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

202 INJURIES OF NERVES.
the body, so that a sudden touch anywhere was unpleasing,
and reacted on the diseased hand.
It would be easy to add numerous instances of causalgia
and neuralgia from nerve wounds, but as I shall have to
relate cases, perhaps to a tedious extent, in illustrating
diagnosis and treatment, I shall cite no more at this time.
—
Effects of nerve injuries upon the function of muscles.
Mechanical disturbances of nerves give rise to the various
forms of spasm and tremor, and to paralysis of motion,
and consequent atrophic changes and contractions.
Local spasm.— 1 have already described the sudden and
violent form of spasm which is sometimes the first symptom
of the wound of a nerve by a ball, and I have also
called attention to the painful spasms which may result
almost instantly from the w^ounding, and probably even
from the division, of a small sensitive skin nerve in bleeding
at the elbow. The latter variety of spasm may
last for
days, and even for weeks, until, as in one instance, the
o-rowing' nails of the clinched hand may cause ulcers in
the wounded palm. In these eases, as in wounds from missiles
of war, the spasms are of reflex origin, and are often
seen in the muscles of unwounded nerves. In the case
of J. H. C.,— related in our Report on Nerve Wounds,—
left median and ulnar nerves, and
the bullet injured the
caused instant cramp of the flexors of both arms, so that
he clutched both gun and ramrod violently. He shook
loose the latter with a strong effort, and then, with the
right hand thus set free, he unlocked the fingers of the
left from their clutch on the gun, after which they did
not ao;ain close.
Tonic contractions of muscles are occasionally met with
at a later stage of these injuries, but are, perhaps, among
the rarest of the secondary symptoms. Such forms of
spasm are readily diagnosticated from atrophic shortening,
by the fact that muscles afl'ected with the latter malady