Treatment.—­It is directed towards removing the cause, if possible.  Chronic cases are difficult to cure.  The patient should be careful not to take cold, keep strong and healthy by regular hours for sleep, good sufficient clothing.  The general health must be improved.  These directions apply to all kinds of neuralgia.

Intercostal neuralgia.—­A neuralgia of one or more of the intercostal nerves.  These nerves run in a groove in the lower edge of the ribs.  Causes.—­It may develop without any special cause.  It comes in anemia, after exposure to cold, from affection of the vertebrae, ribs, spinal cord, or from the pressure of tumors, or aneurism of the aorta.  This is next in importance to neuralgia of the fifth nerve, and occurs more often in women and very common in those who have hysteria.  It is more common on the left side and mostly in the nerves situated from the fifth to the ninth intercostal space.  If it is located in the nerves distributed to the mammary glands it gives rise to neuralgia of the mammary gland.  The flying darts of pain in the chest (pleurodynia) are to be regarded as neuralgic in character.

[266 Mothers’ remedies]

Symptoms.—­The pain is usually very severe, especially on movement of the intercostal (between the ribs) muscles.  With this pain, as a rule, an eruption (herpes) appears along the course of the affected nerve and this is supposed to be due to the extension of the inflammation from the nerve-ends to the skin.  Pain, when pressed upon, is most marked near the spinal vertebral, the breastbone (sternal) end and the middle part of the nerve.  The trouble may continue a long time after the eruption (herpes) has disappeared, for it is very obstinate.

Physicians’ treatment for Intercostal Neuralgia.—­This consists in using remedies that will cause counter-irritation.  Electricity and pain destroying (anodynes) remedies are indicated in chronic cases.  Apply heat for pain in the “breasts.”  For the eruption an ointment like oxide of zinc can be used.

Local Treatment.—­A mustard plaster is frequently good to use.  It produces the counter-irritation desired.  Application of dry heat from hot cloths; a hot sand bag may help in some cases.  A rubber bag containing hot water can also be used.  Fomentations of hops, etc., applied hot and frequently changed to keep them hot are beneficial in some cases.  I have found in some cases that an adhesive plaster put over the sore parts relieves the severe pain.  Porous plasters are also good.  Tincture of ranunculus bulbosus (buttercup) is a good remedy.  Put ten drops in a glass half full of water, and take two teaspoonfuls every hour.

[Illustration:  Sciatic Nerve.]

Sciatica.—­This is as a rule a neuritis of the sciatic nerve or of its cords of origin.  It is characterized by pain chiefly along the course of the sciatic nerve.