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presented, showing the seat of intense pain mostly in the thumb,
at its side, or about the root of the nail. (See p. 477, B, 2, 3.)
Neuralgia, uncomplicated, of the lower extremities, is, perhaps,
most frequently observed as most severe when it occurs in the
sciatic hollow, between the great trochanter and the ischium.
The pain is either fixed there, or shoots along the course of the
great sciatic nerve, or shows itself at the femoro-popliteal nerve,
extending, in one case, upwards to the sacrum, or, in another,
and more frequently, downwards, even to the ankle and foot.
Now, this whole family of sciatica was for a long time classed with
rheumatism, until M. Chaussier and others demonstrated that
there is here essentially a form of neuralgia, although at times
the given case may show an alliance equally with inflammation
or rheumatism ; but these latter are by far the more rare. It
was also formerly confounded with all kinds of painful affections
of the hip region, whether inflammatory or rheumatic, primary
or symptomatic — all were called sciatica. But true sciatica
must be sifted out from these to be viewed and successfully
treated, first as inflammatory, and then as neuralgic. In these
the greatest suffering is sometimes in the anterior tibial branch
that terminates at the great toe ; but oftener still in the peroneal
branch of the external popliteal, which is one of the continuations
of the great sciatic nerve, and terminates on the outer side of the
foot. The accession may be very sudden, but it is usually pre-
ceded by a painful prickling or a numbness along the thigh, or
down outside the fibula. Only one limb is usually affected.
The slightest cause may bring on anew the paroxysm of pain,
as the warmth of bed, mental emotion or excitement, motion or
exertion. The continuance is as tricky and uncertain as other
neuralgia. Where it has been long standing and severe, there
sets in a lameness, and some dragging of the limb, with a par-
tial palsy and wasting of the muscles of the limb. There, then,
may also be trembling of the limb or formicans. (Seep.476,B.)
Neuralgia of the femoro-pretibial occurs less frequently than
sciatica. The seat of pains affects the great trunk of the anterior
crural nerve as it passes out from under Poupart's ligament, or
the crural arch at the groin, and before it so abruptly divides