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

208 INJURIES OF NERVES.
the tenth day he had fever and rigors, with darting pains
in the wound. The nerves became tender on pressure,
and intense burning pain, beginning on the front of the
wrist, extended to the pahii and the face of the indexiins^er
alone.
Six months later, when admitted to Turner's Lane
Hospital, he is described as thin, anaemic, nervous, and
pain-worn sleeps badly, and has ague and dyspepsia. The
;
arm is generally wasted; he keeps the hand wet. Eczema
of forearm above the line of pain is present. There is no
swelling; the odor of the hand is almost fetid. The left
biceps measures seven and a half inches the
; right, eight
and one-eighth. The left forearm measures eight inches;
the right, nine inches. The hand is flexed on the wrist
from contraction of the flexors ;
the nails are much
curved. The median nerve is exquisitely sensitive to
pressure in the forearm, the ulnar only at the wrist. Motion
is entire above elbow and at the elbow, save that extension
is incomplete, from stifiening of the joint. Pronation
and supination are almost lost from joint-troubles.
The hand flexors retain a fair amount of power. There
is no power to extend the hand above the level of the
wrist. The thumb can be passively moved, but there is
no voluntary control over the metacarpal joint movements,
although the last phalanx can be extended or
flexed. The — fingers are very rigid, their joints swollen.
They can be slightly stirred by will in abduction, adduction,
flexion, and extension perhaps to one-third their
usual extent. The movements were more limited by the
state of the joints than by muscular palsy, because, except
the supinator longus and the thumb muscles, the other
muscles respond readily to induction currents. Under
cod-liver oil, quinine, ale, and good diet, the patient
speedily improved, and after a month was treated for the
causalgia by blisters, made at first with liq.
ammonias