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

238 INJURIES or nerves,
iug a ribbon over the surface. jSTothing could have been
less satisfactory. With regard to motion, the interoseii of
these fingers are fed largely by the ulnar, and their share
in bending the first joints is well known. As to the apposition
of the thumb, the inner half of the flexor brevis
pollicis and the adductor pollicis also obey
this latter
nerve, and may well have been concerned in causing
these motions. Tilhiux, in criticising this case, remarks
upon the supposed return of motion before that of sensation,—
the reverse of the common rule in traumatic palsy.
I am unable to concede that there was here an}^ positive
proof of return of motion in the median distribution, and
as to sensation, the examination unhappil}^ leaves everything
to be desired in the way of accuracy.
In June, 1864, Professor Laugier reunited by suture a
divided median nerve on the day following the accident
which severed it. "From the following night sensibility
reappeared in the paralyzed parts. The day after, the
thumb had recovered its
power to of)pose the index-finger,
and the sensibility was much more lively."
On the eighth day, movement, sensation of touch and
of temperature had returned ; ''nevertheless, a jnn i^limged in
the palmar face of the mediiis caused no pain.' ^"^
It is much to be regretted that this, like the former
case, should have been left so incomplete. I agree with
Tillaux in his suspicion that the analgesia leads us to suspect
that the observer was deceived as to touch and temperature,
and that these were perceived through the
nerves which feed adjoining tracts of skin. lie remarks,
also, that the section was so low as not to involve the
muscular branches, so that it is not surprising that the
flexors of the fingers should still have enjoyed motion.
In like manner, by the integrity of the median muscle
* Tillaux, op. cit., p. 92.