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

TREATMENT. 295
thrust to and fro through the knuckles,
a red-hot iron
placed at the junction of the palm and thenar eminence,
with a heavyweight on it,
and the skin was being rasped
off
my finger-ends."
Case 48.— Bullet icoiind of forearm ; causalgia ; relief by
amputation. Corporal I. D., admitted for gunshot wound
of arm, received some days before. A minie-ball entered
near the middle third of forearm while it was in a flexed
position, producing a considerable flesh wound, and splintering
off a fragment of the border of the radius. Passing
across the forearm,
it also struck the arm some distance
above the elbow, inflicting a slight wound. Both wounds
were open, and there were two inconsiderable hemorrhages
from muscular branches in the upper wound.
The patient suffered with most extensive causalgia,
locating the pain principally along the radial site of the
forearm and hand. The tissues of the entire arm and
hand became shrunken and shriveled.
Despite all local and constitutional treatment, including
hypodermic injections of morphia sulph., very little relief
could be obtained. He was unwilling to submit to amputation,
which, it was feared, must eventually be done.
Dr. Morton made an incision through the cicatrix in the
region of the radial nerve, and removed four or five
inches of the nerve. With the exception of slight contraction
of the diameter of the nerve, in the vicinity of
the wound, no other abnormal change was perceptible.
Very little relief followed the operation. A few days
after, the patient being now very anxious for the operation,
the member was amputated; and, upon dissection,
it was found that the ulnar nerve was injured in the track
of the wound. Entire relief followed the operation, and
is said to have been lasting:.
Case 49.— Repeated fractures of
'the humerus ; one involving
the idnar nerve; anchylosis of the shoulder and elbow ; ex-