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

NEURAL MALADIES OF STUMPS. 367
time, rarely executed any violent or wide movements;
but the forearm was much the same as his letter described
it to have been in April. A greater gain was visible in
the chest, neck, and trunk, the muscles of which no longer
twitched. His general health was better, and he had
become quite robust. I desired him to renew the treatment
as soon as he was at rest in any one place, and
hoped to persuade him at a future period to allow of
some such operation as I have alluded to above.
I have heard of Colonel P. very recently, and learned
that he has still the same movements, but is otherwise
in perfect health.
I alluded in the medical volume of " Sanitary Reports"
to a case of chorea following amputation of the thumb,
but have, unfortunately, no notes of it. The choreoid
motions extended from the intrinsic thumb muscles to
the arm and shoulder, and after a year or more became
limited again to the forearm. The patient was cauterized,
blistered, treated by setons, and by an endless variety of
drugs, without avail.
Full doses of the bromides seemed to be of some use
in Colonel P.'s case. In the localized chorea of adults, I
cannot boast of success with these drugs, with any form
of electricity, or with other means of treatment, and there
seems to me to be much resemblance between these cases
and the no less persistent form of chorea in stumps.
To this obstinacy in the face of all therapeutic interference
I can make but one exception.
An officer had
incessant movement of the biceps muscle of an armstump.
The spasm was annoying, but rarely violent, and
was limited to the upper two-thirds of the muscle, the
line of it.
amputation having passed through In this
case, daily injections of atropia (sV to -^V grain)
into the
mass of the muscle, entirely relieved him after nearly
twenty such applications.