420 THE TREATMENT OF DISEASES. 



very severe cases will be all that is advisable, the great thing being to administer it 

 as quickly as possible after the commencement of an exacerbation. If by these 

 means we can prevent the recurrence of severe pain for several days, time is given 

 to the affected nerve to recover itself, and the tendency to neuralgia may be broken 

 through. In some cases a friend or relative might be instructed by the doctor how to 

 give the injection, and in this way a great boon would be conferred on the sufferer. 

 We not unfrequently meet with cases where hypodermic injections of atropia have 

 done more good than anything. 



A single dose of chloral, say one or two tea-spoonfuls of the syrup, will often 

 enable the patient to obtain much needed rest. Chloral, like opium, is not a remedy 

 that can be used indiscriminately and without caution. Nothing can be worse than 

 for the sufferer from neuralgia to acquire a habit of using either of these drugs for 

 the relief of pains. But still, the possibility of a drug being abused does not justify 

 us in altogether rejecting its use. It is very important that the habit of long 

 neuralgic paroxysms should not be set up, and if two or three attacks are promptly 

 stopped by the induction of a sound but not too profound a sleep, time is allowed 

 for so modifying the constitution by tonics and general regimen and diet as to- 

 eradicate the neuralgic disposition, or, at least, to reduce it to a minimum. Indian 

 hemp (Cannabis indica) may sometimes be used as a substitute for chloral or 

 morphia. Half a grain of the extract of Indian hemp should be taken in the form 

 of a pill (Pr. 67), and repeated in two hours should the desired effect not be produced. 



There are many local applications which are used for the relief of the pains of 

 neuralgia. Blisters are often of essential service. A blister to the temple or behind 

 the ear generally relieves neuralgic pains of the forehead or any part of the face. 

 The obstinate form of facial neuralgia dependent on a diseased tooth often yields to 

 a blister, the neuralgic pains ceasing, although the toothache may continue. Blisters 

 relieve the shifting neuralgic pains common in nervous, sensitive women. The 

 obstinate neuralgia of the side left by shingles, and occurring mostly in old people, 

 generally yields to blisters. There is no occasion to make the blister large ; if of the 

 size of half-a-crown it will be quite enough. Blistering paper, although mild in its 

 action, requiring some hour's application, generally produces enough irritation to 

 relieve neuralgia of the face, but should the pain continue unabated it may be 

 necessary to paint on a little blistering fluid with a brush. For application to the 

 side, nothing can be better than a piece of cantharides plaster, as big as half-a-crown. 

 It will probably take from six to eight hours to raise a blister, and it should then be- 

 removed. It is better not to cut the bleb, or prick it in any way, for it serves to 

 protect the subjacent raw surface from the action of the air and other irritants. All 

 that is necessary is to cover the side with a thick layer of cotton-wool to ward off 

 pressure. Other counter-irritants, such as mustard and iodine paint, are used for 

 neuralgia, but they are decidedly inferior to cantharides. Blistering is distinctly a 

 good mode of treatment. 



The external application of aconite is often very useful in neuralgia, although in 

 our present state of knowledge it is impossible to say in what cases it will succeed 

 and in what fail. In neuralgia of the face we have often known it do a great deal 

 of good. In cases in which it effects a cure its action is usually very speedy. A 



