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

138 INJURIES OF NERVES.
The following case illustrates unusually well this very
frequent occurrence :
Case 16.—A sergeant, wounded in the left side of the
neck, was placed in our wards witliin four days from
the date of his wound, which seemed to have directly
implicated the brachial plexus. His arm was totally
as to motion and sensation from the moment he
palsied
was hit; sensation returned within five days. Motor
power was restored in all the flexor muscles of the hand
within ten days and, under three ; applications of electricity,
it reappeared in all the other muscles except the
deltoid and triceps extensor, whicli never perfectly regained
their functions during ver}' prolonged treatment.
This temporary though entire loss of motion and sensation
in nerves not absolutely cut across, and, even in
such as have been untouched by the missile which has
passed near them, may find, perhaps, some explanation
in the experiments upon the effects of pressure already
related.
In certain cases, the nerve wound, in place of causing
primary loss of mobility, occasions either sudden muscular
contraction, followed by instant loss of power, or, in
very rare instances, long-continued spasm. A soldier,
wounded in the brachial plexus at Antietam, was obliged
to ask a comrade to unclasp his rigid fingers from their
hold upon the musket. A still more singular example
is that of C, who was shot through the arm at iShiloh,
and whom I have recently examined. When he was
shot, the thumb turned inward so violently as to cut
the skin of the palm with the nail. It remained in this
position six hours, when the arm was amputated. I recall
other cases of like nature; but lasting spasm after nerve
injury is a rare occurrence.
Early constitutional symptoms ; shock.— One of the gravest
of the instant consequences of nerve injuries is that which