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

REMOTE SYMPTOMS. 161
tive fibres appear to be segmented, the niuscnlar substance
persisting in some places and being absent in others. At
the same time, we observe the formation of a more or less
considerable quantity of fat vesicles in the connective
tissue which separates the secondary bundles of fibres,
and much more rarely between the primitive fibres. Multiplication
of the nuclei and hyperplasia of the general
connective tissue of the muscle are also observed, while
the vessels sufier only a loss of calibre, without other
changes."
Atrophy from complete nerve division is pretty surely
followed by contraction of muscles, but I have been
unable to determine the time at which this begins, and
the stage of atrophic change to which it is related.
It is
usually a remote consequence of complete division of a
nerve, and is, perhaps, the worst of all the signs which
foretell a hopeless loss of function. It sometimes happens
that extreme atrophy takes place without consequent contraction
;
but we may then suspect, enough of time having
elapsed to admit of the change, that the nerve communications
have been in
in such a
part restored, so as,
case, to allow of successful treatment. I have said that
usually the shortening bore a strict proportion to the
amount of wasting; but to this there is another exception
besides the one above mentioned. In a few rare cases,
the atrophy being but slight, the contraction has seemed
to be excessive. I am unable to explain this to mj satisfaction.
The force with which the failing muscle contracts
reminds me of the power with wliich certain scars shorten,
and results, as I shall elsewhere point out, in ruin to the
usefulness of the uninjured muscles, and in subluxation
of the joints concerned.
Influence of nerve injuries upon
the nuMtion of the skin and
its appendages. — As in the muscle so in the skin, the nervous
lesions may fall only on the functional innervation, or