Causalgia. A Report on 32 Cases

lieutenant-colonel, i.m.s. Since Mitchell et al. described causalgia in 1864, the opportunities to study this condition lr* detail have not been many. The following report is based on a series of 32 cases which came under my care during 1944 and early part of 1945 After March 1945 no cases were received up to the end of the year, a very Jmportant fact As I shall explain later this ?an be definitely correlated with the general use of penicillin in forward areas. It is moie than likely that infection in wounds of the nei\es Plays a very important part in the setiology causalgia. All these cases were soldiers who had been wounded on the various battle-fields during the period mentioned above. Out of 32 cases IB ^ ere Gurkhas, a preponderance which cannot be easily explained by assuming a larger number ol Gurkha troops employed. For quite a orig time it was not possible to offer any explanation for this increased liability of Gurkhas to this disorder. Later it was realized at. Gurkhas as a race had a marked tendency to excessive scarring and keloid formation A census of all the Gurkha patients suffering from a" varieties of wounds revealed that out oi ?o cases 38 showed a well-marked evidence of keloid, an incidence far exceeding any seen in fndian troops. The preponderance of causalgia ^ Gurkhas may be explained by assuming a just as they are more liable to form keloids so ey are more likely to develop excessive intradural fibrosis. Support is lent to this view by fact that the use of penicillin, since it reduced infection, reduced intra-neural scarring a ?This is the reason why cases of causalgia stopped coming to this centre after a general Use of penicillin in the forward areas.