Remote consequences of injuries of nerves, and their treatment : an examination of the present condition of wounds received 1863-65, with additional illustrative cases / by John K. Mitchell.

Mitchell, John K. (John Kearsley), 1859-1917.

Date:: 1895

Credit: Remote consequences of injuries of nerves, and their treatment : an examination of the present condition of wounds received 1863-65, with additional illustrative cases / by John K. Mitchell. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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$plexus. The artery, however, coold still be felt, but either from return of callus or from insufficiency of blood-supply, the limb has now for some months ceased to show any improvement. Bemarks. The evil effects of the fractures in this case were due not only to the compression of the brachial plexus by the callus and the misplaced bit of bone, but to their pressing upon the artery as well, thus impairing the nutrition of the arm by greatly lessen- ing the blood-supply as well as by interfering with the trophic usefulness of the nerve. There were no signs of neuritis, contrary to what might have been expected, except the slight and vaguely distributed hypersesthesia, and this was largely a mental symptom, more a fear of being touched or handled, arising from the suffering the poor lad had gone through and the shock of lesions so severe and extensive, than actual supersensitiveness to pain. The condition compares curiously with that of XLY., where, too, there was pressure upon the plexus, in the first place by a dislocation, in the second by a misapplied ligature, and where, too, there was the same undue sensitiveness to mild degrees of heat. The experi- ment of applying hot water to the skin of C.'s hand was suggested by the unusual effect it had on XLV. It was thought there to have done some little good, though rather a severe measure of counter-irritation, but not so severe as it seems, when one remembers that the hand was without sensation to touch, except in a very small area. Case XL Gunshot-wound of right forearm ; partial of sensation ; ankylosis of fingers and icrist ; recovery ; late degeneration of nerve. {Sanitary Commission Memoirs [Medicar], Case I.)—J. A., aged nineteen years. Company G, 83d Pennsylvania, was shot through the forearm at the battle of Chancellorsville, May, 1863. The ball passed between the bones of the right forearm, entering on the inner side of the arm at the junction of the middle and lower thirds, and emerging two inches lower upon the$