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

NEURAL MALADIES OF STUMPS. 357
The lost limb, and especially the arm, is iisnallj^ found
to follow the movements of the stump, whether these be
passive or active, while in some instances it never leaves
its place, or else there is only a vague sense of its common
position having been disturbed.
Involuntary movements of the absent toes or fingers are
frequent, and in very many persons are unfailing precursors
of an east wind. Sometimes onlv one fins^er is thus
active, or the digits flex one after another, and then slowly
extend, while wrist movements are exceptionally rare, and
the elbow and knee are never felt to change place at all.
Leaving out of the question cases which have no sense
of the presence of a lost limb, we find that in a very
small number there is no consciousness of power to stir
any part of the absent members by force of will. All
others are able to will a movement, and apparently to
themselves to execute it more or less eflectively, although
in most of the amputated such phantom motions are confined
to the fingers or toes, which rarely seem to possess
the normal range either of flexion or extension. Yet the
certainty with which these patients describe the limitations
of motion, and their confidence as to the place
assumed by the parts moved, are truly remarkable ;
while
these restricted movements are pretty surely painful, and
the effort is apt to excite twitching in the stump.
A small number have entire and painless freedom of
motion as regards all parts of the hand. " My hand is
now open, or it is "
shut," they say. I touch the thumb
with the little finger."
" The hand is now in the writing
position," etc. Between these cases and such as are conscious
of an immobile member, every grade of difference
as to motion is to be found, with equally wide varieties as
to the associated pain, which perhaps
is most acute in
such as will with vigor a motion that they seem to fail of
executing.