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

90 INJURIES OF NERVES.
sensitive surfaces.
Moreover, the greater number of such
cases were women, and the hysterical element comes
largely into view as the disorder progresses.
The following case from Swan* may answer as an illustrative
example:
Case 6.—" I was desired to visit Mr. B.'s housekeeper
at . I found my patient in strong convulsioiis, and
held upon the bed by several assistants; her hands were
strongly clinched, and she was struggling greatly; she
soon after became comatose. I was informed that she
had been let blood two days before by a gardener; that
she complained very much of the arm where she was
bled, and of a pain shooting from thence to the shoulder.
"I examined the orifice of bleeding, which was in the
median veins ;
it had not healed, was somewhat inflamed,
and a thin liquor oozed from the lips of the wound.
While I was making this examination she became again
strongly convulsed, as I supposed, from the irritation I
had caused. With a view to interrupt the communication
from the diseased point to the sensorium, I applied
a tourniquet above the part; a remission of the spasms
soon followed, and I administered an anodj-ne; but the
convulsions, after a short interval of ease, recurred as
before, and the application of the tourniquet was again
made without any good effect. As I had no doubt that
the cause of the disorder was an injury of a cutaneous
nerve in the operation of venesection, I determined to
endeavor by a transverse incision to divide the nerve
above the injured part, and to destroy its connection with
the sensorium ;
I therefore made an incision while the
convulsions were most violent, of about an inch in length
and small depth just above the orifice: no mitigation of
symptoms was perceived but on ; making
another incision
* Swan, op. cit., p. 121.