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

PATHOLOGY OF NERVE LESIONS. 71
nerve trunks had been slight and remittent, no*r was pain
at all a marked symptom. This was probably a case of
pure sclerosis without inflammation. It is of course very
difficult to decide as to the absolute non-existence of the
latter condition, but I have had every reason to believe
that, in some nerve wounds, the resultant sclerosis had no
connection with inflammatory states except at the very
outset, and that the former, in many cases, made mischievous
progress without the latter.
The. final functional result is the same in either case.
The nerve tubes in large part perish or waste, and the
symptoms aiFect at first rather the sensory sphere than
that of motility. We have pain and anaesthesia or hypersesthesia,
but not as a rule local convulsions.
These atrophic nerve changes, whether due to inflammatory
or sclerotic pressure, or to actual nerve section,
demand a more careful and specific study, since upon
a clear conception of their nature and the time they
need for repair depends our success in the prognosis
and treatment of a large number of local maladies of
nerves.
Treatment of congested or inflamed nerves. — I shall have
frequent occasion to allude to this subject in treating of
neural injuries, and to describe in detail the various means
employed but I have also thought best to give here a
;
more methodical statement.
Whenever, after an injury, such as a blow or wound
involving a nerve, the nerve track in its near neighborhood
begins suddenly to be acutely tender and painful,
especially if rigors be added, it is well to take for granted
the outset of a neuritis, which we should hasten to prevent
from becoming acute. As I have said, ray experience
of this malady, and, indeed, that of most physicians,
is limited. In the only case of acute neuritis of which I
had entire control from the start, the arm from above the