Index ~ Home

 

 

Impaired Health Its Cause And Cure by J. H Tilden, M.D.

D. DISEASES OF THE CEREBRAL NERVES
I. LESIONS OF THE RETINA

   These lesions are not rare, and must be recognized by the physician. A systematic examination of the eye, to find out the condition of the retina in certain diseases, is necessary.

Retinitis

   This disease occurs as a symptom in Bright's disease of the kidneys, syphilis, leukemia, and anemia. The common symptom in all cases is the occurrence of hemorrhage and the development of opacities. Where hemorrhage occurs there is a diffused cloudiness. This is due to an effusion of the serum. The hemorrhage takes place between the layers of the nerve fibers. When recent, the color is bright red; but as times goes on there is a change. In old hemorrhages the color is almost black. The white spots are due to exudates of a fibrous character, or fatty degeneration. The most important form of retinitis is albuminuric retinitis. This occurs in patients suffering from kidney disease, particularly that variety known as interstitial nephritis. The percentage of cases of nephritis presenting this peculiar condition of the retina ranges from fifteen to twenty-five. This disease, when associated with granular kidney, occurs at a stage when the amount of albumin may be slight or even absent. Arteriosclerosis often accompanies this affection. There is a hemorrhagic form, where hemorrhages are repeated, with very slight signs of inflammation; and then there is an inflammatory form, in which there is much swelling of the retina. This latter variety obscures the disk, and in some instances the inflammation of the optic nerve predominates over the retinal changes. This frequently throws one in doubt as to whether the condition is really associated with the retinal changes.

   Retinitis in Anemia.--After large hemorrhages, it is not infrequent for a patient to lose the sight of one or both eyes temporarily. Sometimes the lost sight will be permanent. In such cases there is usually a retinitis of sufficient severity to account for the symptoms. There is also a malarial retinitis, and then a retinitis due to leukemia.

   Treatment.--There is no special treatment of any importance for these affections. The real derangement, which the retinitis represents as a symptom, must be corrected; hence the treatment must be for those diseases. Certainly all stimulants must be given up, including coffee and tea, with an absolute fast until all discomfort is gone, then fruit and vegetables until health is established.

Paralysis of the Fifth and Seventh Nerves

   Where the fifth nerve is involved, sensation and motion are apparently interfered with. Where the seventh is involved, facial paralysis is marked.

   Paralysis may be the result of disease of the pons, particularly hemorrhage or patches of sclerosis. It may result from injury or disease at the base of the brain. It does not occur because of fracture, but meningitis produced by an Injury, or caries of the bone, may extend to and produce paralysis of this nerve.

   Symptoms.--Paralysis of the fifth nerve may cause loss of sensation of the parts supplied, including half the face and the corresponding side of the head. Patients suffering from this will have the features turned to the opposite side, and the eyelids only partially close. The tongue will draw to that side, and when the patient undertakes to spit, it goes to one side. The loss of sensation will extend to the conjunctiva, lips, tongue, and soft palate, with that portion of the nose which is on the side where the paralysis has taken place. The loss of sensation may be preceded by a tingling. The muscles also lose their sensibility. The sense of smell is lost--said to be due to the dryness of the mucous membrane. In all probability it is due to just what causes the loss of sensation of the other parts to which this nerve is distributed. The secretions are lessened from the lachrymal and salivary glands of the side of the face paralyzed. It is perfectly natural and reasonable that a gland which is partially or wholly paralyzed should also lose its power of secretion. The inflammation and ulceration that occasionally take place in the eye in all probability are due wholly to the exposure. The eyelid, not closing, allows dirt to accumulate, which, of course, must irritate. Inflammation will follow continuous irritation, and ulceration will follow the inflammation. Paralysis has nothing at all to do with the eye complication, further than that, on account of lost control of motion, the eye cannot be kept free from dust, etc.

   Herpes (skin inflammation) may be developed in the region supplied by this nerve, especially the upper branch and region of the temples. It is accompanied by much pain. This derangement is inclined to run on for years. Herpes accompanying this derangement is often complicated with a brain lesion. I have known a few cases ending their lives in the insane asylum. Probably the nervous system was so unbalanced from continuous suffering that the mentality gave out, and the disease may have extended to the brain. The most pronounced diagnostic symptom is the loss of motor power--the inability to use the muscles of the side of the face.

   Treatment.--Drug physicians usually resort to morphine; and where there is a suspicion of syphilis, which is very common, anti-syphilitic treatment is given. There is but one proper treatment for this disease, the same as for all others; namely, correct whatever is necessary. If the patient has many bad habits--such as indulging in intoxicants, using tobacco, coffee, and tea, eating excessively of starches, and being sensual to the point of exhausting his nerve energy through venery--these habits must be stopped. A fast should be taken for one week, or longer if necessary; followed by fruit morning, noon, and night for the second week; and then, for the third, fruit twice a day, and salads, with non-starchy vegetables, for one meal a day. After that fruit for one meal, starch for one, and vegetables and salad for another.

 

II. SCIATICA

   This disease is often called sciatica, neuralgia, sciatic rheumatism, and sciatic inflammation. It is neuritis of the sciatic nerve. It is not impossible to have a functional derangement of the nerve, due to pressure, cold, or injury; but where the pain is pronounced it is inflammatory or a true neuritis.

   Pressure on the nerve is the commonest cause. Frequently people will select as a writing-chair one that presses upon some point of the sciatic nerve. Where this is true there is no hope of getting rid of the disease, after it is once established, so long as that particular chair is used. Those who use office chairs or writing-chairs should select one that will pitch forward, so that when the feet are on the floor the knees and legs will be sufficiently elevated to avoid pressure on the back of the leg by the edge of the chair. No one should use a chair that presses on any one particular point of the back of the leg more than on another. Workmen who use lathes, and are compelled to spend many hours in treading a lathe, are very liable to develop this disease. The class of people more inclined to develop sciatica than others are those who are sensual in their natures. As a rule, men have been alcohol, tobacco, coffee, and tea habitues; and where the nervous energies have been drawn upon heavily because of excessive venery, such subjects will be hard to cure, when the disease is once established. Persistence, however, in a correct life will bring a permanent cure.

   Physicians should be on their guard in diagnosing a given case of pain in the region of the sciatic nerve as sciatica. In fact, such a diagnosis should not be made until a thorough examination has proved that there are no such derangements as urethral stricture, irritable prostate, stricture of the rectum; or, in women, metritis, ovaritis, displaced womb, or some derangement of the reproductive organs, sufficient to account for the reflex irritation.

   Symptoms.--The pain is almost constant, and of a character that wears the patient out. There is nothing that will cause one to feel so hopeless as weeks of suffering from this disease. The pain is not so acute as it is tormenting and continuous. It may extend from the spine to the footeven to the toes. The posterior of the thigh, so to speak, is probably a point that is more troublesome than any other in the course of the nerve, because of its being injured more than any other point from sitting on chairs, benches, etc. Keeping absolutely quiet gives the patient the most comfort. A very short walk will often throw him into great distress. The tendency is for the patient to walk on his toes, which relieves the tension. Where the disease has lasted for months and years, off and on, there is more or less perishing-away of the muscles of the leg. Herpes may develop. When it does, it is very intractable.

   Treatment.--First prove whether it is neuritis or a reflex pain. If reflex, of course the disease from which the reflection is made must be corrected. A true sciatica must be taken care of about as follows: The patient should be put to bed, and given a hot bath as often as necessary to bring full relief. If necessary for him to take a thirty- to forty-minute hot bath every three hours, this can be done. Absolutely no food should be given until comfortable--a pint of hot water every three hours. When comfortable give a little fruit--something that is not too acid, on the order of pears, cantaloupe, or any other sweet fruits. The bowels may be cleared out by enema, The patient can use what water is desired while going without food. When eating begins, water-drinking may end.

   Prunes, onions, and spinach should be in the daily menus, because of their laxative influence on the bowels.

   A general rubbing-down twice a day, with a coarse towel or flesh brush or friction mittens, should be given the sciatic patient.

   Many things have been resorted to in the line of drugs--deep injections of chloroform, alcohol, or ether; nerve-stretching, cauterization, etc.; all of which I know to my perfect satisfaction are worthless. The more the patient is abused by such remedies, the longer he will stay sick.

Next General & Functional Diseases