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

^108 INJURIES OF NERVES.
was usually limited to half an hour or an hour. Their
results, therefore, however valuable, fail to enlighten us
as to the effects which weeks or months of graduallyincreasing
compression may bring about. In fact, rapid
or slow pressure upon nerves present distinctive diflerences
of very striking character, so that while the former
is apt to occasion most severe and positive
suffering, the
latter may sometimes cause extensive muscular wasting
without sensor}' loss of any kind whatsoever. Nevertheless,
in a vast number of cases of pressure on nerves, we
have presented, with some modifications, the sequence of
symptoms related by Bastien and Vulpiau, while it is also
true, as a clinical fact, that there are manv and curious
variations from this physiological programme.
These observers divide the phenomena of acute compression
into two periods, the first extending from the
moment of making compression up to that of ceasing it;
the second, from this latter date up to the time of the
return of the normal status.
Each period
is divisible into
four stages, more or less distinct from one another.
First period: stage first is marked by delusive sensory
impressions, such as formication, prickling, and a sense
of
warmth, which may exist throughout the whole period
of pressure. There are also said to be false cramps, whatever
these may be, while tactility and motility remain
unaltered. This stasre beijins with the first moment of
compression, and lasts from two to ten minutes.
Stage second is characterized as the intermediary stadium.
It lasts from a few seconds to a quarter of an hour,
and in it
disappear all the symptoms of the former stage,
to be followed by a seeming return to the normal condition
and feelings.
Stage third.
Hyperesthesia is here the prevalent character,
all the forms of sensation becoming exalted, but the
muscular function still
remaining unaltered.