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

218 INJURIES OF NERVES.
vein, or the pneuraogastric nerve could be found. The
incision was extended downward, and the sternal attachment
of the sterno-cleido-mastoid muscle divided. The
opening in the neck was finally carried up to the parotid
gland, and the region thus exposed was submitted to the
closest scrutiny, but still without discovery of any large
vessel. As the oozing still continued,
I made fruitless
search for anvthine; laroje enous-h to tie, and at lenscth
filled the wound of exit with charpie, and left the patient
to his fate. Ko further bleeding took place, and recovery
was henceforward rapid.
"For a long time there was complete aphonia, and
after the operation he lost power in the right arm."
Admitted at Turner's Lane Hospital, September 11,
1865.
The following particulars were elicited :
Wounds closed. Right arm : sensation and motion
feeble throughout the limb. I believe this to have been
due to changes in the brachial plexus in the neck, consequent
upon the operation. The neck has, from stifthess,
only one-quarter range of movement. Face : touch is
lost on right side efface, cheek, skin of lips,
from half an
inch in front of ear to line of external ancrle of
CD rio;ht CD eve.
•/
Worst on edge of chin, fair on red part of lips, limited
by middle line. Touch lessened on upper neck. Analgesia,
moreover, less complete in all these parts. The
nose is unaflfected. :
Tongue on the right side there is
absolute loss of gustation, touch, pain, and sense of temperature.
This defect is limited by the middle line. Yery
far back there appears to be considerable sensation. On
the right side motion seems entire; and the right side of
the tongue is firm, red, and well nourished. The left side
of the tongue is paralyzed as to motion almost entirely.
It is soft, flabby, wrinkled, and atrophied, rolling help-
muscles. The
lessly with the movement of the right