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

212 INJURIES OF NERVES.
great pectoral muscle, probabh/ hy ivjury to the external anterior
thoracic nerve ; extension of disease from the wounded nerve to
the brachial plexus, with consequeyit loss of sensation and motion
; lesions of nutrition ; intense burning pains ; muscido-spiral
and median p)rbuipally affected. Stephen Warner, aged
thirty-three, farmer, New York, enlisted August, 1862,
Company B, 18th Pennsylvania Volunteers. He was
healthy to date of receipt of wound. At Locust Grove,
November 27, 1863, a ball entered the left chest, under
the first rib, half an inch below the clavicle and two and
a half inches from its sternal end. Passing probably under
the arch of the subclavian artery, it went backward and
downward, and made its escape two inches below the inferior
angle of the left scapula, three and a quarter inches
from the spine. The ball was fired by a skirmisher not
twenty yards distant, and was received while the patient
was in the act of bending forward to aim. He fell, giddy,
but conscious ;
tried to move, but failed, and fainted from
loss of blood. After several hours he revived, and discovered
that the left arm and hand were sensitive throughout.
On the radial side of the forearm there was slight
numbness,— a condition compatible with perfect tactile
sensibility. Motion appears to have been lost, or greatly
lessened during some hours, and within a day to have become
restored entirely. No doubt exists as to this point.
No dressing was used until the third day, when water
was applied. At this date the arm motions were complete
below tlie shoulder, and there had been no pain.
Soon after the cold dressing, to which he attributed the
sequent symptoms, he was seized with neuralgic pain,
which was principally in the median nerve distribution,
but also on the outside of the arm and shoulder, with a
spot of intense pain at the deltoid insertion. The pain
was darting and pricking in its nature. Coincidently with
the pain, the joints of the fingers swelled and became sore,