Injuries of nerves and their consequences - Reflex Sympathetic ...

VARIETIES OF MECHANICAL INJURIES OF NERVES. 101
irritability owing to some niidetermined pathological
cause. It is, of course, quite possible that there may
have been here a co-operative spinal palsy, limited to
nerves of movement; but he does not show that the muscles
were at all insensible to electricity ; and, as regards
the mere fact of there being only motor palsy and no sensory
loss, it may be added that this is a common incident
of nerve wounds of all kinds, as I have elsewhere shown,
and as I shall have occasion to point out more at length
in future.
The essays of Malgaigne and Duchenne are so full of
cases of palsy from dislocations as to make it needless to
quote
all the instances I have seen. The three histories
which follow may suffice as illustrations.
Case 9.— Dislocation of humerus left from a fall ; reduction
in twentyfour hours ; at the fourth week general loss of jpower ;
atrophy and contractions ; rapid cure by electricity.
A soldier
fell from a tree, striking and dislocating the shoulder so
as to displace the left humerus, in what direction is not
known. It was replaced within twenty-four hours, and,
the previous pain and numbness disappearing, he remained
well for four weeks, when the arm began to waste,
with loss of power, which became complete in a few
months. Sensation was much less altered. At the close
of a year, we found him with only partial
the arm, and with slis:ht use of the flexors and extensors
ability to flex
of the fingers.
Marked atrophy also existed, with contraction
of the pronators. Rapid
relief and final cure
were obtained by electricity. In this case there was
plainly some trouble at the time of dislocation, and the
resulting difficulties were due to secondary changes in the
brachial plexus. As a rule, such cases are readily amenable
to treatment.
The following very instructive case was sent to the Hospital
for Deformities and Nervous Diseases, by Prof. D.
H. Agnew
: