Southern Medical and Surgical Journal - Georgia Regents University

—1858.] Editorial 139surgeon, removes in a great degree, the strongest objection any one canadvance against it.It is not, however, simply to signify our approbation, that we havebegun the present notice. Dr. C, in his remarks previous to detailinghis cases, in endeavoring to account for the success of his operationwhen other modes of procedure had failed inadvertently, we are convinced—makesthe statement of an opinion in regard to certain pointsin the physiology of the nervous system, which to our mind, with theexperimental facts before him, should have been given with at least, acertain degree of hesitancy, for it involves, either the correctness or theincorrectness of news loner held as among the established truths of thescience.After presenting a rapid, but a sufficiently lucid sketch of the manyforms of facial neuralgia and of the various operations proposed for theirrelief and after reasoning, we think very justly, on the several causesoperating to produce a continuance or a recurrence of the affection aftermeasures taken for its relief, he says ": from these views we can perceivehow futile the operation of division of the nerve at the foramen infraorbitale must be. When the trunk of the nerve is extensively diseased,no operation can rationally lead to a successful result unless all thebranches emanating from the trunk are cut off from communication withthe brain.I believe that in such aggravated cases of neuralgia, the keyto the operation is the removal of the ganglion of Meckel or its insulation,from the encephalon.Where even a large portion of the trunk of thesecond branch of the fifth pair has been simply exsected from the infraorbitalcanal, the ganglion of Meckel continues to provide to a greatextent, the nervous ramifications which will still maintain and keep upthe diversified neuralgic pains.Besides, the ganglion of Meckel, beingcomposed of gray matter, must play an important part as a generator ofnervous power, of which, like a galvanized battery, it affords a continuedsupply, while the branches of the ganglion under the influence of the diseasedtrunk, serve as conductors of the accumulated morbid nervoussensibility."Now, the objections which might be urged against the confident statementof the above theory, are many and various ;some of which we willhere venture to suggest. In the first place, it is at least questionable,whether or not the centres of the GanglionicSystem can be productiveof sensitive phenomena. Secondly : The nervous ramifications, providedby the Ganglion of Meckel, are not distributed upon parts where the"diversified neuralgic pains are kept up," and especially is this certain,after the trunk of the superior maxillary has been removed ; but theyare distributed to surfaces and parts located internally, as the fauces and6*