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

TREATMENT. 253
move the fingers voluntarily, and tins control has continued
to improve.
In January, 1864, electricity was used in the hospital
where he then was, but he says
it was applied only on
the fingers.
Condition on entering the II. S. A. Hospital for Injuries
and Diseases of the ISTervous System, February 18, 1864.—
Hand congested; palm purplish; nails curved. Measurements:
biceps, right, eleven and three-eighths inches;
left, ten and one-eighth; forearm, right, eleven and onehalf
inches ; left, ten.
Flexors in forearm wasted considerably; thumb muscles
wasted, and all the interossei much atrophied. No
stiffness in the joints. The short flexor of the thumb
and the flexor group in the forearm are moderately contracted.
The former defect has allowed the extensors
of the thumb to act on it so as to bring its metacarpal
bone level with those of the fingers, and to turn the nail
upward.
Sensation.— Ansesthesia and analgesia in palm and palmar
face of all the fingers, but only in the dorsum of the hand,
and not on the dorsal aspect of the fingers.
Motion.— Good above elbow. Supination and pronation
normal. The wrist flexion is incomplete, from want of
power. Extension limited by flexor contraction.
Thumb.— Flexion partly lost from want of power, and
extension limited by contraction of short flexor. lie has
no abduction or adduction of the fingers, and cannot
flex the first phalanges or extend the last two.
It is not necessary to speak in detail as to the electric
properties, which were wholly absent in the interosseal
muscles, and defective in some others.
Treatment.— Electricity, douches ; splint to correct flexions.
Under this treatment, with energetic use of passive
motion, the flexions were corrected, and every motion re-