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

306 INJURIES OF NERVES.
Motion.— Perfect as to range in shoulder and elbow;
would be perfect in wrist, but is limited to three-eighths
range by contraction of flexors. Power is somewhat
diminished. Thumb perfect, but lies adducted. He
can abduct it well. It is also everted so as to form the
"monkey-hand." The first phalanges are constantly at
an angle of forty-five degrees in extension. They can be
extended to ninety degrees voluntaril}^, and flexed to a line
with dorsum of hand. The second phalanges have about
the middle third of their range of motion, but not much
force. The third phalanges cannot be moved voluntarily ,
but can be moved passively well. The joints appear to
be normal, save the subluxation of the knuckles. Abduction
and adduction good.
Sensation.— Im pro ved .
Contractions.— The flexors are contracted so as to limit
extension of wrist; the extensors are not, I think, contracted,
but by the constant flexion of the wrist at ninety
degrees they extend the fingers as above.
Pain.— In August, 1864, he began to lose the violent
pain. It was not gradual, but one day he noticed suddenly
that his glove was dry, and yet he could use his
hand well and without pain. It was not entirely gone,
and he continued to wet his hand for some months; but
it
grew much better. Even now he feels dry rubbing in
the palm of the hand and down to the finger-tips, and a
loud noise, such as a wagon making a great
noise in
passing, or a sudden emotion, as seeing a person fall, etc.^
makes the same impression. In the left hand there is no
pain.
—
Ajypearance of hands. Left hand perfectly normal. The
eczema he is pretty sure passed away before he ceased
wetting the hand. Right hand: color normal; no eczenia.
It continued longer than on the left hand, but also disappeared
before he ceased wetting it. It sweats a great deal ;