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

REMOTE SYMPTOMS. 167
of the skin. In generalized atropine conditions of a
limb,
the connective tissue shared the loss which fell
upon the other tissues, seeming to disappear quite as
rapidly as they. It is, however, indicative of the difficulties
which surround these cases, that in a single instance
I have seen a nerve wound give rise to an hypertrophic
state of the connective tissues. The case is so unusual
that I have been unable to match it either from mv own
material or from the records of others.
Such a condition
of sclerosis of the areolar tissues is, however, a rare incident
of spinal myelitis.
Case 29.— John Graham, Company E, 116th New York
Volunteers. A ball entered three inches below the left
axilla on the posterior face, and made exit two inches
below the axilla anteriorly. The arm dropped, and the
man fell, faint and bleeding freely. It is not easy to fix
the date of the iirst hyperplastic change, but quite early
in the case the first and second lingers and thumb slowly
enlarged without inflammatory signs, and with slight
darting pains. After the wound healed, these parts increased
still more and became firm to the touch and
dark-purplish in tint, the lancinating pains becoming
more severe. For several months there was also burnino:
pain in the fingers and palm, and tw^o months after the
w^ound occurred, the skin of the affected parts was shed
almost entire.
Seven months after he was shot, I saw and examined
him through the kindness of my friend Dr. Morehouse,
in whose service the case at that time was.
He had loss of the sense of touch and pain in the first,
second, and lower half of the third finger, as well as in
the palmar face of the thumb. The index and second
fingers were moveless, but chiefly because of their size
and stiffness. The thumb could be stirred slightly. In
all of these parts there were darting pains, and the skin