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

LESIONS OF SPECIAL NERVES. 321
presented after walking in the heat. It became distinctly
flushed on the right side, and pale on the left. This
fact was afterwards observed anew by one of us. The
patient had used exercise and had just come in. The right
half of the face was very red. The flush extended to the
middle line, but was less detinite as to its limit on the
chin and lips than above these points. He complained
of pain over the right eye, and of red flashes in that organ.
A careful thermometric examination, made during repose,
showed no difl'erence in the heat, of the two sides
We regret that it did not occur
within the mouth or ear.
to us to repeat this when the face was flushed by exertion.
Under a tonic course of treatment he gained ground
rapidly. The eyes became less sensitive, the pupils more
nearly alike, the line of the lid straighter.
He had several
attacks of faiutness after exposure to the sun, and these,
with occasional diarrhoea, retarded his recovery. He was
at last able to return to duty, and left for that purpose in
October, 1863, nearly all of his peculiar symptoms having
disappeared, and his general health having been altogether
recovered.
The case of Captain (now Commodore) Stembel, which
Dr. William Ogle, in referring to one of my papers, seems
to regard as a wound of the sympathetic, could not have
been this.* The ball entered a little to the right of the
median line, immediately above the hyoid bone, which
it touched, and slightly broke, then passing across the
neck directly beneath the left sterno-mastoid muscle, it
emerged through the edge of the trapezius muscle three
and a half inches from the middle line above and to the
right of the superior angle of the scapula. He had complete
but permanent reflex paralysis of the left arm, and
* In an admirable paper on the Symptoms of Injury of the Cervical
Sympathetic, Med.-Chir. Trans., vol. lii. p. l')l.