Causes.—­It occurs most commonly in adult males.  The person may have a history of rheumatism or gout in many cases.  Exposure to cold after heavy muscular work or exertion, or a severe wetting are common causes.  The nerves in the pelvis may be compressed by large tumors of the ovaries or womb, by other tumors, or by the child’s head during confinement.  Occasionally hip joint disease causes it.  The nerve, as a rule, is swollen, reddened, and in a condition of “interstitial neuritis.”  The pain may be most severe where the nerves emerge from the hip bone, behind, or in the inner back, and middle part of the thigh.

      Nervous system 267

Symptoms.—­Pain is the most constant and troublesome.  It is sometimes very severe.  The onset is usually gradual, and for a time there is only a slight pain in the back of the thigh; soon the pain becomes more intense, extends down the thighs, and leg and reaches to different parts of the foot.  The very sensitive spots can often be pointed out by the patient, and on pressure these spots are very painful.  It is gnawing and burning in character, usually constant, but sometimes it comes in paroxysms, and is often worse at night.  Walking usually causes great pain.  The knee is bent and the patient treads on his toes.  As a rule it is an obstinate trouble, and it may last for months, or even with slight remissions for years.  In the severer forms the patient must remain in bed and such cases are very trying for both patient and doctor.

(See Mothers’ Remedies under Neuralgia above).

Physicians’ treatment.  Cautions for Sciatica.—­Remove all causes if you can.  Rheumatism and gout, if the patient have them, should be treated.  The patient should not overwork or expose himself to wet, damp weather.  Keep every part dry.  Rest in bed with the whole leg fixed is a valuable mode of treatment in many cases.  Hot water bags from the hip to the knee placed along the painful nerve, sometimes gives great relief.  Mud baths are beneficial.  Hot Springs baths relieve many cases.  Fly blisters placed along the track of the nerve relieve the pain in many cases.  Fomentations of smartweed and hops are good, but they must be changed often so as to be hot.  Wet or dry cupping is a help in many cases.  It draws the blood from the inflamed nerve.  Morphine given hypodermically will relieve the pain, but it is a dangerous medicine to use in a chronic case.  The patient will be very likely to form the habit, and that is worse than the sciatica.  By care and treatment most cases can be greatly helped and cured.  Rhus tox (poison ivy) is very good in minute doses in cases where it is impossible to remain in one position for any length of time.  Ten drops of the tincture in a glass two-thirds full of water and two teaspoonfuls given every hour.  I have helped many cases with this remedy.  The hot iron along the track of the nerve is helpful.  Electricity is better in a chronic case where there is wasting of the legs, and it should be combined with massage.  The galvanic current should be used.