The Anatomy, Physiology, Pathology, and Remedial Treatment of the Fifth Pair of Nerves. [Volume: 2, Issue: 4, November, 1860, pp. 195-202]

THE FIFTH PAIR OF NERVES.

201

their quivering features and restless limbs indicating that the acute bodily
pang is indeed hard to bear. The pain is usually restricted to one of
the three branches, though sometimes two, and in others all of them are
implicated. The second branch of the fifth pair is, perhaps, more frequently affected than either the first or third.
Apparently the most trivial causes are often sufficient to provoke or
renew paroxysms of suffering in this affection. Thus the necessary movements of the face in speaking or eating, a slight touch, a current of air
upon the face, or a knock at the door, are sufficient to start it. Individuals
whose powers have been broken by advancing years or debilitating diseases, and those who are pale and asthenic, are most apt to be victims.
Derangement of the digestive organs frequently accompanies, and, in
some instances, is the exciting cause of this difficulty. An interesting
case has been reported by Dr. Suesserott, in which the patient had a number of teeth removed, and was subjected -to a long-continued course of
constitutional treatment without any benefit, until Dr. S. discovered that
he was in the habit of swallowing his food, meats, etc., in large pieces,
and without any attempt at mastication. On ascertaining this fact, he
was directed to pay proper attention to the comminution of his food, and
this was followed by the most happy results, the neuralgic affection of
the face soon disappearing altogether.
In the treatment of this affection, the first indication, of course, is to
remove the exciting cause. When this is dependent upon odontitis,
the application of the arsenical paste to the exposed pulp and the
removal of this on the following day, or, when due to periodontitis,
the employment of leeches to the gum, and the administration of a mild
cathartic, may prove all-sufficient. But if it has a more complicated
origin, the endeavor must be made to correct, if possible, whatever is
amiss in the system at large, or in the state of particular functions.
In cases where there is a weakened, debilitated condition of the system,
the employment of tonics will be found quite valuable; of these the carbonate of iron has generally been looked upon almost as a specific; and the
beneficial effects of this remedy is supposed to be owing to its giving firmness to the nervous system, by increasing the quantity of red blood that
circulates in it. Combined with the iron, local applications to the affected
part, of belladonna, and aconite, have been tried with advantage. The
internal exhibition of narcotics may also be demanded where there is little
or no disposition to sleep on retiring to bed. In cases of an intermittent
character dependent upon malarious influences, sulphate of quinia or
Fowler's solution will be found most reliable.
When everything has been done toward improving the general health
without affording any relief in the local difficulty, recourse may be had to
topical expedients, such as division of the trunk of the painful nerve, if
possible, between the seat of irritation and the brain. With this object