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

VARIETIES OF MECHANICAL INJURIES OF NERVES. 85
Whether in man autogenesis of this extremity occurs
when the part remains isolated from the central stem, is
as yet unknown ;
nor have we learned to what degree
the defect of arterial circulation, wdnch in one of the
cases must have followed ligature of the ulnar and radial
arteries, is capable of aiiecting the process
repair.
Case 4.— Section of median nerve ;
of nerve
abscess at the site of the
loound ; loss of sensation and motion. R. L., farmer, Delaware
County, was brought to me by his brother, one of
the former patients of our military hospital. Two years
before he had been accidentally wounded by a reaping
cradle, the point of the scythe entering the forearm and
dividing the median nerve just below the elbow. Unfortunately
the wound, which was closed with care, suppurated
freely at the third week, and an abscess was
opened alongside of the older scar. It is said that there
was at this time some sensibility on the outside of the
forefinger, but it disappeared soon after the abscess
formed, and not the least sign of returning function was
ever seen in any part supplied by the median nerve. The
skin on the radial side of the palm was thick and rough,
and the limits of loss of sensation absolutely distinct,
while all the muscular dependencies of the cut nerve were
in the last degree of atrophy and contraction.
I proposed to my patient to cut down on the nerve and
to bring the two ends together,
when I hoped by galvanism
to complete the cure, which, without the operation, I
had failed to efl'ect
by prolonged faradisations. He declined
to submit to the knife, and finally abandoned all
of relief.
hope
I felt well assured that the suppuration in this case interfered
with, and terminated, the early eftbrts at repair.
The very slight skin changes in this history contrast
remarkably with those of the following case :