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

the connected tissnes.
REMOTE SYMPTOMS. 149
These irritations are in some cases
of inflammatory birth, and in others purely mechanical,
but in all probability they result in the propagation to the
connected parts of a succession of interrupted waves of
force, which give rise to many of the phenomena and
appearances with which these cases A present us. part
of the symptoms is due to loss of nerve force, a part to
irregular nerve force and I use this term because we are
;
not clear as to the nature of the abnormal influences thus
exerted. The separation of these two causes of evil in
nerve wounds is not always easy, so that any one who sees
man}' nerve injuries will constantly be called upon to admit
that in numerous instances we cannot tell whether a
given result be due to one cause or the other, since, as
regards the influence of the hypothetical nutritive nerves,
vaso-motor and all other, upon tissues, we know so little
as to be unable to decide whether this or that condition
of tissues may be caused by a non-supply of their normal
nerve impulses, or by some irregularity in these. We have,
indeed, as yet, no good
test which shall serve us to make
this distinction as clear as it is in wounds of musculomotor
nerves, in which nerve section causes palsy, and
nerve irritation some form of spasm. Yet interesting as
these questions may be, their settlement does not affect
either our clinical prognosis or our therapeutic methods.
In considering the local symptoms which follow nerve
wounds and endow them with an interest belonging to no
other lesions, I shall treat, first, of the nutritive changes;
second, of altered states of sensibility; and lastly, of the
various causes which afi'ect motility and mobility.
— Trophic changes. When, as rarely happens, an injury
has totally destroyed a portion of all of the great nerves
of a limb, iiud there has been no subsequent reunion, the
related tissues undergo atrophic changes which are very
remarkable. The muscles waste away, the areolar tissue