HQ DISEASES CLASS I. 2. 4, 12- 



remaining in the alveolar processes; nor was there any reason to 

 suspect any disease of the maxillary sinus. Whence this did not 

 appear to be any kind of sympathetic hemicrania. He was af- 

 flicted with it for many years till his death. 



The case of Mr. B. a gentleman between 20 and 30 years of 

 age, whom I was lately concerned for, in this disease, is well 

 worthy a minute description; I shall therefore copy a letter, which 

 I wrote on his case to Mr. Cruikshank, and an answer I receiv- 

 ed some time after from his partner, Mr. Leigh Thomas, who I 

 hope will publish the successful method of cure, with adapted 

 prints. 



To Mr. Cruikshank. 



SIR, Derby, Dec. 1789. 



Mr. Bosworth, whose case I wish to remind you of, consulted 

 you some time ago in London, and I believe that you then told 

 him, that his head-ach was owing to a disease of the third branch 

 of the fifth pair of nerves. He came under my care at Derby, a 

 few weeks ago, and complained of much pain about the left 

 cheek-bone; I suspected the antrum maxillare might be diseased, 

 and a$ the second of the dentes molares had then been lately ex- 

 tracted, I desired a perforation might be made into the antrum, 

 which was done by Mr. Hadley, of this town, and kept open 

 for two or three days without advantage. Afterwards, by fric- 

 tion about the head and neck with mercurial unguent, he was 

 copiously salivated for a few days, and had another tooth extract- 

 ed by his own desire, and had lastly an incision made by Mr. 

 Hadley, so as to divide the artery near the centre of the ear next 

 the cheek, hoping to divide a branch of the affected nerve, but 

 without success; and internally, opiates in large quantity were 

 given, when the pain was exceedingly violent, the bark also was 

 used for a time in large quantity without effect. 



On attending, as much as I could, to his sensations when in 

 pain, he seems to express the commencement of the periods of 

 pain to exist about the part of the left cheek before the middle 

 of the ear; and then draws his finger from thence to the fore 

 part of the lower jaw sometimes, and to the ala of the nose on 

 that side; and at other times he draws his finger from the same 

 part of the cheek before the ear upwards to the orbit of the eye, 

 and from thence downwards, a little way on the nose; and also 

 he complains of pain under his tongue on the same side. The 

 pain returns many times in an hour on some days, and continues 

 many minutes, during which he seems to stretch and exert his 

 arm?, and appears tp bave a tendency to epileptic actions; and 



