NEURALGIA. 417 



the case of very young or aged persons. It is advisable to give a larger supply of food 

 than would be necessary for the maintenance of health in people not subject to this 

 affection. Fat is of especial value when taken in conjunction with plenty of meat, 

 milk, eggs, and bread. On this account the continued use of cod-liver oil is strongly 

 recommended, and when it cannot be taken attempts must be made to supply its 

 place by the free use of Devonshire cream, plain cream, butter, olive oil, or pancreatic 

 emulsion. Unfortunately neuralgic patients have an almost insurmountable aversion 

 to fat, and the greatest tact and patience will be required to overcome this difficulty. 

 Many doctors find pulsatilla useful in removing the objection to fatty food. Wine 

 or beer should be taken, if at all, only at meal-times, and then in the strictest 

 moderation, anything like excess being scrupulously avoided. The advantages of 

 uniformity of temperature are not to be overlooked, and the clothing should be care- 

 fully adapted to give protection against sudden cooling of the body or catching 

 cold. 



No treatment is likely to prove of much avail in neuralgia unless anaemia, if 

 present, be previously removed. Poorness of the blood appears to be especially 

 favourable to the maintenance of all neuralgic affections. The sulphate of iron pills 

 (Pr. 63) may be given with great advantage. Another good preparation of iron is 

 the tincture of steel, and this may be given in thirty or even forty-drop doses, well 

 diluted with water, three times a day, about an hour after meals. The perchloride 

 of iron mixture (Pr. 1) may be employed if preferred. A good combination is 

 fifteen drops of tincture of steel and six drops of tincture of nux vomica in a wine- 

 glassful of water three times a day. In some cases the arsenic mixture (Pr. 40) 

 does much to improve the quality of the blood, but it is, as a rule, inferior to iron. 

 Further directions for the treatment of anaemia will be found under that heading 

 (see ANAEMIA). 



One of the best remedies for neuralgia is quinine. In all cases in which there 

 is any suspicion of ague, or when the patient is residing in a district where ague is 

 prevalent, this is the remedy to give. It is indicated, too, when the attacks come 

 on at regular intervals. It has long been recognised that quinine readily controls 

 that form of neuralgia in which the pain is experienced at a spot just above one or 

 other of the eyebrows. Quinine, to do any good in neuralgia, must be taken m 

 fairly large doses thus two table-spoonfuls of the strong quinine mixture (Pr. 10) 

 should be taken every four hours. Some chemists now keep five-grain quinine pills, 

 made up with a drop or two of syrup ; and, by many, these will be preferred to the 

 mixture ; one should be taken every four hours. Quinine is said to control neuralgia 

 and ordinary faceache more effectively when the powder is taken in small quantities 

 every few minutes as much, for instance, as will adhere to the tip of the finger 

 dipped into the powder. We need hardly point out the importance of getting your 

 quinine pure. The three great indications for the use of quinine are (1) suspicion of 

 ague; (2) paroxysms being periodical; (3) pain being experienced chiefly over 

 eyebrow. In very obstinate cases of neuralgia, which have resisted all other treat- 

 ment, the Germans often give what we should consider enormous doses of quinine 

 from forty grains to two drachms a day. 



Croton chloral must take a high place as a remedy for neuralgia. It succeeds 



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