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

62 INJURIES OF NERVES.
track half-waj to the knee. After death I found the
softened nerve lying in the pelvis behind a cancerous
mass.
Exterior to the pelvis it was swollen, red, and vascular
to a remarkable degree.
I have seen sudden and violent neuritis set up in an
unhealed nerve wound, but have had no chance of examining
such cases pathologically.
Sijmptoms.— The symptoms of acute neuritis as it is
seen to follow upon a nerve wound are these: At some
time between the reception and the healing of the wound
the patient
is attacked with rigors, which are not usually
very severe. In the only case in which I have studied
the temperature, the chill came on at noon, owing to a
wound of the right median nerve received a week before,
and followed by exposure in an open car during a journey.
At four P.M. the rigors still
continued, and at this hour
the right axilla* gave a temperature of 102|° F. Fever
came on in the night, and continued with evening exacerbations
for three days. With the rigor there was, in
this case, a gradually increasing pain, which seemed very
soon to pervade the whole limb. In four cases of which I
have notes, there was slight delirium, owing as much to
the horrible pain as to any other cause. In
fact, some of
these cases become what in a woman we should call
hysterical, and by turns bewail their condition, or pitifully
apologize for their want of manly endurance. The
pain seemed to be worse at night, and to be aggravated by
motion and by a dependent position. In three of my cases,
all arm wounds, it gradually increased both in severity
and in the extent of the region affected, until it seemed
to influence not merely the nerve first injured, but all the
cords of the parent plexus. In one man there were, on the
second day, sympathetic pains in the fifth nerve of the
* The left was the same.