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

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136 INJURIES OF NERVES.
and down the nerve tracks. A clever sergeant, a Canadian
by birth, described his first pain as like that which is
felt when a cricket-bat carelessly hehl is struck by a swift
ball. This feeling of numbness, with tingling pain, is
common in cases of slight nerve wounds or contusions.
Even when the primary pain is severe, it is lost in a few
moments. Indeed, cases of pain which arise at the moment
of the hurt, and continue steadily, are ver}' rare.
I recall but one instance, that of a man who said he
had burning pain in the hand from the instant he was
hit.
In the book on Gunshot Wounds and Injuries of Xerves,
by Drs. Morehouse, Keen, and myself, fortj'-three cases
of nerve wounds are analyzed in regard to the immediate
symptoms. To these I now add forty-eight. Of the
ninety-one so brought together,
were shot
rather more than onethird
had no pain, and many did not know they
until weakness or the sight of their own blood betrayed
the presence of a wound.
We may suspect that the difference as to pain in these
cases depends upon the rate of motion of the ball, which,
Indeed, we
if slow, w^ould be more likely to cause pain.
all know from personal experience how little pain is given
by a sharp cut made quickly, and it has even been proposed
by Dr. Richardson to utilize this fact in order to
open abscesses without pain. I presume that a man in a
high state of excitement would be less apt to know of his
being wounded, and this is certainly the case; but there
are also men who have been shot throuo-h the brachial
plexus while quiet spectators, and have first been informed
of it
by the flow of blood.
Other and rare cases have remote pain, and none at the
point hurt.
I have seen an instance where the ball, having
traversed the inner and upper region of the thigh,
partly divided the sciatic nerve. The pain was altogether