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

TREATMENT. 245
dueed currents have failed, so that Duchenne's dictum, that
after ten days of separation the muscles in man no longer
reply to the most intense electric current, is scarcely
correct.
Where no douht exists that the whole nerve has been
severed, the case is more simple. The muscles begin to
lose irritability ver}' early,* and continue to do so until
theii'
power to move under irritants is extinct, and only
to be reawakened usefully by a repair of the connected
nerves.
Meanwhile the muscles, thus set at rest, undergo atrophy,
and, in some cases, shorten, Avhile their sensibility to
as it is
pain is lost, and the supply of blood diminishes,
sure to do in tissues which are no longer in a condition
of functional activity.
According to Duchenne, it is useless to faradise muscles
so situated, until many months have elapsed and the nerve
has had time to undergo a process of repair and reunion.
At the IT. S. A. Hospital for Injuries and Diseases of the
]!^ervous System, we very early reached the conclusion
that it was wiser, in all cases, to apply to the muscle the
stimulus of electricity rather than to leave it to itself.
M. Duchenne informed Dr. W. W. Keen, in 1865, that
he had changed
his former views in regard to this
matter; and my own later experience has more and more
convinced me that the practice here advised is correct. I
now direct the use of faradaic or galvanic currents from
the earliest date at which the healing of the wound allows
of their use, while with them I combine daily massage or
deep kneading, and alternate hot and cold douches. The
mode of using these means will presently be more exactly
described. The general result which I hope to
attain is the nutritive activity which electricity sustains,
* Six days, Landry four to five
; days, Duchenne de Boulogne.