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

156 INJURIES OF NERVES.
reported in 18.13.* The patient described the sensation
of pain "as beginning
at the extremities of the tliumb
and all the lingers, except the little one, and extending
lip the arm, to the part wounded. It was of a burning
nature," he said, " and so violent as to cause a continual
perspiration from his face. He had an excoriation on the
palm of the hand, from which exuded an ichorous discharge.
He could not bear to be touched without evincing
additiotial torture." In our wards, we found this remarkable
form of skin disease associated, as a rule, with a very
characteristic burning pain, which in most of the cases
became at length the dominant symptom. f Mougeot, in
quoting our description, labels the condition as erythema ;
but no conception of erythema as known to me would at
all fill
up the picture of this extraordinry malady. Since
we published our history of numerous cases thus affected,
Hutchinson, Annandale, and others have encountered
similar instances, but as yet none have appeared which approach
in severity certain of the examples furnished by us.
I shall therefore content mj'self with a somewhat altered
statement taken from our book, and shall refer the reader
to the annexed cases and to the chapter on sensation for
fuller details.
The state of skin to which I refer is never present
without burning pain, and commonly the earlier presence
of this form of neuralgia enabled us to predict the coming
of the skin disease. In no case did it become visible
short of two weeks, but usually
it
preceded the healing
of the wound, and not rarely was to be traced to an outbreak
of inflammation involvins^ the wound.
The duration of the malady varied from a few weeks
to years, but in all of the cases I have been able to follow
it
has either been cured or gradually disappeared.
* Med.-Chir. Trans., London, vol. iv. p. 48.
J It was singularly rare in cases of ordinary shooting neuralgic pain.