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

116 INJURIES OF NERVES.
istence, in the few painful cases, of some coefficient factor
besides the physical condition to which I have been
alluding. Painful scars have been again and again extirpated,
but I have been unable to find any microscopic
examination of the state of their contained nerve fibres.
The nearest approach to a satisfactorj' insight in this
direction is to be had from a study of the terrible Spedalksed
or Tubercular Leprosy of ISTorway.
Danielson and Boeck* have shown that in the anaesthetic
form of this disease the nerves undergo certain
changes which are finally propagated from periphery to
centre.
The earlier symptoms are neuralgia, with tingling,
and hyperaesthesia, which become intense, and are followed
by anaesthesia and loss of motion, much as happens
in the gradual compression of nerves. The earlier of
these symptoms seem to be related to simple congestion
of the neurilemma; the succeeding and latest phenomena
are due to a hyperplasia of the connective tissues within
and without the nerve sheath, which occasions compression
of the nerve fibres, and ultimate extinction of their
functional life.
Perhaps some such alteration may occur in the nerves
of certain painful scars, but it seems at all events quite
certain than in others which have undergone like contraction
no nerve injury exists, so that we must look
further than the mere fact of cicatricial contractions, and
concede the existence of other and unstudied pathological
conditions.
Pressure from
— callus. Pressure upon nerves by the excessive
growth of callus used to be thought a common occurrence;
but although nerves are sometimes imprisoned
in forming callus, there does not seem to be in it
any
* Kecueil d' Observations sur les Maladies de la Peau. W. Boeck et C
Danielson. Christiania, 1860.