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

122 INJURIES OF NERVES.
nerves, or in affections of the pupil from lesions of the
sympathetic nerve,— effects which may also arise from
glandular and other enlargements.
As interesting illustrations of some of the conditions
which have influence in cases of pressure on nerves by
tumors, as well as of skillful surgical interference, the two
following cases may answer.
Dr. D. Hayes Agnew* presented to the Pathological
Society of Philadelphia a bursal tumor, about an inch in
diameter. It had occupied a place at the bend of the
elbow, on the inner side of the tendon of the biceps,
causing pain and loss of motion in the flexors of the
thumb and fingers, and the extensors in general. It was
so bound down by the deep fascia as to project but slightly,
and to greatly exaggerate the pressure it was making upon
the nerves. After cutting through the bicipital aponeurosis,
the growth was found to be invested on the surface
by the flattened median nerve.
On dissecting this away, pushing it aside, and turning
out the mass, a like connection was discovered beneath it
with the posterior interosseous trunk. It was thus endangering
both nerves at once; but, notwithstanding this
curious complication, the recovery which followed its
removal was in all respects satisfactory.
On tlie same evening, Dr. Packardf exhibited to the
same society, a tumor as large as a lemon, which grew
just under the lower edge of the gluteus maximus. Its
position caused incessant pressure upon the sciatic nerve,
and made motion painful, and rest on the back or left side
impossible.
For eight months the patient had been unable to remain
in bed, and found only temporary ease in incessant
changes of posture. Removal of the mass was readily
* Proc. Path. Soc. of Phila., Oct. 1863. f Ibid.