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

340 INJURIES OF NERVES.
assisted. Motion and feelino^ returned within four days
to the right arm, but the left recovered more gradually,
and was still Aveak as late as August 10, 1863.
During the first week there was great swelling of the
neck, which was relieved when the ball was cut out.
During September two or more small spicule of bone
escaped from the neck, below the chin. They were probably
fragments from the injured jaw.
When Schultze entered our wards, August 10, 1863,
his wounds were healed. The mouth could be but slightly
opened, owing to the amount of deposit on the cheek and
over the articulation. Early in his case, before swelling
occurred, he could open and shut the mouth easily. Motion
gradually returned.
August 12, 1863.—The skin of the left lower lip and
chin is perfectly insensitive to pain and touch from the
middle line to the left angle of the mouth, and, within a
space between the middle line of the chin and a line drawn
obliquely downward and outward, from the left angle of
the mouth to the lower edge of the inferior maxillary
bone. The curve of the lip within the mouth is dead to
touch, and so also are the gums in this
and region.
gums of the left lower jaw are generally
The teeth
less sensitive
to touch and pain than is natural, but they are not
altogether deprived of sensation. The external region,
defined above, has no appreciation of touch or pain, but
the point of exit of the nerve is the seat of neuralgic
pain, and pressure on this point is felt by the patient, so
that even here the deeper tissues are less aflfected than
the skin. The most intense applications of the electric
brush to the dried and powdered chin caused no pain.
Wet conductors, which threw the subjacent muscles into
contraction, seemed to cause deep-seated pain. Under
the use of dry conductors, Schultze improved, but not