A Request for Diagnosis.

Related entry: A Few Practical Suggestions

Editor Ellingwood's Therapeutist:

I would be pleased if you would make a diagnosis of, and suggest a plan of successful treatment, for the following case which I have had under my observation for some time.

The patient suffers from an excruciating pain within the right orbit, behind the eye. It descends the nerve into the last upper molar tooth. Many years ago the patient had the tooth pulled-the right upper molar. An injury at that time to the nerve and continguous parts was sustained. He has been subjected to recurrences of this pain irregularly ever since. If hot applications be applied for a long time the pain will gradually subside.

The patient was advised to use methyl and continued it with some relief for a year or two, he has also been thoroughly examined by an oculist who adjusted glasses but with no avail. The oculist corrected pronounced astigmatism, but this had no influence upon the pain. Occasionally, the left eye is the seat of the pain but seldom affected to so great an extent as the right eye.

If the patient is exposed to the direct rays of the sun or remains long in bright sunlight, paroxysms of pain will occur. When lying down he invariably finds it necessary to cover the eyes so that no light will strike them, otherwise the pain occurs. This is not true when he is sitting up. Is there likely to be any connection between this pain and the action, of the heart? The patient was given at one time acetanilid phenacetin and cannabis indica, which had a depressing influence on the heart. The patient is 40 years old, a student, and has been afflicted nearly 15 years.

J. C. DUNN.
Ft. Gage, Ill.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.