The  spinal  column  is  a  very  common  seat  of  neuralgic  pain,  especially  in
weakly  women  and  after  concussion  of  the  spine.  It  constitutes  one  of  the
most  troublesome  of  the  many  pains  of  hysteria,  and  one  of  the  most  endur-
ing consequences  of  railway  accidents.  The  pain  is  in  most  cases  felt
through  a  considerable  vertical  extent  of  the  spine,  and  is  specially  intense
in  certain  spots,  commonly  in  more  than  one.  The  dorsal  region  is  the
most  common  seat,  next  the  lower  cervical,  and  least  frequently  the  lumbar
region.  Sometimes  the  pain  is  localized  on  one  side  of  the  spine,  close
to  it.  The  pain  felt  in  the  spine  in  cases  of  gastric  ulcer  seems  to  be  a  sort
of  reflex  neuralgia.  Often  the  pain  seems  to  passup  to  the  back  of  the  head.
Spinal  neuralgia  may  be  associated  with  a  similar  pain  in  some  other  part  of
the  trunk,  shoulder,  arm,  or  leg.  It  is  usually  accompanied  by  considerable
tenderness,  and  is  increased  by  fatigue,  by  use  of  the  legs,  by  long  sitting


1148  NEURALGIA.
or  standing,  and  also  by  vibration,  such  as  the  movement  of  a  carriage.
