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

TREATMENT. 273
the equal efficacy of injections
at points remote from the
seat of pain; but I am well satisfied that in causalgia
something is gained by the local proximity. Numerous
experiments were made to determine whether as full relief
might not follow injections at distant points, but although
the injecting of the burning hand produced in many cases
torture, the patient was sure to insist upon
it after a few
trials of other localities.
Symptoms of neuritis, where this was plainly the paincause,
were met by the means already described ;
but the
use of ice on the burning part was commonly too painful
to be long endured.
Blisters.— The curative treatment was simple. It consisted
in blistering the burning part repeatedly with
Granville's lotion or cantharides. Nor was it
necessary
to merely blister until we lessened or destroyed the
burning pain, since relapses were common ; and, to avoid
these, the part required to be several times vesicated after
an apparent cure had been effected. In light cases two
or three blisters have answered in ; others, ten or twelve
have been needed, and, in very rare examples, this and
every method failed us, although such was — never the case
in any instance which was treated early, only the oldest
cases being thus obstinate. The following history is a
good illustration of the varieties of treatment essayed,
and of the terrible nature of this most interesting symptom
:
Case 44.*— Gunslwt wound of the left brachial plexus; paralysis
of motion and sensation ; muscular hyperesthesia ; intense
burning in hand and arm ; nutritim changes ; atrophy ;
contracted extensors ; relief ; discharged. A. D. Marks, sergeant
Company C, 3d Maryland Volunteers, aged fortythree,
enlisted August, 1861. Previously healthy.
* Gunshot Wounds and other Injuries of Nerves, p. 148.