Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.
453/740

3. The point of emergence of the nasal branch, which can be found at the upper part of the side of the nose, a little inside, and below the internal angle of the eye, and this is called the nasal neuralgic point. 4. The malar or inferior branch that emerges upon the cheek, through a groove in the malar bone, and passing through the fibres of the orbicularis palpebrarum muscle, is called the malar neuralgic point. 5. The point of union, in the interior of the car, of a branch of the superficial petrosal branch of the vidian nerve, witli a branch of the porlio dura — a union which arises from the chorda tympani, and is designated as the internal auricular neuralgic point* 6. The point of emergence of the upper alveola and dental nerve, which may be called the superior dental neuralgic point. 7. The two very important points of emergence from bone are found first at the infra-orbital foramen, well known as the site of tic douloureux, and now called the infra orbital neuralgic point; the second is at the mental foramen, and called the neur ra/gic point of the chin. 8. The point in the masscter nerve branch, where it crosses * I will remark here, — as we observe that this point is quite different from the su- perficial points, — that I think I find a lawt that at the very point of bifurcation or branch- ing off of nerves, as also at the point or larger spot of anastomosing and interlacing, that there, especially, (and next to the " points of emergence," and becoming superfi- cial, as discovered by Valleix,) is the nerve more liable to become the seat of neural- gia, and that all the more according as these are more complicated at any given place. True, Dr. Valleix laid down four different positions of a nerve as most liable to become the seat of neuralgia ; but I do not see what portion of any superficial nerve is left out, if we define, first, " the point of emergence," second, " the course of the nerve branches through the muscle fibres to become superficial," third, " the point where the nerve becomes superficial," fourth, " the point where the nerve has its ultimate superficial distributions." Besides, this is not sufficiently definite for a rule in practice. I think I am justified, therefore, in mentioning seven points in the course of nerves that are peculiarly liable to be the seat of neuralgic pains : — 1. The point of emergence of the nerve trunk from bone or any deep seat. 2. The point of branching off. 3. The point of becoming superficial, or running very superficially. 4. The point of interlacing, as for plexus and ganglia. 5. The point of anastomosing with other nerve fibrils. 6. The spot of ultimate ramification in the integuments. 7- The spot of ultimate ramification in the fascia and muscle fibres.