Injuries of Nerves and Their Consequences

J.B. Lippincott, 1872 - 377 páginas

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Página 1 - I hold every man a debtor to his profession; from the which, as men of course do seek to receive countenance and profit, so ought they of duty to endeavor themselves, by way of amends, to be a help and ornament thereunto.
Página 196 - In two cases, at least, the skin of the entire body became hyperaesthetic when dry, and the men found some ease from pouring water into their boots. They said, when questioned, that it made walking hurt less ; but how or why, unless by diminishing vibration, we cannot explain. One of these men went so far as to wet the sound hand when he was obliged to touch the other, and insisted that the observer should also wet his hand before touching him, complaining that dry touch always exasperated his pain.
Página 156 - Paget's comparison of chilblains, is one which we often used to describe these appearances ; but in some instances we have been more strikingly reminded of the characters of certain large, thin, and highly polished scars. " Where a single nerve, as the ulnar, had been attacked, the described state of skin was seen only in its ultimate distribution ; but in other instances of more extensive nerve injury, the central palm suffered, or a single finger, or the pulps of all of them. In others the palm...
Página 155 - Glossy fingers appear to be a sign of peculiarly impaired nutrition and circulation due to injury of the nerves. They are not observed in all cases of injured nerves, and I cannot tell what are the peculiar conditions of the cases in which they are found ; but they are a very notable sign, and are always associated, I think, with distressing and hardly manageable pain and disability.
Página 196 - ... tap of the finger increases the pain. Exposure to the air is avoided by the patient with a care which seems absurd, and most of the bad cases keep the hand constantly wet, finding relief in the moisture rather than in the coolness of the application. Two of these sufferers carried a bottle of water and a sponge, and never permitted the part to become dry for a moment. As the pain increases the general sympathy becomes more marked. The temper changes and grows irritable, the face becomes anxious,...
Página 155 - In well-marked cases, the fingers which are affected (for this appearance may be confined to one or two of them) are usually tapering, smooth, hairless, almost void of wrinkles, glossy, pink or ruddy, or blotched as if with permanent chilblains. They are commonly also very painful, especially on motion, and pain often extends from them up the arm. In most of the cases this condition of the fingers is attended with very distinct neuralgia both in them and in the whole arm...
Página 160 - In other instances a change takes place which is quite peculiar, and which to us at least was new. The skin at that end of the nail next to the third finger-joint becomes retracted, leaving the sensitive matrix partly exposed. At the same time the upper line of union of skin and nail retreats into or under the latter part, and, in place of a smooth edge, is seen through the nail as a ragged, and notched border.
Página 194 - Perhaps few persons who are not physicians can realize the influence which long-continued and unendurable pain may have upon both body and mind. The older books are full of cases in which, after lancet wounds, the most terrible pain and local spasms resulted. When these had lasted for days or weeks, the whole surface became...
Página 195 - ... we do not need a direct wound to bring it about " The seat of burning pain is very various, but it never attacks the trunk, rarely the arm or thigh, and not often the fore-arm or leg. Its favorite site is the foot or hand. In these parts it is to be found most often where the nutritive skin changes are met with ; that is to say, on the palm of the hand, or palmar face of the fingers, and on the dorsum of the foot ; scarcely ever on the sole of the foot, or the back of the hand. Where it first...
Página 317 - ... across the neck, rising a little, and emerged immediately below, and a half inch in front of the angle of the jaw on the left side. He fell senseless, and may have remained so •luring half an hoar.

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