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

TREATMENT. 301
with a generous diet. IS"© medicine of any kind was
afterwards necessary.
" There was no return of the chills after the operation,
but he was much annoyed by a peculiar feeling of the
surface, which he described as ' craving of his skin for
morphine,' with burning of the feet; but these gradually
passed away until he experienced no unpleasant or unnatural
sensations. He has not suflered a moment's pain
in the hand or arm since the operation, now seven months
past, and has gained forty pounds in weight, and is, in his
own language, Mn perfect health without pain or ache.'
He has good use of the small and ring fingers, and the
paralyzed parts are well nourished.
" The operation was undertaken under the belief that
there still remained near the original wound some injured
portion of the nerve, and that relief might be given by
severing its connection with the seat of pain,
as the
result has happily proved.
"
What seem to me to be the important points in this
case are— first, the unceasing and great severity of the pain,
from the moment of receiving the wound until I severed
the nerve; second, the entire freedom from pain since
the operation ; third, the vast amount of morphine used
by the patient, estimated by him to amount to from two
hundred and fifty to three hundred drachms, requiring
the use of the syringe from six to twenty times every day
for six years and some days; fourth, the rapidity with
which he recovered from the effects of this long-continued
and excessive use of morphine, sufiering no inconvenience
from its omission, in a few weeks after the operation ;
fifth, the fact that the operation was undertaken in opposition
to the freely-expressed opinion of all the medical
gentlemen here and elsewhere who had been consulted
after the failure of Dr. Bliss's operation."
The following cases have been selected from ray notes.