338 DISEASES OF THE PERIPHERAL NERVES. 



gland. Severe pain, like tic douloureux, occasionally shoots out tow- 

 ard the shoulder, axilla, or hip. Occasionally, at the height of these 

 attacks of pain, vomiting comes on. The patients cannot lie on the 

 affected side ; they are unable to bear the weight of the breast. Tho 

 pain usually increases shortly before the appearance of the menses. 

 The disease often lasts for months or years without any perceptible 

 change in the mammary gland. In other cases, sharply-bounded, very 

 movable tumors, as large as a pea or a hazel-nut, develop in the mam- 

 ma and form the starting-point for the pain, occasionally they cease to 

 be painful ; they consist of connective tissue, not of the substance of 

 the gland ; they have been previously mentioned as tubercula dolo- 

 rosa or neuromata. Fur worn on the breast, a plaster of equal parts 

 of emplas. saponat. and extr. belladonna, recommended by Cooper ', and 

 pills of ext. conii, ext. papaver (ana gr. ij), ext. stramonii (gr. J J), 

 are mentioned by Momberg as the most trustworthy remedies. 



CHAPTER X. 



LUMBO-ABDOMINAL NEURALGIA. 



NEURALGIA lumbo-abdominalis is the form that affects the cuta- 

 neous nerves of the lumbar plexus, going to the lower part of the 

 back, to the nates, anterior abdominal wall, and genitals. In this 

 neuralgia, also, there are constantly pains at circumscribed points, 

 which are occasionally accompanied by lancinating pains. These 

 points are : 1. The lumbar points, somewhat outward from the first 

 lumbar vertebrae. 2. The hip point, somewhat above the middle of 

 the crest of the ilium, where the ilio-hypogastric nerve perforates the 

 transversalis muscle. 3. The hypogastric point, somewhat inward 

 from the anterior-superior spine, where the ilio-inguinal nerve per- 

 forates the transversalis muscle ; and, lastly, some points on the monp 

 veneris, vulva, or scrotum at the terminations of the cutaneous nerves. 

 Where the posterior branches are affected, the lancinating pains chiefly 

 pass toward the nates ; where the anterior are affected, they chiefly 

 pass toward the external genitals. The etiology, course, and treat- 

 ment of lumbo-abdominal neuralgia are exactly the same as in inter- 

 costal neuralgia. 



CHAPTER XI. 



NEURALGIA ISCHIADICA ISCHIAS ISCHIAS NERVOSA POSTICA COTUN- 

 NH SCIATICA HIP-GOUT. 



BY sciatica we mean a neuralgic affection of the sensory nerves of 

 the sciatic plexus, which is formed from the fourth and fifth lumbar 

 and first and second sacral nerves. 



