342 DISEASES OF THE PERIPHERAL NERVES. 



excitement. Regarding the use of veratrine, aconite, and morphine as 

 palliatives, we may refer to what we said in the treatment of neural- 

 gias in general. 



CHAPTER XII. 



CRURAL NEURALGIA ISCHIAS ANTICA COTUNNII. 



BESIDES the branches of the lumbar plexus whose neuralgic affec- 

 tions we have described as lumbo-abdominal neuralgia, the sensory 

 filaments going to the thigh and leg are occasionally affected by neu- 

 ralgia. This affection has received the peculiar name of ischias antica, 

 because in it the pain is along the anterior and inner surface of the 

 thigh, leg, ankle, and dorsum of the foot, and in the great and second 

 toes, instead of being along the outer and posterior surface as in sci- 

 atica. Ischias antica, or crural neuralgia, is far more rare than ischias 

 postica. Like the latter, it may be caused by pressure on the nerves 

 at then: point of escape from the spinal canal, or by injuries to the 

 sacral plexus in the pelvis, or to its peripheral branches. Irreducible 

 inguinal hernia, sprains of the thigh, hip-joint disease, not unfrequently 

 induce morbid excitement of the cutaneous branches by pressure on 

 or tension of the crural nerve. The course and results of crural neu- 

 ralgia are analogous to those of sciatica, and the treatment must be 

 according to the same general laws. 



In very rare cases the obturator nerve is also affected with neural- 

 gia. This is characterized by the extension of the pain to the inner 

 surface of the thigh, and, as the motor filaments of the obturator sup- 

 plying the adductor muscles usually participate in the morbid excite- 

 ment, the function of these muscles is frequently disturbed. The sudden 

 occurrence of these symptoms, together with those of acute obstruction 

 of the intestines, with ileus and peritonitis, are the only means of 

 diagnosticating strangulated hernia through the obturator foramen. 



CHAPTER XIII. 



ANAESTHESIA OF THE CUTANEOUS NERVES. 



ANAESTHESIA that is to say, lack of sensitiveness to external im- 

 pressions arises : 



1. When the portion of the brain by which the excitement of sen- 

 Bory nerves is recognized has been destroyed or incapacitated. In 

 such a case, notwithstanding that the patient is entirely insensible to 

 external impressions, the excitability of the sensory nerves may still 

 oe normal. For the present, we shall, without notice, pass over this 



