The Medical Clinics of North America
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Northwestern University Medical School COCCYGODYNIA Oppenheim1 thus describes coccygodynia: ''The name coccygodynia is given to a severe neuralgiform pain in the region of the coccyx which occurs almost exclusively in women. The pain comes on spontaneously or in the act of sitting down, of walking, or of emptying the bladder and intestine, or it is increased by any factor which is associated with contraction of the muscles which are inserted at the coccyx. The coccyx is usually sensitive to pressure and to movement. The disease follows a severe confinement or trauma, but it may have an insidious onset. It has even been observed in children. It may develop without any exciting cause in hysteric persons. In many cases it is a true neuralgia; in others it is due to an inflammatory process in the muscles inserted at the coccyx, or in the surrounding soft parts or bones. These conditions can usually be distinguished from neuralgia by careful bimanual examination. I have seen slight cases recover in a few days or weeks, e. g., under the influence of opium suppositories, others in which the refrigerating double current sound was helpful, and severe cases which defied all treatment and necessitated an operation (separation of all the soft parts from the coccyx or its removal)." One wonders just what is meant by a "true neuralgia," and just what the author means when he says "it may develop without any exciting cause in hysteric persons." The case I wish to tell you about today is of interest because it shows that what might be considered a real physical cause 1 Brace's Translation of the 5th Edition of Oppenheim's Text-book of Nervous Diseases, p. 595. 37