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

132 INJURIES OF XERVES.
An ac-
water-carriers of tlie town of Rennes are liable.
count of this singular malady is given by M. Bachou.*
The water-carriers use a huge iron vessel, holding about
eighteen quarts of water, and furnished with a single
handle on the side. The belly of this great vase rests on
the antero-lateral part of the thorax. The arm thrust
through the handle, which is turned outward, embraces
the circumference of the jar, which it presses against the
side. At the same time the humerus is thrown outward
and upward, so as to give the handle a solid support.
This enormous load, which is at least seventy-six pounds,
exerts by the agency of the handle a strong pressure on
the external and posterior region of the arm, crossing
obliquely the direction of the radial nerve. Paralysis of
the extensors of the wrist and hand is a common consequence,
and in some instances this is complicated by
neuritis, of which the reporter gives a clear and interesting
account.
Cratch palsy.
— A common cause of paralysis from pressure
in army practice, but one very rare in civil life, was
known to our hospital stafl' as " crutch palsy." Early in
the war a great number of instances of this malady were
sent to our wards, and some occurred while patients were
under our own care. Such were usually emaciated men,
who, being of large stature, and therefore of great weight,
bore heavily upon the cross-piece of the crutch, which
was commonly of wood, and not cushioned. I do not recollect
seeing this malad}' in any person whose axilla was
well defended b}' adipose tissue, and by the iirmness and
tone of the muscular folds which bound it before and behind.
Neither was it
frequent after the wounded began
to be supplied with a proper form of crutch. The trouble
* Kec. de Mem. de Med., de Chir. et de Pharm. ruilitaires, t. ii. (3 serie)
quatrieme Fascicule, No. 52, Avril, 1864.