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

REMOTE SYMPTOMS. 155
and as Hutchinson relates, they assume the form of whitlows,
which are painful or not, as they chance to be in
anaesthetic or hyperaesthetic regions. The vesicular diseases
of the skin which, in our experience, followed nerve
w^ounds by missiles, we described as eczematous, a term
which haa been criticised by Hanfield Jones and Charcot.
In reality, these eruptions were somewhat peculiar, and
more like eczema than herpes. In a few cases they ap-
made one of the
peared upon healthy skin, but usuallj'
features of that singular condition of atrophied skin with
burning pain which followed a remarkably large proportion
of gunshot wounds of nerves. The eruption consisted
of small, scattered, acutely-pointed vesicles, full of
a thin, serous Huid. On the healthy skin they were larger,
and dried up without sequelse but when situated on the
;
thin and altered teguments, they
left behind them minute
ulcers, which horribly increased the itching or the burning
so constantly present.
It was somewhat rare to see any case of glossy skin,
especially with causalgia, unattended by vesicles; but
these w^ere apt to come and go in successive crops, and
we soon observed that when present the burning pain
was lessened,
— a fact which our patients also recognized.
As a rule, the eruption was widely spread over the affected
skin, and was not gathered into groups.
from the United States Army Hospital for
—
Atrophic conditions of the skin. Previously to the Report
jN'ervous Diseases,
Mr. Paget had described briefly, but forciblj-, a
peculiar shining, glossy state of skin, the accompaniment
of certain intractable neuralgias.* The earliest mention
of this form of pain from nerve wound is, however, to be
met with in the classical case of a portion of ball imbedded
in the radial nerve which Mr. Alex. Denmark
* Paget's Cases, Med. Times and Gazette, March 26, 1864.