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

REMOTE SYMPTOMS. 159
to speak more cautiously, when the eczema came back
the pain declined."
Since our report, Mr. Annandale* has published a
very interesting history of wound of a finger with tender
cicatrix, followed by glossy redness of the skin of the
same hand, and finally of the opposite hand. Mr. Syme
removed the finger, which soon relieved the hand first
involved, but was succeeded by swelling and increase of
pain in the other hand. The history, unfortunately, ends
here, and there was no microscopic examination of the
portion of nerves removed. This is especially to be regretted,
because of the mystery which hangs over the
production of this form of mal-nutrition of skin and its
accompaniment of burning pain. I have never seen in
these cases any distinct redness or swelling upon the
opposite side, although in severe examples the sense of
burning and the hypereesthetic state of the skin was apt
to aflect first the symmetrically related member, and then
other regions or the whole surface.
In a single instance,
the unwounded limb was attacked by a vesicular eruption
like that which existed on the other palm. Before leav-
it were well to notice the fact to which I
ing this subject,
have already called attention, f that glossy skin, with
causalgia, may follow central disease, as in the following
very interesting case, which was probably an example of
what it is now the fashion to call
" sclerosis" of the antero-
also have
lateral column of the spine. That there may
been alterations of nerve trunks,.! cannot, of course,
deny. Charcot has shown that, both in old spinal sclerosis
and in cerebral palsies,
aflections of extra central neural
fibres are not uncommon, so that the present case was
probably an extreme example of similar disease.
* Malformations of the Fingers and Toes. London, 1866, Case 35.
t San. Com. Kept., p. 429.