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

336 INJURIES OF NERVES.
the patient thought he could not articulate as distinctly
as formerly.
Sensation was not at all impaired. Several tests were
made at diiFerent times, but the result was always the
same. iTo ditierence was discovered by means of the
sesthesiometer. He could readily distinguish salt from
sugar when placed upon either side. The right side of the
tongue readily responded to the electric current, the
wounded side did not, but seemed the more sensitive
under the current. The wounded side of the tongue
was notably atrophied before the patient was discharged.
Several attempts were made to find the bullet, but all
were unsuccessful. The wound healed without any difiicult}',
and the patient left December 12, 1871, the paralysis
continuing unaltered.
Lesions —
of the oculo-motor nerves and of the fifth nerve.
Mechanical injuries of the motor nerves of the eye which
do not at once involve loss of life are rare. I have several
times seen cases of injury to the base of the brain atiecting
these trunks, especially the sixth nerve, there being
at the same time no permanent cerebral or other symptoms
indicative of lesions of centres. There is at present
such a case under treatment at the Hospital for Deformities
and for iTervous Diseases.
The following case, which I report at length, stands
alone in the history of oculo-motor-nerve lesions, and is
interesting for its relation to the physiology of the iris.
Case 65.— Pistol-hall wound involving
the third, fourth^ sixth,
and ophthalmic branch of the fifth nerve ;
the olfactory nerve ;
death.
secondary injury of
December 31, 1870.— I saw in consultation with Dr.
Morton the case of W. P., male, aged thirteen, who was
accidentally shot on the 29th of December, in the afternoon.
A pistol-ball entered the right temple, and, passing
inward beneath the right optic nerve, lodged in the body