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

160 INJURIES OF NERVES.
Case 27.— Intense neuralgia and motor palsy of legs,
with
contracted toes and ankles; no loss of sensation; neuralgia of
arms and hands ; contraction of fingers ; no pcdsy of upper
limbs ; hyper aesthesia of pcdms ; causalgia, and glazed i\'dm\ss
of ulnar side of palms. October 19, 1865. Mrs. S., aged
fifty-two, twice married, has had no children, and never
was pregnant. During the latter years of her last marriage,
and after her husband's death, she had a good deal
of distress and annoyances of various kinds. In 1859,
Mrs. S. had a fall, in which she struck the back of her
neck. Two weeks later she felt suddenly a dull but severe
pain between her shoulders. Within a few days this extended
into the arms, with dragging and tearing pains
down to the wrists. A few months later the pains attacked
the legs,
and were accompanied by violent cramps. About
this time she had distinct articulation ;
but this did not
endure. The intellect was clear throughout the case.
The next symptom was feebleness in the legs, which increased
until she ceased to walk. She has since remained
on a couch or in bed. After a year, as well as can be recalled,
her feet and hands became contracted. The toes
were flexed, the feet extended. The fingers became slowly
flexed to a right angle with the palm, the index-finger
remaining extended. The thumb was drawn tightly into
the palm, and the fingers were extended tightly on themselves.
Sensation was said to have been normal at all
times. It is now entire everywhere. On the ulnar half
of the palm, in both hands, the skin is dark-red, shining,
and glazed. It is in these parts exquisitely tender to the
touch, and is the seat of a constant causalgia or burning
pain. The soles also burn, but are not red nor shining.
All the motions are limited by the contractions, but there
does not seem to be any distinct paralysis.
The flexors
of the toes are somewhat atrophied, but still have voluntary
motion. Her bowels are always costive, never being