Neuralgia : its various forms, pathology, and treatment : being the Jacksonian prize essay of the Royal college of surgeons for 1850 : with some additions

Front matter

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Public Library ofthe

City OF Boston,

Preface

It is not without some degree of anxiety that the following pages are submitted to the medical profession.

Notwithstanding the favourable auspices under which the work appears, stamped by the approval of the Royal College of Surgeons, yet I confess to some little uneasiness, when I reflect on the high character of the previous Jacksonian Essays, and how much will naturally be expected from those that bear the same honourable title. In preparing it for the press, I have therefore availed myself of the kind permission of the Council, and incorporated such facts and observations, of a practical nature, as subsequent thought and experience suggested, in the hope that it might be rendered somewhat more worthy of consideration.

The subject Neuralgia, when considered in all

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its bearings — its various forms, pathology, and treatment — is not only replete Avitli interest and importance, but very extensive in its range. Numerous large works have been written upon it in France, England, Italy, and Germany. That it required further investigation, notwithstanding the labour and talent that had already been bestowed, may be inferred from the acknowledged obscurity in which the chief points connected with it were involved, and the extremely conflicting opinions regarding them. Hence we may suppose it was selected as the theme for competition.

What advance towards elucidation has been made in the present volume, it is not for me to determine. Most certainly I have not the folly to imagine that I have supplied all the desiderata, or cleared up every mystery connected with these . painful afi'ections. My task has rather been, with all due diligence and research, to prepare a digest of the various facts and observations scattered through previous and contemporaneous authors, and to educe from them certain fixed- and general principles. In this I have been aided by rather a large share of personal experience, among all classes of society; more especially since the publication, a

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short time back, of a small work on the same subject.*

The limits of a volume like the present, precluded any lengthened discussion of many important topics. Yet I believe, it ranges over a wider field than its predecessors. The section devoted to Traumatic Neuralgia is quite novel, and although but a sketch, may serve as the basis for future investigations of great interest to the surgeon. A new plan of treatment is also described — the same advocated in my pamphlet — and is introduced simply from the fact, that I have found it highly beneficial in cases that had resisted every other system of management. Many of these are detailed, but more for the purpose of illustrating the various forms of the malady, than of advocating any special application.^

That all my conclusions will meet with unqualified approval is more than I have a right to expect. Many of the opinions advanced, I am aware, are open to criticism — some may even be considered fanciful. But it should be borne in mind, that the subject is rather of a speculative nature, involving the most secret workings of the vis nervosa, and * On Painful Affections of tbe Nerves. Cliurchill.

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not capable of demonstration by either the scalpel or microscope of the pathologist. All is thus left to observation and hypothesis. It would have been easy to have compiled a treatise more in accordance with the received doctrines of the day, which would have escaped censure if it did not meet with approbation. But I preferred stating my opinions freely, however peculiar they might seem, as they were the result of impartial inquiry, and selecting for my motto the words of the Roman poet,

C. T. Downing.

42, Great Russell Street.

Noveirtber, 1851.