The Symptoms of Neuralgia

Pain either constant or intermittent; may be continuous with frequent exacerbations; when it occurs in paroxysms is described as darting, tearing, or lancinating, and is often very severe; an attack may last a few minutes, or may continue several days; pain usually follows the course of the nerve, along which small, tender points may be felt on pressure with the end of the finger; pain is generally shifting, changing from one nerve to another; it is usually confined to one side; there is, generally, no fever.

The Causes of Neuralgia

The principal cause of neuralgia is defective nutrition of the nerves. Romberg has very aptly said that pain is "the prayer of a nerve for healthy blood." Disorders of digestion are very often accompanied with neuralgia in various parts of the body. The same is true of anaemia, which, in many cases, also depends upon derangement of the digestion. Neuralgia may also be caused by pressure of a tumor upon a nerve trunk, by the contraction of a cicatrix, or scar, in which the end of a nerve trunk is entangled. In malarial diseases it is often due to malarial poisoning. In cases in which it is due to malaria the paroxysms generally occur at regular intervals. Neuralgia is one of the symptoms of lead poisoning. High living, particularly the excessive use of meat, may be fairly set down as one of the causes of this affection. It may also frequently be the result of taking cold, or exposure to cold, of dissipation, loss of sleep, and especially the use of tobacco, alcohol, and of tea and coffee. In many cases it is connected with rheumatism and gout.

The Treatment of Neuralgia

Improve the patient's general health by a wholesome, simple, and nutritious diet, and the employment of tonic baths, as a daily sponge bath, and massage in feeble cases. The use of electricity by general faradization two or three times a week, sun baths, exercise in the open air, and all other known means, are a matter of first importance in the treatment of this disease. Ordinary neuralgia may almost always be relieved by either moist or dry heat. In some cases, cold applications give more relief than hot. It is impossible to tell, without trial, whether cold or hot will be most effective. In many cases, it is also necessary to give the patient a warm bath of some kind. The Turkish, Russian, hot-air, electro-vapor, and electro-thermal baths are particularly useful in these cases. A blanket pack is also a very excellent remedy which we have used very many times with success. Probably the best of all known means for relieving neuralgia is the use of electricity. It often succeeds when all other remedies fail. The galvanic current is generally the most effective, though sometimes the faradic current acts the best. The positive pole should be applied over the painful part, and the negative pole near by, or on the nerve center from which the affected nerve originates. Sometimes the pain is temporarily aggravated by electricity, but more often it is relieved during the application. It frequently returns, however, so that repeated applications are necessary. The current should be applied from twenty to thirty minutes daily. We have, in several instances, succeeded in curing obstinate cases of neuralgia by hot and cold applications, when other means have been ineffectual Quite prompt relief has been obtained by freezing the skin over the af fected part. This treatment is administered by making a mixture of equal parts of salt and shaved ice, wrapping quickly in a piece of thin muslin, and applying it over the affected part. From three to five minutes is as long a time as is necessary to produce the desired effect. When the disease is evidently the result of malarial poisoning, which is shown by its regularity, the patient may resort to the use of some of the preparations of Peruvian bark in case relief is not obtained otherwise. Opium should be seldom used in this affection, never when its use can be avoided, since so many cases of confirmed opium-eating have originated in the use of the drug for neuralgia. The remedies which have been recommended for this disease are almost innumerable. But few of them are anything more than palliative, and most are worthless even for giving temporary relief. Other methods of treatment will be mentioned in connection with the description of special forms of neuralgia.