The history of the tic douloureux: autopathograph of an Italian lawyer who suffered from trigeminal neuralgia from 1803 to 1824.

In the years from 1803 to 1824 an Italian lawyer suffered from paroxysmal facial pain that resembled essential trigeminal neuralgia. He kept a diary of his disease from its onset until 1823 when he was admitted to the old Arcispedale S. Anna in Ferrara (St. Anna's Hospital), Italy. The diary was recently discovered in the library of the Arcispedale S. Anna where it was probably put when the patient died. The patient was a man of notable culture and was able to describe with great diligence not only the course of his disease but also the most accredited treatments of that age. Some of the most famous Italian physicians of the period (A.G. Testa, V.L. Brera, G.A. Tommasini, A. Scarpa) examined and treated the patient. Letters of theirs were attached to the manuscript as well as notes on several treatments for trigeminal neuralgia drawn from medical magazines of that age. A copy of the patient's autopsy was enclosed: it ruled out the possibility of secondary neuralgia. This manuscript gives us information on the clinical and pathogenetic theories about trigeminal neuralgia and the state of diagnostic and therpeutics in the first years of the nineteenth century.