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

apidly-developed tuberculosis. >
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326 INJURIES OF NERVES.
which fractured the angle of the left jaw and caused
extensive inflammation of the face, followed by a large
abscess. The jaw united, leaving him with slight neuralgia
of the chin, owing no doubt to injury of the inferior
maxillary branch of the fifth nerve. For a few weeks the
facial muscles twitched a good deal, and as the inflammation
subsided, the suspicion which existed very soon after
justified.
the blow, that the left face was palsied, became distinctly
After two months he came to the city to consult
me. I found him suifering from an uncomplicated
peripheral palsy of the left seventh nerve. All the usual
muscles were palsied, the eye open, and the skin singularly
relaxed. The tongue had all the normal motions,
the voice being unaffected, and the taste perfect on both
sides of the tongue.
One year later I saw this case again. The palsy had
diminished during two months, and then become worse
without known cause; but his health seemed to have
declined from this period, and he complained of some difficulty
in speaking for any length of time. The trouble lay
chiefly in uttering the Unguals. His tongue could be
thrust out and moved laterally, but not bent upward
with the usual readiness. The left side of the tono;ue was
tardy in recognizing all sapid substances, and he made
frequent mistakes if urged to a hasty decision. The sense
of touch in the tongue remained perfect, but the left half
of the palate hung lower than the right, and was partially
paralyzed, failing to respond to galvanism as perfectly as
did the sound side. The palate was bent, the tip turned
forward, and to the the left, upper portion curved towards
the right, and the whole body of the palate twisted a little
from left to right. These newly-acquired symptoms seem
to me to have been caused by centrally progressive changes
in the injured nerve. The patient died the year after of