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

94 INJURIES OF NERVES.
More severe lesions break the fibres, and subject the
entire tubes to the pressure of multiplied clots of blood
and to the destructive effects of compression by the material
poured out for purposes of repair.
In two of these cases artificially produced in the rabbit,
the nerve trunk became considerably enlarged, so as in
one case, at least, to be fitly described as a neuroma.
—
Si/mptoms and results of contusions. Contusion of nerves
is a common incident of civil practice. In military
experience contusions are met with arising from the
impact of fragments of shell or entire round shot, and
are of course sufiiciently grave in their results, whether
the skin be broken or not. I have seen in the United
States Hospital for Nervous Diseases, and elsewhere, a
number of instances of contusions from blows, kicks, or
falls, some of them slight in character, and others causing
the most entire crushing of the nerve involved. As a
rule, a blow with any blunt instrument over the length of
a nerve is
unlikely to be serious; but when the same
injury falls upon the nerve at its exit from a bony foramen,
or where it rests in a furrow of bone, or lies superficially
on the prominences of a joint, the consequences
may be much more severe, as I have already pointed
out, when speaking of certain wounds in relation to the
spinal nerves at their points of exit from the intervertebral
foramina.
As a rule, contusions, unless violent, do not cause im-
^mediate symptoms
of loss of function. A little numbmess
and tingling may succeed to the first shock of pain,
.and only after a time be replaced by grave troubles, as
•changes by-and-by occur in the bruised nerve; changes
only too apt to result in evils quite as permanent as those
which arise from more immediate injuries, I have several
times met with bad cases of atrophic alterations of muscles,
the result of a contusion of a nerve, which for some