralgic pains of the trunk and extremities often originate in a morbid state of the spinal column. Of the exciting causes, the most frequent is probably cold, or cold and wet conjoined; but the transition to a hot room after being for some time exposed to the cold, is still more likely to bring on an attack. Sometimes a removal from a low damp neighbourhood, to one that is higher and drier, (even if it is colder), will completely cure a bad attack of neuralgia. Fatigue, strong mental emotion, excesses at the table, intemperate drinking, the abuse of tea, coffee, and tobacco, the driving in of gout, and rheumatism, and the striking in of cutaneous eruptions, are exciting causes.

Neuralgia is strictly functional or nervous. Some practitioners are inclined to consider it the result of inflammation of the nervous tissue; but, in most cases, there is no symptom of inflammation, and the mode of attack, the intermittent character of the pain, its occurrence especially in states of debility, the frequent want of tenderness on pressure, the absence of fever, and the fact that it is often aggravated by depletion, and cured by tonics and stimulants, are sufficient evidence that it is not inflammatory.

Treatment

In order to cure neuralgia we must endeavour, if possible, to ascertain the cause. If the disease arise from a disordered state of the digestive organs, we must endeavour to restore them to a healthy state. To do this, we had better give at first a tolerably active purgative of salts and senna; following it up with two of the pills, No. 4, every night at bedtime, and two tablespoon-fuls of the tonic mixture, No. 11, three times a day. Sometimes when the patient has been worried with business, or domestic affairs, together with an exposure to heat and cold, there will be a loss of tone which can be quickly restored by sedatives and stimulants. A farmer's wife who had been suffering from neuralgia in the teeth for some time, came to me one evening, saying she was half crazy, and wanting me to take out two of her teeth. I reasoned with her, shewed her that it would be a waste of teeth to no purpose, gave her a small dose of morphia, and another dose to take at bedtime. I told her before she started for home, (she had three or four miles to drive), to get a good stiff glass of hot grog; that I thought it would do her good. When I saw her, three days afterwards, she told me she took the grog, and before she got half way home the pain left her, and she had not had a return of it. When the pains are of an intermittent character, as they frequently are, quinine combined with iron will be found beneficial; the patient, if an adult, may take five grains of the citrate of iron and quinine three times a day, the bowels being kept regulated with the pills, No. 5. Where the patient is disturbed at night, a pill of five grains of extract of Henbane, may be taken at bedtime, or live grains of Henbane, and three grains of Camphor, made into two pills. Sometimes the application of flannels wrung out in hot water to the seat of pain, and sometimes cold bathing will be of service. Considerable benefit has been obtained from bathing the spine every day with flannels wrung out in hot water, and in other cases considerable relief has been obtained from the application of a waterproof bag filled with pounded ice along the course of the spine. Among modern remedies for Neuralgia, none seem so beneficial as the Bromides of Potash and Ammonia; they may be taken for a week each, alternately, in doses of ten grains three times a day, in half a wineglassful of water; the last dose to be taken half an hour before bedtime. The dose may be gradually increased by adding an extra grain to each dose.

The diet in Neuralgia should be light and nourishing, consisting of mutton, poultry, light puddings and things of that kind; with well fermented strong beer, or good wine. The patient should always wear flannel next the skin, keep the feet warm, and avoid exposures to extremes of heat and cold. In Neuralgia of the head and face, putting the feet in hot water will sometimes give relief.