1 1 8 DISEASES Class I. 2. 4. 1 1: 



fevere, paffing from the ear under the zygoma towards the nofe 

 and mouth, and upwards round the orbit. This route proved 

 pretty clearly, that the portio dura of the auditory nerve was al- 

 fo affected \ at lea II the uppermoft branch of the pes anferinus. 

 Before I proceeded to divide this, I was willing to try the effect of 

 arlenic internally, and he took it in fufficient quantity to excite 

 naufea and vertigo, but without perceiving any good effect. 



I could now truft only to the knife to alleviate his raifery, as 

 the pain round the orbit was become mod violent ; and therefore 

 intercepted the nerve by an incifion acrofs the fide of the nofe, 

 and alio made fome fmailer incifions about the ala nafi. To di- 

 vide the great branch lying below the zygomatic procefs, I found 

 it neceffary to pafs the fcalpel through the maffeter mufcle, till 

 it came in contact with the jaw-bone, and then to cut upwards \ 

 this relieved him as ufual. Then the lower branch was affect- 

 ed, and alio divided : then the middle branch running under the 

 parotid gland. In cutting this, the gland was confequently di- 

 vided into two equal parts, and healed tolerably well after a co- 

 pious difcharge of faliva for feveral days. 



I hoped and expected; that this laft operation would have ter- 

 minated his fufferings and my difficulties -, but the pain (till af- 

 fected the lower lip and fide of the nofe, and upon coughing, or 

 fwallowing, his mifery was dreadful. This pain Could only arife 

 from branches from the fecond of the fifth pair palling into the 

 cheek, and lying between the pterygoideus internus mufele, and 

 the upper part of the lower jaw. The fituation of this nerve 

 rendered the operation hazardous, but after fome attempts it 

 was accompliihed, and this day he fet out for Leicefterfhire per- 

 fectly reftorcd. 



I am, fir, Sec. 



Leigh Thomas. 



Since I wrote the above, I have feen an equally deplorable and 

 inflructive cafe, of hemicrania idiopathica, of an elderly perfon, 

 defcribed by Dr. Haighton, under the name of tic douloureux, 

 with an equally fuccefsful cure, by dividing the difeafed nerves. 

 Medical Records and Refearches. Cox, London. 



Two cafes of tic douloureux are related by a Dr. Watfon, in 

 the Recueil periodique de Medecine, Paris, 1798, torn. IV. 

 which are laid to have fubmitted to mercurial frictions and warm 

 bathing. Thefe pains were probably venereal fymptoms, as the 

 author fufpects ; but would perfuade us again to try the ufe of 

 mercury, though it failed in the cafe above related, and efpecially 

 as it fometimes fucceeds in the hemicrania fympathetica, as men- 

 tioned in Clafs IV. 2. 2. 8. Five grains of the powdered leaf of 



belladonna 



