Neuritis. Perineuritis 185 



if not from actual paralysis, still from the pain which attends on 

 their contraction. In some cases they are the seat of clonic 

 spasms or twitching. Under a current of electricity they show a 

 decreased irritability which bears a direct relation to the grade of 

 degeneration which has occurred in the nerve fibres. In cases of 

 deep-seated neuritis paralysis may be the only appreciable symp- 

 tom. In traumatic injuries like bruises of the seventh nerve 

 or fracture of the sacrum the local swelling and tenderness are 

 marked initial symptoms, upon which supervene the paralysis and 

 atrophy of the muscles cut off from full innervation. In neurec- 

 tomy the tender swelling in the stump which is still in connection 

 with the nerve centre may arhount to a distinct neuroma, while 

 the peripheral and detatched portion of the nerve steadily loses its 

 irritability as shown by electric stimulus. 



Prognosis. This will depend on the nature of the lesions. A 

 single transverse section of a nerve, without loss of substance may 

 be repaired in a few months, while with loss or degeneration of a 

 considerable part of its substance it may maintain a paralysis for 

 years or even permanently. Lesions due to slight bruises may 

 recover in a few weeks, while the more severe ones will persist for 

 months or years. The response to electric stimulus distal of the 

 lesions, is a guarantee of the absence of degeneration and a feature 

 hopeful of recovery. Pressure by bony displacement or neoplasia 

 must be done away with as the first condition of improvement in 

 such cases. Rheumatic and gouty cases will persist until these 

 constitutional infirmities are corrected. 



If the neuritis and paralysis have lasted for any length of time, 

 the degeneration of the muscles will keep up a degree of muscular 

 weakness (and if in the limbs lameness) after the repair of the 

 nerve has been completed. 



Treatment. Rest is the first consideration accompanied by 

 soothing and anodyne application to the inflamed nerve. When 

 neuritis exists in a limb a softly padded splint may be useful at 

 first. The skin over the inflamed nerve may be rubbed by one 

 or a combination of the anodyne essential oils, (oil of cajeput, oil 

 of peppermint, oil of lavender). If the pain and tenderness are 

 extreme, a bag of ice or snow may give relief and should be kept 

 applied for a length of time. Or hot fomentations with a lotion 

 of lead and opium may be preferred especially in rheumatic cases. 



