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

252 INJURIES OF NERVES.
healthy tone of uninjured muscles, but in the end the latter
yield to the diseased groups, and in turn suffer elongation.
The power with which atrophic contractions act is
enormous, and reminds us of the relentless shrinking of
cicatrices. It overcomes the healthy muscles, distorts
the members and subluxates the joints so as to place
the most serious difficulties in the way of cure. The
following case is a good
illustration of these disastrous
results, which, however, vary endlessly according
to the
part involved :
Case 42.*— Gunshot wound of left
arm ; injury of the ulnar
and median nerves ; paralysis of motion, slight of sensation ;
contraction of flexors; relaxation under treatment; atrophy;
claw-hand from paralysis of interossei ; stinging pain in hand ;
great gain; interosseal paralysis alone remains; discharge
with prothetic apparatus. Henry Gervaise, aged twenty,
Canadian, blacksmith, enlisted February, 1862, in Company
F, 1st Vermont Cavalry. Healthy until shot, July
7th, 1863, in the left arm. Probably the wound of entry
was the one over the artery, at the edge of the biceps,
six inches above the internal condjde of the humerus.
Exit on postero-internal face of arm, half an inch above
and three and a quarter inches behind the other wound.
He felt pain in the arm, but dismounted, the artery
jetting blood. After walking a little way he fainted,
and awakening after some hours, found that the bleeding
had ceased, but that he had no motion from the shoulder
to the linger-tips and that sensation was lessened below
the elbow. The pain in the hand grew worse gradually,
and was neuralgic in character. On the second day he
could move the elbow, and during the
first week could
stir the thumb. About December, 1863, he began to
* Mitchell, Morehouse, and Keen, op. cit.