HEALTH COLUMN.

Otago Witness, Issue 3212, 6 October 1915, Page 81

HEALTH COLUMN.

KEURALGIA. To some folks (writes Dr Robert Watson) neuralgia is a disease whoso distinguishing feature is pain about the face. And toothache is always neuralgia if one has a strong disinclination to visit tho dentist. An odd sufferer discovers with horror that the malady has appeared in his arm or leg or side; but the average lay person is slow to perceive that you may have neuralgia anywhere. For neuralgia simply means pain of a nerve or nerve-pain, and the term is used by doctors to indicate those cases in which an ache appears in a region supplied by certain nerve fibres without an obvious cause like inflammation of the tissues of the region or tumour there. If the nerve itself be inflamed the disease is not neuralgia, but neuritis. Yet there are border-line cases in which the distinction between neuralgia and neuritis cannot easily (or at all) be drawn, and it is well for people to bear this fact in rnjrd. since such nice points in labelling diseases have cost doctors patients and nave cost patients doctors. A moment's reflection will convince you that there are two different losses, ahd you may take my word for it that only a sort of modest esprit de corps prevents me pointing out which is the graver calamity. Wherever you have a nerve of sensation —and that is pretty well all over the body —you may have neuralgia. Why, then, the reader may ask, does neuralgia occur so often about the head and face that tne popular conception of the disease is a face ache? It is a fair question. And the answer is that there, above all places in the body, you have the most sensitive nerve endings associated with the most frequent opportunities for annoyance. The shin of the face, the tooth, the ears, the eyes, the nose, to mention only some of the avenue of irritation, are highly specialised regions exposed to changes of temperature, wet winds, tho attacks of microbes, and innumerable other trials. Your eyes are perhaps not perfect to begin with, and you expect interminable service of the most exacting, unfair kind from them—over fine work, tiny type, in shaking vehicles, by blinking light or half-light, etc., —annoyances made doubly trying because the instrument is so fragile, so sensitive. Your teeth have lapsed from their proper structure and conditions during generations of faulty feeding, and you tax them beyond their powers by occasional rough usage or damage their enamel by too hot or two cold mouthfuls, or insidiously wear down their resistance by unhealthy or untimely sweetstuffs. So with the other parts. And annoyance tells upon the nerve-endings, and the nerve loses its fine healthy impartiality, as it were, and feels and suffers far, far more than circumstances warrant. —-.Factors in Causation and Cure.—

That, in popular terms, is a just enough presentation of the facts of neuralgia. But there are other factors in the business. A person is generally in a state of debility, more or less marked, before neuralgia attacks him. Overwork, unhealthy surroundings, worry, disease elsewhere in the body, pregnancy in women, and other exhausting or depressing conditions predispose to it. Even pleasurable excitement carried to excess can so weary the central nervous system as to make neuralgia easily possible. All stimulants and narcotics, like tea and coffee and the alcoholic beverages, may act as predisposing causes. And the depression induced by the onset of a common cold very frequently leads to neuralgia. It is characteristic of certain types of neuralgia that pain recurs regularly at the same hour or hours daily, the explanation probably being that at those periods, the system is by the duties of the day, or the length of time that has elapsed since the last meal, or some less obvious depressing circumstances, reduced even below the average level of efficiency- maintained in its debilitated state.

From what has been said, it should be clear that two points require attention in any attempt to cure neuralgia. The obvious point (relief of pain) generally receives most attention, and this attention, especially in amateur efforts at treatment, is apt to overshadow the more important point, which is, of course, the raising of the patient’s general condition to a higher state of health. —Treatment.— Many a case of neuralgia drifts into a very serious stage because the patient or the patient’s friends devote all their energies to combating the agony. For it is not alone that neglect of the factors concerned in the production of neuralgia allows the condition of general debility to grow worse; but the drugs they employ are very often dangeiously depressing, and short periods of relief from pain are purchased at the expense of the constitution. Thus I want especially to emphasise here the things that must be considered in treating the body. A few words will suffice for the means aimed at the relief of pain. Work must be reduced so as to eliminate strain and permit decent opportunities for regular meals and sufficient rest. In bad or obstinate cases it must be stopped altogether, and the patient should then have a change to some quiet and bracing place Diet must be simplified and meals recur with clockwork regularity. Anything difficult of digestion is forbidden, and tea, coffee, and alcohol should be left alonecocoa, milk, or a beef extract- taking the place of the two former drinks. Excite ment must be avoided and quiet habits cultivated. Early to bed is a good rule, and if the patient can face a cold tub on rising so much the better. Or a quick sponge with cool water may he substituted. Then a tonic like Easton’s syrup or Parrish’s chemical food or a. malt or maltine preparation with hypophosphites is distinctly helpful. When _ pain is severe a s,gr tablet of acetyls?,licylic acid may be taken every four hours, the region of pain being fomented with hot water, and. after drying, rubbed with oil of gaultheria (winter-green) or sweet birch or with any oil or paste containing salicylate of methyl or menthol, and covered with warm, dry flannel or absorbent wool.

—Pressure and Absorption.—

I showed hoW a familiar example of trouble resulting from pressure and absorption occurs in certain cases of blood-poison-ing. You have germs introduced into your tissues —the microbes responsible for sup-puration-through some tiny wound like a needle-prick or other trivial stab; the wound heals, or practically heals, before the microbes assert themselvesbut they are not overcome by the soldier-cells of your system, and they multiply, and more soldier cells are rushed to the spot,

find a microscopic war occurs. The part inflames. Ultimately the area of fiercest conflict, surrounding the deepest part, it may bo, of the original stab, becomes cut off by entrenched soldier-cells, and a fight to the death ensues within this zone. The flesh actually perishes and breaks down into liquid matter (pus) with, it may be, shreds or clots like the core of a boil. Up to a certain stage you suffer nothing more than the pain and throbbing incident to the inflammation, but the pus goes on accumulating and the tension increases. In some instances it makes its way readily to the surface and escapes, and the end is in sight. But often relief does not occur so readily, the pus is too closely held in. and pressure and absorption occur. Poisons from the germs arc picked up by lymphatic channels, which inflame and show as red lines under the skin. Then the glands to which these vessels go swell and grow tender. If poultices or fomentations are not applied and the abscess soon lanced worse things may happen'.