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

LESIONS OF SPECIAL NERVES.
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b} food entering the glottis, while at times it is thrust back
asrain into the mouth.
Speech.— He pronounces many letters with difficulty or
imperfectly, so that his speech may be said to be a little
thick, and he so describes it, referring the trouble to his
lips and tongue. The labials are of course affected, but
the guttural sounds are also imperfectly executed.
Taste is apparently impaired over the entire left tongue.
Electric state of tongue. — No loss of its electric properties
was detected. Hearing ou the left side was destroyed.
The back part of the bony meatus was carious, and the
membrane absent, perhaps from inflammation consequent
upon the wound.
Treatment.— The patient was industriously faradised for
several months without the least gain in any respect.
In this case, in which there was a deep injury of the
facial nerve, taste, deglutition, and speech were all alike
impaired.
The following history is yet
Case 63.— Ball wound of right
more conclusive :
neck destroying the ear and
injuring the facial nerve; deafness ; vertiginous
attacks icith
forward imjmlses ; facial j^lsg ; contracted muscles; nasal
voice ; impaired deglutition ; nutrition arui functions of right side
—
of tongue affected ; sense of taste diminished. J., aged about
thirty, was shot in 1864, the ball entering the right neck
behind the mastoid process, through which it passed. Its
course after entrance is unknown, except that it seemed
to have traversed and destroyed the inner and middle ear.
The tympanal membrane was gone, the bones of the
middle ear absent, and a constant discharge occurred
through the meatus and the wound of entry for many
months, W'hen finally the latter healed.
The flow from the ear, June, 1869, was slight, but the
probe detected caries deep in the temporal bone. The
missile was probably a small rifle-ball, not a minie.
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