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

SIO INJURIES OF NERVES.
exchanged. The foot swelled within a week, and began
to burn on top of the instep and toes. At first he had no
power to extend the foot or toes, but could slightly flex
them. The wound healed in a month, and at Georgetown
Hospital he got on crutches,
— the limb improving.
In February, 1863, he could walk with a cane, and at
this time the oedema disappeared. In the third week
after the wounding, the toes began to twitch in a curious
manner, moving laterally. This symptom still exists,
He thinks that touch and pain
although to a less degree.
were totally lost in the foot at first, but admits that he
might not have noted the
sides of the foot near the malleoli
as being normal,— if
they then,— were so as they
certainly were when he was admitted to our own wards,
June 15, 1863. The foot is still somewhat swollen, and is
worse in hot weather, when in bed, or when the limb hangs
down ; cold, exercise, and water, whether cold or not, ease
the intense burning pain. The foot and leg are scarred
remarkably by repeated crops of papules, which break
out every two weeks with unendurable itching, and then
fade away, always leaving the foot much better for a time.
When admitted, the muscular motions remained, as above
described, and he could stand a moment on the leg, the
calf of which measured two inches less than the other.
The track of the internal saphena nerve is alone fully
sensitive touch,— to elsewhere it is deficient. The flexors
of the foot and toes respond well to the current of Duchenne's
large coil,
— the extensors have lost electro-muscular
contractility and sensibilit}^
Treatment. June 15th.— Faradisation of extensors was
practiced daily, and thorough rubbing of the weakened
limb twice a day. The causalgia and congestion were
treated by coating the foot with collodion, and hot and
cold douches were used alternately to stimulate the enfeebled
vessels.