CLASS I. 2. 4, 12. OF IRRITATION, 117 



his life is thus miserable to himself, and uncomfortable for his 

 friends to witness. 



I write this to you to beg that you will acquaint Mr. Bos- 

 worth, whether you think you could divide by incision the dis- 

 eased nerve; as he is willing to undergo such an operation, if you 

 think it practicable, as I believe it to be the only means which 

 promises to cure him; and have therefore advised him again to 

 apply to you; and if you think this can be done with effect, he 

 designs to wait on you in London. 



I am, sir, c. 



E. DARWIN. 



The following answer of Mr. Leigh Thomas shews the disease 

 to have existed in every branch of the affected nerve. 



SIR, Leicester -square. May, 1799. 



About the middle of December last, you did Mr. Cruikshank 

 the favour to write him an account of Mr. Bosworth, a young 

 gentleman, some time under your care at Derby, with a painful 

 affection of the nerves of his face. The patient soon after came 

 to town in a much worse state, than you described him to be at 

 that time; as the pain was extremely acute and almost unremit- 

 ting, opiates, which he had been in the habit of taking occasion- 

 ally, afforded him now little or no relief, though taken to the 

 quantity of six tea-spoonfuls of laudanum at a time. After pay- 

 ing every attention to the case, your suggestion of the necessity 

 of dividing the diseased nerve appeared obvious. 



As the pain felt was more acute in the left ala of the nose, and 

 the upper lip of the same side, we were induced to divide the 

 second branch of the fifth pair of nerves, as it passes out at the in- 

 fraorbital foramen. He was instantly relieved in the nose and 

 lip; but towards might the pain from the eye to the crown of 

 the head became more acute than ever. Two days after, we 

 were obliged to cut through the first branch passing out at the 

 supra-orbital foramen; this afforded him the like relief with the 

 first. On the same day the pain attacked, with great violence, 

 the lower lip on the left side, and the chin; this circumstance 

 induced the necessity of dividing the third branch passing out at 

 the foramen mentale. During the whole period, from the first 

 division of the nerves, he had frequent attacks of pain on the 

 side of the tongue; these however disappeared on division of the 

 last nerve. 



Mr. Cruikshank performed the above operations, but being 

 particularly engaged at this time with lectures and other busi- 

 ness, he now gave up the case to my management. The patient 

 was evidently bettered by each operation; still the pain was very 



