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

344 INJURIES OF NERVES.
removed, the stump which forms is liable to certain nervous
disorders, which are often intractable. The part
which they affect exists nnder physiological conditions
so new and peculiar that it is desirable to comprehend
them as fully as possible before proceeding to study these
maladies. So far as I am aware, there is but one essay
on the physiology of stumps, and this by no means
covers all the g-round. Mv ow^n information on the subject
is derived from the careful study of ninety stumps,
and from the statements of fourteen persons who have
consulted me on account of neuralgia or choreiform movements
of their stumps, as well as from dissections of such
parts.
Sensihilittj.— The sense of touch, which soon after amputation
is oftentimes dull or deficient in limited areas of
stumps, becomes in time more acute, but is rarely perfect.
In cases of arm amputations remote from the date
of operations, I have often found portions of the skin of
the stump almost devoid of tactile feeling, while the rest
of the stump showed as distinct an appreciation of the
distance of two compass points as regions similarly
placed in the corresponding limb.
Sense of pain.
— A large proportion of stumps, especially
those of the arm, are hyperaesthetic,
or have some unpleasing
sensation as a consequence of any, and especially
of rough contacts. Lateral pressure is very annoying
to many, and if long continued is apt to cause aching
neuralgia; complete anaesthesia is much more rare. I
have seen one case in which the entire end of the limb
was insensible to a needle, but this was the remote, and,
I may say, the fortunate consequence of a severe attack
of painful neuritis.
The sensitiveness of stumps varies greatly with the
season of the year, with the weather, and with constitutional
conditions, while of course there are many in-