Abstract
Major trigeminal neuralgia, often called tic douloureux, usually can be distinguished without difficulty from other forms of neuralgia. The mere recounting of the tale of woe by the patient is sufficient; often no questions need be asked by the examiner. The disease is constant in its expression if in nothing else. In my clinic or office I have the records of 760 cases, and in but one of these have I any account of the symptom here described. The patient was brought to my clinic at the University Hospital by Dr. J. M. Beffel of Milwaukee. Dr. Beffel told me he had noticed that<i>while asleep</i>the patient grabbed his cheek, as he was wont to do during the paroxysms when he was awake. Not only did he clutch his cheek, but there was a spasm of the facial muscles often seen in the paroxysms. He was under observation for
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