On Tic Douloureux, 347 



various forms, has sometimes afforded relief, and preparations 

 containing the metallic tonics, more especially the oxides of 

 iron, have been regarded as giving more permanent and 

 beneficial assistance. Local remedies are of very uncertain 

 utility, and electricity and galvanism have generally done more 

 harm than good. The division of the nerves has been resorted 

 to, but never with permanent, and often not even with tem- 

 porary benefit. The cause of the disease is unknown, and 

 though sometimes organic derangement would appear to 

 excite it, no plausible source of the mischief can usually be 

 discovered. The patient's principal solace is that the disorder 

 frequently wears itself out, and as far as my experience goes^ 

 the less we rely upon individual remedies, the better — the main 

 thing being strict attention to the general health, and especially 

 to the state of the stomach and bowels. These remarks apply 

 to the genuine Tic Douloureux ; but it has of late years been 

 the fashion in physic to give that alarming name to a variety 

 of painful affections, resulting from very various causes, by 

 which much needless uneasiness has been given to the patient, 

 and which has often led to erroneous and even mischievous 

 systems of practical treatment. As cases of this kind are of 

 every day occurrence, a short notice of them can scarcely be 

 inappropriate to a Journal, the chief object of which is to 

 familiarize every branch of science. 



Rheumatic affections of the head and face oflen put on the 

 appearance of Tic ; like it, they come on at short intervals, 

 and are limited to a small space ; there is, generally, more or 

 less of external tenderness, sometimes confined to spots upon 

 the face and scalp, not larger than a shilling ; at others, more 

 diffused. More or less of this is usually attendant upon habits 

 subject to chronic rheumatism, and it not uncommonly is the 

 leading feature of the complaint. The internal use of opiates 

 and sudorifics, especially small doses of Dover's powder, 

 warm fomentations, and keeping the head, especially at 

 night, wrapped up in flannel, are sovereign remedies. 



But the most common cases of painful affections, mistaken 

 for Tic, are those which occur in nervous and irritable persons, 

 and especially amongst men of business, statesmen, lawyers, 

 merchants, over-studious persons, and all whose minds are 



