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

LESIONS OF SPECIAL NERVES. 339
the fifth 2Mir. John Scliultze,* aged twenty-three, German,
enlisted August, 1862, Company G, 26th Wisconsin
Volunteers. His previous health was good. At Gettysburg,
July 3, 1863, while marching at a long distance
from the enemy, a single shot, from some remote picket,
took effect on his left cheek, over the lower edge of the
malar prominence.
It was probably fired from an elevation,
since it passed across the ramus of the jaw and
entered the anterior margin of the trapezius muscle,
whence, two weeks later, it was removed by Dr. Keen.
The ball, a minie, was very much deformed. It somewhat
injured the ear in its passage, but although it
crossed the ramus of the jaw obliquely, and probably
broke off some splinters,
it did not fracture the bone so
as to affect mastication. The patient fell senseless when
hit, and remained thus for at least half an hour. He had
no pain. The whole left side of the face was devoid of
feeling, and so continued until the second day, when sensation
came back rather suddenly, except in a space,
which included a large part of the ultimate distribution
of the left mental nerve.
The first and larger loss of sensory appreciation was
probably a result of the local shock. When he recovered
his senses, he found that the left arm was almost useless
from loss of power. The fingers could be moved well
enough, but the arm could not be flexed at the elbow.
Sensation was but slightly
altered. The arm was merely
numbed. The right arm was also w^eakened, though to
a less degree, but in it the sense of touch was defective
to a remarkable extent, so
that when he sought to undo
his belt he could not feel the buckle. This was not
merely a general shock or weakness, for his legs were as
strong as usual, and he was able to walk to the rear un-
* (Junshot Wounds, etc., op. cit.