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

TREATMENT. 233
caused darting pain in the palm with quivering of the
thumb flexors. I gave opium freely, dressed the wound
with laudanum, placed the arm at rest on a splint, and saw
the symptoms subside and disappear within two days. At
present I should keep such a case well under the influence
of morphia with the aid of the hypodermic syringe,
and prescribe in addition the local dressing described.
Lancet wounds of the sensitive cutaneous nerves about
the elbow we shall probably see no more until bleeding
is partially restored to fashion, as it is sure to be. The
older surgeons were accustomed to treat them by cautery
at the point wounded : this was effected by placing a
morsel of potassa fusa in the lips of the cut;
while others
made an incision above the wound or isolated it
by carrying
the knife around Both it. methods answered in many
cases, while in rare instances, where no such means were
used, excruciating pain and local spasms continued for
weeks or months, until, as in Fare's royal patient, the
symptoms gradually subsided, or some such operative procedure
was employed, as I have just mentioned. Swan*
speaks of cases in which the relief thus obtained was
instant and complete, and thinks that where the symptoms
are not immediate the trouble has arisen from too
early use of the arm. He relates many slighter cases in
which rest, warm opiate fomentations, and the local use
of belladonna gave ready relief.
Mr. Pearsonf reported in 1817 cases of extreme pain
from lancet wounds, in which, after every other means
had been exhausted, the most remarkable ease was
afforded by the use of the following liniment:
R.— 01. OlivoB, 5iiss;
01. Terebinthinge, Jiss ;
Ac. Sulphuric, fon. 31. M.
* Swan on the Nerves, p. 117.
f Med.-Chir. Trans., vol. viii. p. 252.
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