MEDICAL NOTES.

Marlborough Express, Volume XLV, Issue 55, 6 March 1911, Page 6

MEDICAL NOTES.

COLD FEET AND INDIGESTION

Coldness of feet and limbs is almost invariably an evidence of indigestion. Tire coldness; is due, not to the weakness of the heart or feebleness of circulation, as is generally supposed, but to the contraction of the small .arteries, preventing blood fuom entering the parts. There is generally an irritation of the aMomiwal sympathetic nerve centres which control the circulation of the lower extremities. This difficulty is not to be removed by exercised or by any special application to the limbs, but by removal of tue* causes of irritation.

SJJSEPLESSNESS: ITS TREAT-

MENT.

Drugs in the treatment of sleepTessr ness should be employed with th<s--greatest caution. When insomnia occurs as an occasional result of some? known violation of the laws of health, no -account- heed be taken of it. Excessive fatigue and eating just before' retiring are common causes. There is. also a simple insomnia due to an empty stomach, which needs only a little hot milk to set it right. Flatulence or an over-loaded colon may*

prevent sleep

The effects of tea,,

coffi&a, and tobacco are familiar toiall. Strychnine, caffein, and theob-omift, when given medicinally, also cause insomnia. Mental excitement is adispeller' of sleep. Tiie high ai*terial tension of kidney disease, arteriosclorosif.; and digestive disturbances often causo persistent insomnia. Sleep-

lessness in old age is due to rigid vessels in the brain. On the other hand, insomnia may be, due to weakness cf the vessels, or rather of the nerves and muscles which should keep the vessels in tonic contraction, as in anemia, in recovery from influenza and typhoid,' aiid in Orave's disease. These patients readily fall asleep sitting up, but when they lie down, such is the automatic dilation of the cerebral vessels that the brain is suffused with blood, and sleep is effectually prevented. Each case must be studied on its merits Ifc goes without saying thac sleep-producing drugs are not to be given indiscriminately. Look for ano correct underlying causes. Drugs aro to be regarded only as expedients, when they are used, while the cause is being sought out.

NEURALGIA

Under this name are included affections which have their seat in t^ie nerves o£ the face and head, althougu it may tie noted that, using the term, in a wider sense, neuralgia may, of course, affect any nerve of the body. Sciatica, which affects the great nerve supplying the leg, is thus a form of neuralgia, and is characterised by severe pain extending from the hip. down to the outside of the thigh, ana affecting the leg ,ns well. It may also be s&idihat neuritis is closely related to.neuralgia, although the pain experienced seems to partake more of the nature of rheumatism than is the case in neuralgia pure and simple. " Physiciams in dealing with cases of neuralgia tell ns that the nerve itself does not undergo any special.change, and many are of opinion that the real seat of the pain is to be located not so much in the nerve itself as in the sheath within which the fibres of the nsrves arc contained. The causes of neuralgia are many and varied. Tafc- j ing them in the probable order of 'i their commonness, it may be said that a run-down state- of health is that most frequently-represented. Something happens in the history of .an individuaf which, throws him backM^ards in the matter, of his physical welfare. It may be mental trouble or worry, orV the weakness resulting, from some definite affection ranging from indigestion itself' to gout <.r rheua-atism. Whatever be the caws©, the goneraL tone of the system becom«es; lowered! ■ the p;airi. of. neuralgia nc^d-'' The second: c&use^ ttC >f jreqWeii* occurrence is represented' U& bold and chill, aiid it is undeniable -tiKat in . the. case of; certain persons residonce in particular places will induce neuralgia, whilst remov 1 from such place is usually attend©-' by the disappearance of the troubl \ Probably dwelling in any place wher©' persistent dampis present represents &: typical illustration of what locality may mean in the producticn of this trouble, and the fact that-sucb conditions axe also provocative of fiteuiriatism may serve to establish a certain link between th»& complaint &n& .the- one we are cor'isid'ei'ing.. THE PART OF THE TEETH. A very important part in ordinary neuralgia, affecting- the head is played by the teeth. In the first place where the teeth are-decayed, and where the condition of: the. niou*h is not what i± should be m respect of strict cleanliness being', maintained' in that cavity, neuralgia is Eable;to^ develop. The ncirv-es whiieii supply- the teeth are naturally iii very close relation to the great nerve w.hich'supplies the face at large, and njany persons complain: of neuualgiai.affieet;iHg.tlie^lxead when their teeth are decayed. But it is necessary to remark that in many oas;^ persons with perfectly sound teeth may suffer from neuralgia, and if the pain be loqa£e>d' in the mouth, and more especi|J|y/-at onei tooth, there Js generally a^^isit paid to the dentist, and a; peri'ectlj?' sound! tooth may he removed under the impression that the diseaso .will' be cured. This is an entirely erroneous practice. The teeth are such valuable instruments that- except in rare cases the extraction of a sound, tooth for neuralgic pains is hri operation not at all warranted. Such a neuralgic attack can be cured by taking proper medicines, tor the pain experienced in the tooth in such a'case is simply part of a general affection of the nerves,, and not an ailment located in the teeth themselves.

There arc,., of course, other causes <-f neura%ia ta. hd .considered, such as pressure oil a nerve exerted by some form or growth or other. These cases, however, can only be detected by'trie physician. Curiously enough,, neuralgia as a condition may affect the iiiterna.il organs of the body. Thus a certain variety of heart pain which comes and ( vgf>es may be of neuralgic character. . ■ Women especially/ ar* liaßfo, to sti filer from forms of ne'iralgiai affecting internal organs, the pain in such a case sometimes bein;;; of a veary acute nature.' What is. called: "stitch in the side"' is-- another instance ot neuralgia affecting th<* trunk oi; the body. This pain affects the- nerves;: which run between tha ribs« r and. is. frequently mistaken for the pain of pleurisy. Here- again the therntonreter shows that when there: ik no rise of temperature the pain is neuralgic, and not that of' inflammation.. • TREATMENT. In tb© treatment of neuralgia one drug has always been relied upon to afford relief. This drug is quanino. Tt may be taken in doses or two or three grains twice dfaily between metals. A teaspoonfulSof ammxaasiateel quinine is also excellent, or an ordinary quinine solution may be used. Sometimes an iron and quinine tonic, which any chemist will' supply, will oe . found to be of service. Other remedies are found in the shape of aoitipyrin and pbenacetin. Beuhaps as good a combination as any- is five grains of each of these substances ta ke-n when the pain is very severe every four hours or so. If any suspicion cf rheumatism exists it will be proper fco avoid any excess of meat and to try the effect of 10 grains or two tabloids of aspirin twice daily between meals. It is important in neuralgia to attend to the digestion. As a rule neuralgic patients must- not starve themselves, and according to physiological rules their diet should include a. fair amount of fat, which is regarded as the special food of the nervous system. The taking of Jbynol after meaj's has been followed in many cases by excellent results. Another excellent tonic adapted for run-down states of the systenY is bynO-iiypophosphitei-:, wliich should be taken after maals. In the: way of local appulioations, rubbing mertholcone over the track oi the pdin v/ill sometimes give relief. A useful application for external use j.:> composed of three parts of menthol, i four parts ehlbroform^ and olive.^ot? i to eight or ten parts, .1 little of this, being rubbed or applied on lint to. tliw seat of the pain.