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

REMOTE SYMPTOMS. 169
Ball * who, without ffoins; so far as to consider rheumatism
a neurosis, is plainly at a loss to fasten upon any
clinical distinction between ueuro-traumatic arthritis and
that due to common rheumatism.
In 1868 Charcotf published his excellent paper upon
arthropathies consequent on spinal or cerebral lesions;
and other facts resembling those which he has related
have since then accumulated largel3\|
In a certain number of nerve wounds, notablv most
often in those of the upper extremities, one or more of
the joints in the wounded limb become swollen. The
nature of the injury does not seem to influence the case,
as I have seen it follow dislocations, ball wounds, and contusions
of nerves, while in an interesting case of Dr. Packard's,
it was one of the consequences of compression of
the sciatic nerve by a tumor. More lately, in the service
of my friend Dr. J. A. Brinton, at the Philadelphia
Hospital, I saw a man who had extensive joint lesions,
owing to the brachial nerves having suffered during the
dislocation, or upon the subsequent reduction
of the humerus,
so that I suspect
than has been supposed.!
these troubles are more common
In one case the joints of the
fingers became swollen and tender on the third day after
ball wound of the brachial plexus, but usually the swelling
appears much later, and, like the glossy skin, is fre-
Often masked
quently the olispring of secondary neuritis.
at first
by the general inflammation of the limb, or concealed
by the cedema so common after nerve wounds, it
is more persistent than these, and, as they fade, begins to
* Eheumatism Visceral, Benj. Ball. Paris, 18G6, p. 88.
t Arch, de Physiol., 18G8, p. 160.
X Dr. Scott Alison (Lancet, March, 1846, p. 278) was the first to describe
the arthritis of hemiplegia. Although brief, his account of the
malady
is clear and sufficient.
I have since met with similar cases.
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