NEURALGIA. 419 



spoonful doses of the mixture (Pr. 40) four times a day, or half the quantity 

 may be given twice as frequently. Arsenic succeeds best in the sufferers from an 

 exhausted or debilitated condition, who have a small pulse, and cold hands and feet. 



Tincture of belladonna is not unfrequently given in neuralgia. It is indicated 

 when there are acute, throbbing, intermittent pains, with redness of the affected part, 

 and unusual sensitiveness to light, noise, and movement. It should be given in three- 

 drop doses every three hours in a little water, or a smaller dose may be administered 

 more frequently. Pr. 39 may be used. Belladonna does most good when the patient 

 is full-blooded, and of a plethoric habit 



Bromide of potassium seems to lie useful in a certain limited number of cases. 

 It is said to succeed best in young men and women of high principle and high mental 

 culture, to whom marriage is delayed by fate till long after the natural period for it. 

 The dose of the bromide has much to do with the success of the treatment. "We may 

 commence with two table-spoonfuls of the mixture (Pr. 31) three times a day, but it 

 will probably be necessary to double the quantity before its full benefits are obtained. 



Tonga is a remedy for neuralgia which has long been used by the natives of the 

 Fiji Islands. It consists of parts of at least two plants, the botanical names of which 

 are not yet known. It is made into a fluid extract, and of this the dose is from half 

 a tea-spoonful to a tea-spoonful in a little water three times a day. Relief generally 

 follows the third or fourth dose, without the production of any constitutional disturbance. 

 We have used it in a large number of cases with marked benefit. No ill effects follow 

 the administration of larger doses. It has only recently been introduced into this 

 country, but is now imported in large quantities, and can be obtained without difficulty. 



So much, then, for what may be called the specific remedies for neuralgia. But 

 even when we cannot cure the complaint, we can do much to alleviate pain ; and we 

 should do well to consider what means are at our disposal for effecting this purpose. 

 First and foremost comes the hypodermic injection of morphia. The great advantage 

 of administering opium by the skin instead of by the mouth is, that it does not upset 

 the stomach, and, moreover, a smaller dose will suffice. Indeed, the case is hardly 

 expressed with sufficient force when we say that the hypodermic injection of 

 morphia is usually harmless to the digestive functions, for in a great number of 

 instances it will be found actually to give an important stimulus both to appetite 

 and digestion, and the patient, who without its aid could hardly be persuaded to take 

 food at all, will not unfrequently eat a hearty meal within half an hour after the 

 injection. Such a case has quite recently come under our notice. We are thus 

 enabled, not only to alleviate pain, but to carry out simultaneously that plan of 

 generous nutrition which is so essential to successful treatment. The dose required 

 is usually one-sixth of a grain of acetate of morphia to begin with, corresponding to 

 two drops of the pharmacopreial solution. There is not the slightest occasion to 

 inject the drug over the seat of pain, for it will prove equally efficacious if introduced 

 under the skin of the arm or leg. We cannot recommend the patient to adopt 

 this mode of treatment for himself, but still, in exceptional cases, where the 

 paroxysms are very severe, and other treatment has proved unavailing, it may have 

 to be resorted to under medical advice. It is very important not to repeat the in- 

 jection with unnecessary frequency j once a day in the milder, and twice a day in 



