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

REMOTE SYMPTOMS. 163
distressing ulceration is apt to occur at their angles, and
to break out again and again, despite of every care and
attention."
Besides the curious changes here described, the nails
suffer in nerve wounds other nutritive alterations which
have been nowhere well delineated. In many nerve
wounds, where there is
only ordinary neuralgia, and not
glossy skin and causalgia, I have seen the nails clubbed in
some cases, and in others dry, scaly, cracked, and fragile.
Occasionally they are very thin, tender,— so as to be atrophied
in fact. I have not seen their growth suspended
by any nerve lesion, as occurs in some fevers, or rarely in
constitutional S3q:)hilis,
and even complete nerve section
does not prevent lost nails from being reformed. In a
recent case of wound of the
ulnar nerve, the nail of the
little finger was marked transversely by a series of closelyset,
indented furrows, such as I have since seen but once,
and that in a case of hemiplegia, now under my care.
The hair is very apt to desert the red and gloss}' skin
surfaces which accompany causalgia.
In the case of Mrs.
S., quoted above, the hairs on the legs were sparse, and,
under the microscope, the part of the hair nearest the
skin was ragged, the external cells of the hair being ruffled
up in a remarkable manner.
In neuralgia or injury of the fifth pair, alterations of the
hair are common, such as its
becoming partially gray after
an attack, or falling out for a time.
Mougeot quotes Pouteau* as having seen in traumatic
neuralgia the hair growing large and hard, with an inconvenient
tendency to stand erect. Larrey,t whose relations
of his campaigns are rich in interesting cases, describes a
like change in hairs springing from hypersesthetic skin,
* (Euvres posthumes, p. 92. 1783.
f Larrey, cliniquc Chir., v. i.
p. 200. 1829.