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

NEURAL MALADIES OF STUMPS, 351
Closely related to these facts is a curious symptom,
"wliicli M. Gueniot (op. cit.)
was the first to describe. In
about one-lhird of the leg cases, and in one-half of the
arm amputations, the patient asserts that the foot or hand,
as the case may be, is felt to be nearer to the trunk than
is the extremity of the other limb. The lost limb seems
to be shortened. This is a sensation which, in many cases,
is first felt within a w^eek of the amputation, and goes on
progressively, the hand, for instance, slowly approaching
the stump. Very often the change
is not noticed until
attention is called to it, although usually the gradual alteration
is recognized during its occurrence. The phantom
hand at last reaches a point where it ceases to move, and
this may be at almost any part of the intervening distance
which once separated
it from the seat of operation.
Sometimes it continues to approach the trunk until it
touches the stump, or lies seemingly interior,— in its the
shadow within the substance.
We are competent in health, even with closed eyes, to
know where and how far removed the hand may be at
any moment, and this knowledge is the result of long-continued
and complicated sensor}^ impressions, ocular, muscular,
and tactile. Should we lose these by amputation,
we cease to have consciousness of the extremity of a limb
as set at any fixed distance. Such is very nearly the explanation
which M. Gueniot ofiers in his interesting
account of the delusion in question, but we fail to learn
from him why, after losing sense of the distance of the
hand or foot, these should seem to approach the stump.
Wherefore, indeed, should they not appear to recede?
Perhaps the following explanation may
assist us to answer
this question. To the lost hand alone are sensations referred.
There are none in the intervening portions of the
lost limb, and the stump is the lowest visible point where
pain or touch is felt; and therefore it is that the sensorium