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

REMOTE SYMPTOMS. 165
temperament. Tlie nail lesions, on account of which I
have quoted the case here, were very unusual in character.
I am indebted to Dr. J.
C. Norris for notes of the earlier
history of the case.
Case 28.— D. IL, a girl, aged thirteen, of highly nervous
constitution, applied at my clinic for nervous disease,
December 5, 1871.
May 24, 1868, while she was playing in the street, a lad
accidentally ran a small penknife blade into her right
hand. Dr. Norris supposed that it w^ounded the median
nerve at the point where the digital nerves are given ofi:',
because it caused at once decided tingling in the third
linger. The injury seemed trifling,
and gave no further
trouble until thirty-six hours later, when she became sick,
and began to suffer excruciating pain in the right hand,
arm, sternum, and back, with fever, rigors, nausea, and
t^light convulsions, without loss of consciousness. The
liand and arm were slightly swollen, and the liead was
drawn backward, while there w^as also tremor of the jaw
and dysphagia. She could not bear to be moved, and the
least jar was intolerable. The treatment consisted in the
application of ice to the spine, poultices to the hand
and arm, and full doses of anodynes. After four days of
acute suftering she improved, and was nearly free from
annoyance until the tenth day, when she began to compUiin
of burning pain in the injured palm. Meanwhile the
hand remained slightly swollen, livid, and low in temperature.
At this time all the finger-nails of the hurt
hand began to turn dark from blood effused under them.
In a few days they became perfectly black, and their
growth, although not entirely arrested, was for a time
retarded. The least touch increased the pain in the
palm, but a firm pressure did not so much affect it. After
a good deal of ineffectual treatment, the burning pain
yielded to repeated blisters made with liq.
ammonite fort.