This disease is often called sciatica, neuralgia, sciatic rheumatism, and sciatic inflammation. It is neuritis of the sciatic nerve. It is not impossible to have a functional derangement of the nerve, due to pressure, cold, or injury; but where the pain is pronounced it is inflammatory or a true neuritis.

Pressure on the nerve is the commonest cause. Frequently people will select as a writing-chair one that presses upon some point of the sciatic nerve. Where this is true there is no hope of getting rid of the disease, after it is once established, so long as that particular chair is used. Those who use office chairs or writing-chairs should select one that will pitch forward, so that when the feet are on the floor the knees and legs will be sufficiently elevated to avoid pressure on the back of the leg by the edge of the chair. No one should use a chair that presses on any one particular point of the back of the leg more than on another. Workmen who use lathes, and are compelled to spend many hours in treading a lathe, are very liable to develop this disease. The class of people more inclined to develop sciatica than others are those who are sensual in their natures. As a rule, men have been alcohol, tobacco, coffee, and tea habitues; and where the nervous energies have been drawn upon heavily because of excessive venery, such subjects will be hard to cure, when the disease is once established. Persistence, however, in a correct life will bring a permanent cure.

Physicians should be on their guard in diagnosing a given case of pain in the region of the sciatic nerve as sciatica. In fact, such a diagnosis should not be made until a thorough examination has proved that there are no such derangements as urethral stricture, irritable prostate, stricture of the rectum; or, in women, metritis, ovaritis, displaced womb, or some derangement of the reproductive organs, sufficient to account for the reflex irritation.

Symptoms

The pain is almost constant, and of a character that wears the patient out. There is nothing that will cause one to feel so hopeless as weeks of suffering from this disease. The pain is not so acute as it is tormenting and continuous. It may extend from the spine to the footeven to the toes. The posterior of the thigh, so to speak, is probably a point that is more troublesome than any other in the course of the nerve, because of its being injured more than any other point from sitting on chairs, benches, etc. Keeping absolutely quiet gives the patient the most comfort. A very short walk will often throw him into great distress. The tendency is for the patient to walk on his toes, which relieves the tension. Where the disease has lasted for months and years, off and on, there is more or less perishing-away of the muscles of the leg. Herpes may develop. When it does, it is very intractable.

Treatment

First prove whether it is neuritis or a reflex pain. If reflex, of course the disease from which the reflection is made must be corrected. A true sciatica must be taken care of about as follows: The patient should be put to bed, and given a hot bath as often as necessary to bring full relief. If necessary for him to take a thirty- to forty-minute hot bath every three hours, this can be done. Absolutely no food should be given until comfortable--a pint of hot water every three hours. When comfortable give a little fruit--something that is not too acid, on the order of pears, cantaloupe, or any other sweet fruits. The bowels may be cleared out by enema, The patient can use what water is desired while going without food. When eating begins, water-drinking may end.

Prunes, onions, and spinach should be in the daily menus, because of their laxative influence on the bowels.

A general rubbing-down twice a day, with a coarse towel or flesh brush or friction mittens, should be given the sciatic patient.

Many things have been resorted to in the line of drugs--deep injections of chloroform, alcohol, or ether; nerve-stretching, cauterization, etc.; all of which I know to my perfect satisfaction are worthless. The more the patient is abused by such remedies, the longer he will stay sick.