A case of traumatic brachial neuralgia, treated by excision of the cords of the brachial plexus / by Henry B. Sands and E.C. Seguin.

  • Sands, Henry B. (Henry Berton), 1830-1888
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: A case of traumatic brachial neuralgia, treated by excision of the cords of the brachial plexus / by Henry B. Sands and E.C. Seguin. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    jS their division Such an explanation seems plausible, from the results that attended an operation recently performed by Professor von Nussbaum, an abstract of whose paper appears in the present num- ber of this journal. It may also be supposed that the cutting off of a considerable portion of irritated nerve trunk from communication with the spinal cord diminished the neuralgia, by reducing the total amount of irritation transmitted to the nervous centre. known to resist all ordinary treatment was much relieved by an operation not dangerous in itself. We did not obtain radical success, because we failed to find healthy nerve trunks at the place of section. The diagnosis of the seat of injury was correct enough, but the ascending neuritis baffled us. * We are indebted to Dr. Caro for a statement of the case as it appeared to him, but as his letter contains nothing that is not recorded in the above history, we take the liberty of omitting it. Fig. i. Tranverse section of fasciculus of normal spinal nerve. a, Nerve fibres seen in section, exhibiting circle (membrane of Schwann', hyaline contents (mve- line), excentric dot (axis cylinder). b, Sheaths of secondary fasciculi. b\ Trabeculae of connective tissue which subdivides fasciculi. b, Inter-fascicular connective tissue. c, Sections of bloodvessels. Fig. 2. Fasciculus from ulnar nerve, in middle of arm, showing the lesions of the Wallerian do generation. a, Confused outlines of nerve fibres, caused by loss of myeline and axis cylinder, and collapse of membrane of Schwann. Not one axis cylinder is to be seen. b, and b'. Sheath of fasciculus, and inter-fascicular areolar tissue, a little thickened. c, Unaltered bloodvessel. Fig. 3. Section from lower cord of brachial plexus near intervertebral foramina, showing the lesions of chronic neuritis. a, Secondary fasciculi, showing atrophied fibres (circles not much larger, under 300 diam., than those of normal nerve under 65 diam./; very few axis cylinders present. Tissue between fibres increased. a', Small aggregations of fibres, separated from others by dense inter-fibrillar connective tissue. b, Immensely hypertrophied inter-fascicular areolar tissue. Sheaths of fasciculi no longer dis< I inct. c, Dilated bloodvessels surrounded by altered connective tissue. d, Yellow granular pigment lying in areolar tissue, mostly in neighborhood of vessels. EXPLANATION OF PLATE I. The various specimens were prepared according to Clarke’s method.
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