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

VARIETIES OF MECHANICAL INJURIES OF NERVES. 95
time after the injury gave few signs of latent injury.
Some such evidences of hidden mischief do, however, exist
in nearly every case, and should be taken as indications
for anticipative measures of treatment. Considering the
number of nerves exposed to this form of it is
injury,
surprising that it is not more frequent. The nerves, however,
yield somewhat to sudden pressure, and roll aside
with great readiness, so that, except when they are tirmly
bound to a bone, it is not easy to hurt them with any
weapon except one which possesses a blunt surface.
I have seen the supraorbital and infraorbital both contused
by a single blow from the head of a cane. The
lower nerve suffered most, and it was some months before
the parts to which it runs regained sensibility.
The sliofhter results of blows on the ulnar nerve behind
the elbow are within every one's experience, and occasionally
this nerve is so injured as to involve permanent results.
I saw, some years ago, a singular instance of this, which
arose during play between two lads who were striking
each other w^ith knotted ropes. One of them, in protecting
himself, threw the elbow upward and outward,
receiving a severe blow upon the ulnar nerve, thus stretched
and held steady by the bent elbow. The tingling pain
soon passed away, but in the course of the third week an
attack of measles resulted in the return of pain and tino'lino;
in the ulnar distribution. These assumed a distinct
intermittent type, became very violent, and were at length
relieved by placing the arm at rest in half extension on a
splint and by the use of morphia subcutaneously.
Causard,* Descot,t IIamilton,| and Duchenne all report
cases of contusion of more or less interest. Examples are
V
* Essai sur la Paralysie suite de Contusion des Nerfs. These de Paris,
f Affections locales des Nerfs. Paris, 182-5.
i Arch. Gen. de Med., 1838, t.
ii.