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

VARIETIES OF MECHANICAL INJURIES OF NERVES. 119
Verneuil communicated to Tillaux a case of formation
of callus, which is
probably unique as yet in medicine.
A gunshot wound broke the elbow, and after resection,
amputation became necessary at the close of a month.
On examination, the radial nerve, a little above the bend
of the elbow, was found swollen and inflamed, and on one
side of the enlargement, and penetrating it,
was seen an
irregular bony mass of the size of a bean, and plainly of
recent formation, as the color, feeble consistence, and the
form of its osteoplasts attested. As this was not a piece
of old bone, it was probably-due, as M. Verneuil believed,
to a morsel of accidentally transplanted periosteum, which
had given rise to a certain amount of ossification at a
point quite remote from the callus.
Pressure hy tumors.— The gradual growth of pathological
new formations in almost any region of the body is
a common cause of pressure upon nerves. Here,
as in
other examples of compression, it is important to consider
two points,
— the rate of growth in the compressing mass,
and the anatomical relations of the nerves aflfected. In
most cases of nerves of mixed function, we have the usual
sequence pointed out by Bastien and Yulpian. First
prickling, tingling, and sense of heat, then exaltation of
sensory function and even hyperagsthesia, with finally loss
of sensibility and motion. The speed with which these
follow one another is
governed by the rapidity of growth
of the compressing mass, and the ease with which the
nerves influenced are capable of suftering from the physical
effect. This will depend in a great measure upon how
firmly they are tied down. Tumors occurring in relation
to the sciatic, for example, at the middle of the thigh,
easily carry it with them unharmed for some time, and
until the growth has become very large. But a tumor
near to the outlet of this nerve, or a subperiosteal growth
within the pelvis and beneath the points of emergence of