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

VARIETIES OF MECHANICAL INJURIES OF NERVES. 121
that ill the coccyx also increased. The sense of touch was
nowhere impaired, but the whole leg,
and the anterior
crural region, as well as the penis, always
felt unnatural.
The spine and coccyx exhibited no tenderness, but the
On his return, some weeks later, my assistant,
sciatic nerve, at its exit and in the thigh, as well as the
whole left buttock, were sensitive to pressure. Presuming
that we had to do with a case of slight neuritis, and perhaps
of inflammation of the lower end of the cord, I
ordered ergot, tonics, and ice to the nerve track.
Dr. "Wharton
Sinkler, noticed that the buttock was enlarged.
carefully re-examining the part, we then observed that it
was also too lirm, and that the surface was covered with
dilated vessels, its temperature being at least a degree
above that of the other side. To remove my doubts, I
plunged a hollow needle into the mass, and after rotating
it, so as with its sharp, pen like edges to cut loose small
pieces of the tissue, I applied a syringe, and by
its aid
sucked up a little blood and several of the loosened fragments.*
There was no pus, but the shreds, when examined,
proved almost certainly to be cancerous.
As regards their early influence upon the nerves they
stretch or compress, aneurisnial growths probably act
sooner than innocent fibro-plastic masses, because of their
continual pulsating movement. In the abdomen, aortic
aneurism is apt to occasion pain, which is one of the
earlier signs of disease, and sometimes antedates all otherforms
of deeper constitutional disturbance.
In the chest or neck, the nerve affections due to thoracic
aneurisms are seen in the form of hoarseness or
aphonia, froyn
On
injury to the vagus or recurrent laryngeal
* This method is far more sure to bring away the needed portions of
tissue than Duchenne's trocar, which often fails, and has the disad*-
vantage of not securing any fluid which may be present.
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