PERHAPS of all known torments, there is none that can be compared, either in intensity or duration, with that curious disease which has been called Tic Doloreux. Like the term Neuralgia, it is merely a hard word to express a violent pain in a nerve. Conventionally, the term neuralgia, or nerve-pain, is generally used to express a case where the suffering is of a more or less diffused character. The term "tic " is more usually applied in cases where the seat

154 HIS REMARKS ON TIC DOLOREUX.

of pain is found in some superficial nerve. Neither term has much claim to the character of scientific nomenclature, they are merely equivalent to saying that we know very little of the matter. This obscurity, however, may be soon lessened, if not entirely cleared, by any one who will go to work in the way suggested by Mr. Abernethy's principles, and in which to a certain point they will conduct him. He must, however, recollect that the pain, though a most distressing symptom, is still a symptom, and not the disease which gives rise to it.

This disease teaches us how beneficently framed we are in relation to all around us, and how small a deviation from a healthy condition of our sensations converts all usual sources of pleasure into so many elements of agony. The breeze, of late so grateful and refreshing, may produce more suffering than would be excited by the most intensely-heated furnace. In other cases, the cool spring, or the most delicious fruit, become causes of torture. We should exceed all reasonable limits if we

SUFFERINGS OF TIC DOLOREUX. 155

were to enumerate all the usual sources of pleasure, which, in different cases, are converted into so many instruments of suffering.

Tic doloreux is indeed a horrible malady; but one, which, when properly considered, becomes very instructive. It admirably illustrates the views of Abernethy; and how ready he was to concede all that examination of the views of others, which modesty and common sense requires, as well as how superior his own were both in philosophical acumen and practical value; first examining the views of others, and finding them defective, he, with the true philosophical spirit which first discovers what is wrong

"Primus gradus est sapientiæ falsa intelligere,"

then proceeds to develope his own.

The nerves are the organs from which we receive impressions from without, and when their ordinary sensibility is thus morbidly augmented, we may be persuaded that there is something very wrong within.

The tic doloreux is one of the examples showing how cautious and circumspect, and how

156

DIVISION OF NERVE CASE.

modest withal, Abernethy was in advancing to his own comprehensive views of disease, and how entirely antithetical the method he pursued in arriving at them, was to that which attempts to cut the knot of difficulty, by gratuitous hypotheses. When this disease first began to attract attention, it was suggested that it might be cured by the division of the nerve. The phenomena of the nervous system afforded abundant grounds for mistrusting the soundness of this view. The tendency, however, to confound the more salient symptom of a disease with its intrinsic nature, caused such phenomena to be overlooked or little considered; and the consequence was that where the nerve was divided, the treatment was sometimes entirely confined to that proceeding.

In the end, the operation disappointed expectation; and that which careful reasoning might have predicted as probable, was left to be determined by experiment. In some cases circumstances concurred to produce temporary relief, but on the whole the operation was a failure.

In the case he here published, Abernethy

removed a little bit of nerve from a lady's finger. As she had suffered severely, and he was anxious to give her more permanent relief, he did not rest with merely dividing the nerve. For about nine months the lady was in comparative ease, but then the sensation returned. He remarks on the interest attached to this return of sensation, and observed on the analogy it suggests between the supply of blood and nervous power. For if the vessels conveying the former be tied or obstructed, the supply is gradually restored through collateral channels. The return of the nervous functions after the removal of a portion of the nerve, seemed to favour that view of the nervous system, which regarded as the proximate cause of the phenomena, some subtle principle or other, like electricity or magnetism, or some analogous power, of which the nerves might be the conductors.

Perhaps the most interesting fact of this case, however, was the significant bearing it had on those views which he was beginning to deduce from a multitude of other sources. The fact being, that when the lady died, which she did