NEURALGIA IN THE FINGER. 61 
could be. ‘The appearance was certainly very remarkable ; for on 
one hand the nails were, as I have just said, as short as they could 
be ; and on the other hand, though they were not so Jong as they 
might be, yet they were of very great length. I believe whenever 
he had a very violent attack of pain, the nails of the affected hand 
became discoloured, and remained so for some time. — 
T ecould detect no cause for this at all. I could connect it with 
no obvious morbid state, and therefore, what produced the pain I 
could not tell. I could only say there was a pain, and that the pain 
was clearly situated in the nerves—following the course of nerves, 
affecting other parts also exactly in the situation of branches of 
known nerves, and having the usual character of pain of the nerves, 
or at least, what it very frequently is, stabbing and plunging. 
There was no heat or inflammation of the fingers ; nothing what- 
ever to beseen ; but yet there was agonising pain, and the slightest 
touch aggravated the pain when present, or brought it on at a mo- 
ment when he scarcely felt any. | 
“ Treatment.—One of the best remedies in this disease, but by 
no means a specific, and by no means so successful I think as in 
some other nervous complaints, is carbonate of iron. Its efficacy 
in this disease, so far as 1 know, was first pointed out by Mr. Hutch- 
inson, a surgeon in the country, who, I believe, is now dead. * * 
‘This man’s complaint having lasted two years, and carbonate 
of iron being an innocent remedy, provided you keep the bowels 
regularly open, he took half an ounce three times a day ; and when 
he had taken that for five days without any benefit whatever, he 
took the same quantity every four hours. 
“ Now this did him a certain degree of good. He was better. 
Still he had pain sufficient to keep him awake at night ; and I gave 
him, in addition, a quarter of a grain of muriate of morphia. The 
benefit was but temporary ; and I applied to the finger a solution 
of the cyanuret of potassium, which has been so much praised by 
the French. But it did not relieve him materially, and the solution 
was then made stronger than the French have recommended it. It 
was carried as far as twenty-four grains to an ounce of water. After 
a time it was suggested, that it was merely the cold which did him 
good, and I applied ether, to see if that would relieve him, and it 
did so, much more than the solution of cyanuret of potassium had 
done. Still, however, he was very little better. The amend- 
ment which he at first experienced on taking the iron ceased, and | 
was obliged to increase the dose of medicine, and likewise the mu- 
riate of morphia, for he obtained’no sleep. He took a whole grain 
of the latter every night. The iron was then increased to the 
quantity of an ounce, and it was given every four hours. His 
health improved under it, and from being pale and thin, he ae 
great paleness, and gained flesh, and thought himself quite another 
man, so far as his general health was concerned. ‘The quantity of 
eyanuret of potassium was increased now, to a drachm in an ounce 
of water; but it afforded no relief, He still found more benefit 
| 6 
