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

360 INJUKIES OF NERVES.
will to move; so that given the volition, there springs up
in the mind a consciousness as to the act and its qualities,
which is too generally believed to originate altogether
from the external parts disturbed. On the other hand,
the second series of experiments proves, or makes probable,
that certain nerves carry centrally, during motion,
impressions which, with those nascent in the centres
when the act is willed, go to complete the general knowledge
as to motor activities. The subject admits of much
further study and of other inferences, which, however,
are scarcely entitled to a place here, but are related in an
interesting way to the group of ataxial diseases.
Neuralgia of stumps.— I have elsewhere said that many
stumps are extremely sensitive, and this is especially true
of the arm. In these cases it will almost always be found,
upon careful examination, that certain nerves are enlarged,
hardened, and tender. I have relieved a number of such
cases by cold, by repeated leeching, and by general irritation
of the surface of the stump.
Acute neuralgia of stumps is happily more rare. It
sometimes follows the operation closely, or is
brought on
by a blow or by more occult causes. In one case it came
on during an attack of acute rheumatism ;
in another
from an influenza; and I have seen two instances where a
sudden spasmodic motion of the arm-stump was followed
at once by intense pain, and seemed to be the startingpoint
of an attack of neuritis. One of these eases I saw
with Dr. Packard. It yielded to leeches and hot fomentations
after much torment. So far, indeed, as my own
never exist without
experience goes, old stump neuralgias
a sclerotic state of the nerve,—originating, I presume,
in neuritis, and tending without fail to progress centrally.
The rules for treating neuritis of course apply here, and
every care should be taken to deal early and boldly with
indications of neural pain in stumps.