Steadily improved by many technical advances, the original intracranial attack on the branches of the trigeminal nerve, independently and almost simultaneously suggested by Hartley1 of America and Krause2 of Germany, has gradually evolved from a procedure of questionable merit and great danger into one of the safest and most successful of major surgical procedures. There are, indeed, few greater triumphs in the history of surgery, for the obstacles at that early period of cranial surgery must have seemed insuperable. But the operation in its most approved form is still far from perfect, largely because of certain disturbances which follow in its wake. With the belief that these defects are now, in a large part, avoidable and with no greater risk to life, another operation for the permanent cure of tic douloureux is proposed.
Although tic douloureux has been recognized as a clinical entity for centuries, its relationship to the trigeminal