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

TREATMENT. 261
total motor paralysis of the arms and legs.
He is not
sure whether sensibility was also extinct. Two days after
being wounded, he became delirious, but gradually recovered
his senses after three or four days. lie was finally
sent to the Douglas Hospital, Washington, then under
the charge of Assistant Surgeon Thomson, U. S. A., and
was transferred to our own wards July 19, 1863.
The wound healed in nine weeks after the discharge of
a few small fragments of the jaw. Meanwhile his left leg
.
improved slightly.
His case is thus described on his entrance to our wards.
A more wretched spectacle than this man presents can
hardly be imagined. He lies in bed, motionless, emaciated
to the last degree, and with bed-sores on both
His hands lie crossed on his chest,
elbows and both hips.
perfectly rigid; the fingers extended; the skin congested
and thin; the nails curved; false anchylosis of all the
joints of the upper limbs; the head and neck rigid,
with acute pain in these parts on movement. The right
leg has motion of a feeble nature in all of the joints;
the left only very slight voluntary movement. The
hands, the appearance of which has been already alluded
to, present certain characteristics which belong usually to
cases in which there have been wounds of the brachial
nerves.
In the present instance, as in many others, these
peculiarities have been modified by the long-continued
rest of the limbs in one posture. The results of the nerve
injury and its consequent effects on the nutrition of the
part may, however, be partially discriminated,
so that
what is due to them and what is due to mere rest may be
discerned to some extent. Thus, the shining palm, the
slight eczema, the burning pain, the atrophy, and the
swollen joints, whose appearance simulates subacute
rheumatism, with the contractions of certain muscles,
are all
owing to the nerve lesion ;
while the anchylosis