414 THE TREATMENT OF DISEASES. 



one or other eyebrow. The fact of the attacks coming on at regular intervals is 

 one of the great characteristics of neuralgia really resulting from ague. 



Neuralgia is seldom met with in young children, but not unfrequently it makes 

 its appearance about the age of fourteen. Usually, however, it comes on later, 

 between the ages of twenty-five and forty-five. It is at this time that the indi- 

 vidual is subjected to the greatest strain from external circumstances. A man, if 

 poor, is engaged in the absorbing struggle for existence, in the endeavour to main- 

 tain his wife and family, or if rich and idle he is immersed in dissipation or 

 haunted by the mental disgust generated by ennui. A woman, if married, is going 

 through the exhausting process of child-bearing, or if single is probably idle and 

 weary with waiting, fearing lest she should lose her chance of fulfilling those duties 

 which so essentially constitute her mission in life. Sometimes neuralgia makes its 

 first appearance when the race of life is well-nigh run, and indications of physical 

 decay are already making themselves apparent. 



Neuralgic pains may occur in any part of the body, but they are met with 

 most frequently about the head and face. One variety of neuralgia of the head is 

 more or less familiar to us all under the name of " tic " or " tic douloureux." 

 Neuralgic pains are usually suspended during sleep. The tic, for example, may 

 keep the sufferer awake for hours and hours, but once asleep hb slumber is likely 

 to remain undisturbed. Sometimes the pain is experienced chiefly in the region 

 of the lower jaw, and then it usually affects the lips, the teeth, the chin, and it 

 may be even one side of the tongue. Curiously enough the pain is usually 

 strictly limited to one side, often stopping abruptly in the middle line. The 

 paroxysms of suffering in this frightful disease are apt to be induced by the most 

 trivial causes ; a sudden jar, a current of cold air blowing on the face, a slight 

 touch, or even the mere mention of the malady, may be sufficient to excite it. 

 The necessary movements of the face in speaking or eating may bring on the 

 pain, and the patient is in constant dread of a visit from his enemy. Often 

 enough neuralgia is associated with toothache, and still more frequently a decayed 

 tooth, or long-forgotten stump, although not itself painful, is found on examina- 

 tion to be the exciting cause. Wonderful instances of the cure of long persistent 

 neuralgia are attributable to the dentist's art. In one case, and this is but one 

 of many, attacks of agonising pain coursing along one half of the jaw were at 

 once arrested by stopping a hollow molar on that side. 



The pain of some forms of neuralgia is agonising, and it has been supposed 

 by many that it is the most severe the human frame is capable of suffering. 

 Usually it comes on in sudden twinges, which are very characteristic of the 

 complaint. Some people compare it to an electric shock of great intensity, 

 others to the conflagration of gunpowder, or to the explosive violence of fulminating 

 powder whilst others declare that it is simply indescribable. A well-known 

 physician, now dead, is reported to have stamped out the bottom of his carriage 

 during a paroxysm, and another member of the medical profession was induced 

 by the excessive agony to make deep cuts into his face and then to apply a 

 red-hot iron to the wound, and the pain not being mitigated, he several times 

 attempted suicide. Even in comparatively mild cases the patient often on the instant 



