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

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312 INJURIES OF NERVES.<br />

with a h<strong>and</strong>kerchief. The blood shot out in jets, <strong>and</strong> he<br />

soon fell senseless, remaining unconscious two hours.<br />

"Within an hour the wound was dressed with water, the<br />

hemorrhage having ceased. No splint was used at any<br />

time. On examining the part after it was dressed, he<br />

found it absolutely motionless, even to the finger-ends.<br />

I^ext day he could move the digits a little, <strong>and</strong> more easily<br />

in a week. As to sensation, he is not certain. He thinks<br />

in the wound <strong>and</strong> down the forearm, with hyperes-<br />

it was impaired for a long while on the outside <strong>of</strong> the arm<br />

<strong>and</strong> on the back <strong>of</strong> the forearm. July 8th, was sent to Baltimore,<br />

<strong>and</strong> thence to Philadelphia. He was then greatly exhausted,<br />

<strong>and</strong> on the afternoon <strong>of</strong> the 8th he began to havepain<br />

thesia <strong>of</strong> the skin <strong>of</strong> the whole member, while at the<br />

same time the fingers <strong>and</strong> thumb became drawn in tight<br />

flexion, so that they could neither be moved nor extended.<br />

Rest on a splint, cold dressings, <strong>and</strong> liberal<br />

diet rapidly improved him, <strong>and</strong> within a fortnight the<br />

arm became less sensitive <strong>and</strong> the <strong>nerves</strong> less tender. In<br />

a week the h<strong>and</strong> could be passively extended, while by<br />

slow des:rees volition returned. After a time faradisation<br />

was employed, but as it renewed all the symptoms, the<br />

nerve tracks near the wound were leeched, ice-water freely<br />

employed on the whole arm, <strong>and</strong> active <strong>and</strong> passive movement<br />

added. December 20, 1863, he was nearly well, <strong>and</strong><br />

could act as orderly.<br />

The following case is valuable as showing the remote<br />

dangers <strong>of</strong> contusion in a person <strong>of</strong> bad constitution, <strong>and</strong><br />

as a good illustration <strong>of</strong> the manner in which disease <strong>of</strong><br />

one <strong>of</strong> the <strong>nerves</strong> <strong>of</strong> a limb may come finally to involve<br />

others.<br />

Case 56.— Conhision <strong>of</strong> right ulnar nerve at bend <strong>of</strong> elbow ;<br />

parali/sis in ulnar distribution ; general extension <strong>of</strong> paralgsis to<br />

the forearm <strong>and</strong> h<strong>and</strong> ; atrophy. "^ Charles A. P., aged forty-<br />

* Gunshot Wounds <strong>and</strong> <strong>Injuries</strong> <strong>of</strong> Nerves, Case 16.

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