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

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92 INJURIES OF NERVES.<br />

M. Berard has described a case <strong>of</strong> true puncture <strong>of</strong> a<br />

nerve Avliich may be taken as a typical example. For<br />

certain galvanic experiments, he passed a needle into the<br />

supraorbital nerve. The electric current was then sent<br />

through the nerve, causing great pain, which soon passed<br />

away, to return again <strong>and</strong> again, until it took on a quotidian<br />

type, which yielded for a time to quinia, but recurred<br />

at intervals witli<br />

great violence.*<br />

I saw many years ago, in Paris, a man in Pr<strong>of</strong>. Roux's<br />

wards who had driven an awl through the ulnar nerve.<br />

Excruciating pain followed, with choreal twitchings <strong>of</strong><br />

the flexors <strong>of</strong> the fingers, which in the end gave way to<br />

spasm. I believe that the case was finally relieved by applications<br />

<strong>of</strong> the actual cautery along the nerve track.<br />

The passage <strong>of</strong> a needle into the nerve <strong>of</strong> an animal<br />

causes usually a little intrafibrillar bleeding, which passes<br />

away without grave result. Berard describes punctures<br />

as occasioning inflammation <strong>and</strong> final thickening <strong>of</strong> <strong>nerves</strong>.<br />

He quotes Descot to like etiect, but I have been unable<br />

to find that this author makes any such statement regarding<br />

simple punctures.<br />

Contusion; pathologi/.<br />

— The only pathological study, <strong>and</strong><br />

that a brief one, <strong>of</strong> bruised <strong>nerves</strong> has been made by Tillaux,<br />

who subjected nerve trunks to slight blows from a<br />

hammer, <strong>and</strong> then examined the injured part. He found<br />

that the neurilemma remains unbroken, but that numerous<br />

hemorrhages occur within the main sheath, <strong>and</strong> that<br />

the blood gliding along between the fibres may pass to<br />

some distance beyond the part afl'ected.<br />

Lesser collections exist even within the perineural<br />

sheaths, <strong>and</strong> traverse, in places, the intervals between the<br />

broken nerve tubes. At the seat <strong>of</strong> injury, many <strong>of</strong> the<br />

fibres are lessened in calibre, <strong>and</strong> beyond it, on either<br />

* La Xouvelle Encyclographie, 1846, p. 37.

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