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

60 INJURIES OF NERVES.
palm, and this region, in my own case, sweats excessively.
At the same time, the ulnar nerve at the elbow grows
very excitable, and the least tap on the nerve causes slight
pain in the third and fourth fingers,
and sudden flexion
-of the first phalanges of all the fingers save the first, as
well as adduction of the thumb.
The averasce rise of the thermometer in moderate chillins:,
which does not annihilate sensation and leaves motion
but slightly impaired,
is '2° F. In more complete freezing,
it is in my case from 3° to 4° F.
The symptoms which follow the thaw are, as I believe,
due chiefly to congestion. The nerve remains sore at the
elbow and even some distance below and above it,
while
the brachial plexus may become tender (Waller), and as
the thawing occurs, the heart may be enfeebled and syncope
threaten (Waller) or vertigo occur, as I have felt
in my own case. The terminal distribution of the nerve
suflers, after severe freezing, for hours or days, so that
soreness of surface, numbness, prickling, and partial loss
of power may continue, together with a certain fullness
which is felt and which makes itself visibfe to the eye.
Even after slight freezing, there may remain for hours
certain uncomfortable sensations which scarcely admit
of distinct description. In one instance these symptoms
endured for eleven days, according to Waller, and
in my own case they usually
lasted from ten to fourteen
days.
We may therefore conclude, without being thought
hasty, that numbness, hyperesthesia, slight prickling,
formication, and more or less loss of motility are the
symptoms of congestion of a great nerve trunk. Temperature
affords us no aid, as it becomes equal in all parts
of the hand soon after the freezing
is over. Such a combination
of symptoms in clinical experience should teach
us at once to explore the whole nerve track with care, in