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Sir Astley Cooper, however, in his work on the Testis, (p. 110,)
gives some cases of tic douloureux of the spermatic cord. He
believes the pain to be truly seated in the nerves, as the pains
dart only along their route. He states that he carefully dissected
all the testicles which he removed on account of this fearfully
painful affection; but there was found no kind of structural
change in any of them — proving that they were actually neu-
ralgic. (See Appendix E, Note 1.)
Both the aggravating and alleviating agents and circum-
stances, lead us to see that " lumbago " is, after all, more nearly
allied to neuralgia than to rheumatism, in respect to the charac-
ter of the pains, and is referable, in a great majority of cases,
to impeded venous circulation in that portion of the spinal cord
that is below the origin of the cauda equina at the second lum-
bar vertebras, and evidently now and then involving also the
roots of those nerves that supply the lumbar muscles. If the
anterior branch of the first lumbar nerve is involved, the pain
extends from the loins and crest of the ilium to the groin, the
spermatic cord, testicle, or scrotum, or to the labia of the vulva
in the female. (See p. 477, and Appendix B, E, F.)
Neuralgia of the upper extremities is more frequently found
seated in that portion of the cubital nerve at the elbow, which
passes between the internal tuberosity of the humerus and the
olecranon, from which spot the pain darts down in the route of
the nerve, even to the ring and little fingers. Sometimes the
pain starts from the brachial plexus and shoots backwards
through the supra-scapular nerve, but more frequently through
the sub-scapular nerve; and still more frequently through the
nerve circumflex; the pain then being seated in the back and
lower portion of the deltoid, and near its insertion into the
humerus. A most excellent and somewhat aged lady, who had
suffered from this painful nerve for about two years, in spite of
skilful care, was sent to me by Dr. J. B. S. Jackson, and was
entirely cured of it by a dozen sittings for the primary current
of galvanism, aided by electro-puncture. Some exceedingly
painful and protracted cases of neuralgia of that branch of the
median nerve that ramifies the dorsal aspect of the thumb, have