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

72 INJURIES OF NERVES.
wound to the finger ends was enveloped in bladders of ice
and iced water, which certainly lessened the pain. The
limb was elevated above the body, and ^V gi'-
hypodermic
doses of sulphate of atropia with J gr. of sulph, of
morphia were given every four hours, or oftener, as
needed. This plan, with attention to the secretions,
seems to me sufficient. I have also used leeches very
freely and with good efifect, the ice being afterwards
replaced. I should add that leeching
is sometimes excessively
painful, and that the leech bites are more apt to
give trouble than in other cases. Absolute rest is one of
the essential conditions of treatment, and if the limb can
be put upon a rigid splint it is wise to do so.
Chronic neuritis is generally subacute, and is one of the
most difficult of all maladies to treat with success. It
very often occurs in persons who are perfectly well able to
walk about ;
and as it is vain to hope for good results without
entire repose, the comparatively good health of the
patient is a real obstacle, especially in the arm cases.
Constitutional treatment.— In the army
it Avas above all
things needful to look for the existence of scurvy or malarial
disease, and to treat these with appropriate means,
— dietetic and therapeutic. But under all circumstances,
it is well to remember that the presence of such torture as
accompanies this disorder of itself induces a lowered vital
tone, which requires tonics and support, and that sometimes
the long use of opiates has a depressing effect, which
we shall be wise not to forget.
Best.— "When the disease is really subacute, and the
nerve tender on pressure for some considerable part of
its length, I insist upon the most absolute rest. If it be
the leg Avhich is attacked, the patient must go to bed and
consent to wear a carved splint for several weeks. If it
be the arm, a splint answers to put it in a state of repose ;
and without this it is vain to employ other means.