THE TREATMENT 
OF 
SCIATIC NEURITIS 
BY THE 
LOCAL ABSTRACTION OF BLOOD. 
BY 
F. GUNDRUM, M.D., 
ESCONDIDO, CAL. 
REPRINTED FROM THE THERAPEUTIC GAZETTE, FEBRUARY 15, 181)2. 
DETROIT, MICH. : 
GEORGE S. DAVIS, PUBLISHER. 
1892. THE TREATMENT 
OF 
SCIATIC NEURITIS 
BY THE 
LOCAL ABSTRACTION OF BLOOD. 
NO physician can appreciate the excru- 
ciating pain of a severe attack of sci- 
atica unless he has suffered himself, nor can 
he feel how grateful the poor sufferer feels 
for prompt relief unless he has had such re- 
lief himself. Therefore, those remedies which 
give prompt relief in well-selected cases should 
be known and used by the practitioner. I 
do not desire to go into the pathology of the 
disease, except to say that I believe the great 
majority of cases of sciatica are due to in- 
flammation of the nerve-sheath, or the nerve 
itself, and that rheumatism, gout, syphilis, 
anaemia, etc., have very little to do as factors 
in the causation of the disease. 
The great majority of cases that have come 
under my observation were healthy males, 
above the age of twenty-five, and inclined to 
corpulency. In nearly every case I have 
traced the attack either to a direct injury 2 
or taking cold, most frequently the former, 
the most frequent injury being strain or over- 
stretching of the nerve, by lifting heavy weights 
from the ground, or remaining in a stooping 
position, where the nerve is kept continually on 
the stretch, besides being inordinately pressed 
on by the overlying muscles. The inflamma- 
tion may involve a considerable extent of the 
nerve, as shown by the extreme tenderness 
on pressure over its course down the thigh. 
At times it is entirely confined within the 
pelvis, and I have good reasons for believing 
that the inflammation may affect any one of 
the individual nerves composing the great 
sciatic. Believing that the reduction of the 
inflammation in the nerve is the quickest 
way to overcome the disease, I have acted 
on this principle for nearly twenty years, by 
using one of the retired methods of treat- 
ment,-viz., wet-cupping,-the first subject 
being myself. I will give a couple of cases 
from the many I have treated by cupping, 
which will illustrate its beneficial effects. 
Case I.-This case was myself. In 1872, 
when I was 26 years of age and in robust 
health, I rode nearly night and day. My 
vehicle was a light two wheeled sulky, which 
had the seat so much tilted back that I had 
to lean forward very much, thus keeping the 
sciatic nerves on the stretch all the time. 
Besides, there was a wire-railing around the 
seat just high enough to strike the sciatic 
nerve a little below where it passes out o.f 
the pelvis. This soon had the undesired 
effect of producing the severest sciatic neuri- 
tis imaginable. The pain was principally in 
the lower lumbar region and the upper third 3 
of the thigh. The nerve was extremely ten- 
der even to light pressure from where it 
issues through the great sciatic notch to the 
junction of the upper and middle third of the 
thigh. For four weeks nearly every known 
method of treatment was tried, with but 
temporary or no benefit. I suffered horribly 
unless well under the influence of morphine 
or brandy. Believing in the inflammatory 
nature of the disease, I had my brother 
apply fourteen wet cups over the lower lum- 
bar region, on the hip and down the thigh 
over the course of the nerve. As the blood 
began to flow I began to feel easier, and, to 
make a long story short, I suffered no more 
pain, and took no more morphine or brandy. 
I stayed a week in bed, got up, and went to 
the springs to get away from business and 
recuperate my strength. 
Case II.-Mr. C., a Frenchman, aged 52 ; 
has always been very healthy. He eats a 
great deal of meat and drinks liberally of wine, 
and has accumulated more adipose tissue 
than is good for him, weighing two hundred 
and ten pounds. About December 1, 1891, 
he handled a considerable amount of grain 
in bags, and sowed grain for two days, which 
started a pain in his back and hip. He thinks 
he also took cold while at work. The pain 
gradually grew worse. Domestic remedies 
were tried for rheumatism, and a gout pill 
was tried. December 20 he was taken sud- 
denly worse, suffering excruciating pain, and 
his son then came for me. I found him on 
a " pallet" on the floor, before the fireplace, 
yelling from pain. The pain was located in 
the posterior part of the hip, down the thigh 4 
for twelve or fourteen inches, and in the 
lower half of the outside of the leg and foot. 
The nerve was extremely tender to pressure 
in its upper part, but nowhere else did press- 
ure elicit any tenderness. I gave him a hy- 
podermic injection of morphine, 3/% grain, and 
atropine, grain. Not having eased him in 
an hour, I gave him grain, and in another 
hour another grain. Besides, I applied 
several dry cups. I left grain of mor- 
phine, all I had, to be given if pain returned. 
This was given during the night. 
I returned next morning at ten, and found 
Mr. C. suffering greatly again. I had sharp- 
ened my scarifier, and got ready to abstract 
blood. Having no regular cupping glasses, 
I used small tumblers and wine glasses. I 
commenced below the crest of the ilium, and 
followed the sciatic down the posterior part 
of the thigh, applying six small tumblers and 
two wine-glasses, and on the calf I applied 
one large and one smaller glass. 
After dry cupping for five or six minutes, 
distending and paralyzing the capillaries, I 
scarified deeply, and succeeded in drawing 
about ten ounces of blood. I then wrapped 
my patient up in thick woollen blankets, and 
gave him 3 ounces of whiskey, and left him 
for an hour. As in my own case, he began 
to get ease as soon as the blood began to 
flow, and when I got through cupping, he felt 
only a slight pain in the outside of the foot. 
When I returned he was enjoying his pipe, 
and was as happy as could be. I ordered 
him to keep between blankets, not to move 
for anything, and to use a bed-pan when his 
bowels moved, so as not to put the nerve on the stretch in sitting on the ordinary cham- 
ber. I also gave him the following pre- 
scription : 
5 
R Extract, gelsem. fluid., fjii; 
Potass, iodidi, Jjiii; 
Potass, acetatis, 
Aquae, q.s. ad sjvi. M. 
Sig.-Two teaspoonfuls four times a day in half a glass 
of water. 
He was kept a week in bed, and then allowed 
to get up. He suffered from some pain on the 
outside of the ankle for three days after cup- 
ping. His wife applied mustard, which was 
left on till it produced some vesication. This 
removed the pain ; since then there has been 
no more pain. 
I have been induced to write this article for 
three reasons,-first, I know of no standard 
work which says a word about this method, 
and I have not seen anything concerning it in 
any of the journals which I have taken for 
twenty years ; second, in well-selected cases, 
and taken before permanent pathological 
changes occur, I believe there is no remedy 
that will act so quickly both to relieve the 
patient and to bring about so rapidly a subsi- 
dence in the inflammatory process ; and, 
thirdly, it is the most rational treatment and 
the most prompt remedy we have in the purely 
inflammatory types of the disease. When one 
cupping does not have the desired effect, I do 
not hesitate to repeat it once or even twice. 
The patient should be kept in bed, between 
blankets, and perspiration encouraged. The 
limb should be kept absolutely quiet, but I do 
not believe in the straight splint. I have suf- 6 
fered many times with the disease since 1872, 
but never very severely, and my experience is 
that the easiest position of the limb is to have 
the thigh slightly and the leg considerably 
flexed. Under these circumstances the pa- 
tient can lie on his back or either side, which 
is a great comfort to him. The use of adju- 
vants may be necessary or advisable, such as 
circumstances may suggest. I would espe- 
cially advise the use of morphine and atropine 
for a few days if there is any remaining pain 
after cupping. 
Before discharging the patient he should 
be fully advised to be careful in the future 
not to strain the sciatic or expose himself to 
" catching cold."