Class I. 2. 4. 12. OF IRRITATION. 1:7 



his life is thus miferable to himfelf, and uncomfortable for his 

 friends to witnefs. 



I. write this to you to beg that you will acquaint Mr. Bof- 

 worth, whether you think you could divide by incifion the dif- 

 eafed nerve ; as he is willing to undergo fuch an operation, i£ 

 you think it practicable, as I believe it to be the only means, 

 which promiies to cure him ; and have therefore adviied him 

 again to apply to you ; and if you think this can be done with 

 effect, he defigns to wait on you in London. 



I am, fir, &c. 



E. Darwin. 



The following anfwer of Mr. Leigh Thomas (hews the difeafe 

 to have exifted in every branch of the affected nerve. 



Sir, L.e'icefler-fquare> May y 1799. 



About the middle of December laft, you did Mr. Cruikihanfc 

 the favour to write him an account of Mr. Bofworth, a young 

 gentleman, fome time under your care at Derby, with a painful 

 affection of the nerves of his face. The patient foon after ca-me 

 to town in a much worfe ftate, than you defcribed him to be at 

 that time; as the pain was extremely acute and almoft unremit- 

 ting, opiates, which he had been in the habit of taking occafion-i 

 ally, afforded him now little or no relief, though taken to the 

 quantity of fix tea-fpoonfuls of laudanum at a time. After pay- 

 ing every attention to the cafe, your fuggeftion of the neceffity 

 of dividing the difeaied nerve appeared obvious. 



As the pain was felt more acute in the left ah of the nofe, and 

 the upper lip of the fame fide, we were induced to divide the 

 fecond branch of the fifth pair of nerves, as it paffes out at the in- 

 fraorbital foramen. He was inftantly relieved in the nofe and 

 lip \ but towards night the pain from the eye to the crown of 

 the head became more acute than ever. Two days after, we 

 were obliged to cut through the firft branch pafling out at the 

 fupra-orbital foramen ; this afforded him the like relief with the 

 firft. On the fame day the pain attacked, with great violence, 

 the lower lip on the left fide, and the chin ; this circumftance 

 induced the neceffity of dividing the third branch palfing out at 

 the foramen mentale. During the whole period, from the firft 

 divifion of the nerves, he had frequent attacks of pain on the 

 fide of the tongue ; thefe however difappeared on divifion of the 

 laft nerve. 



Mr. Cruikfhank performed the above operations, but being 

 particularly engaged at this time with lectures and other bufi- 

 nefs, he now gave up the cafe to my management. The patient 

 was evidently bettered by each operation > ftill the pain was very 



fevere, 



