vascularity. This is followed by a fall in the local
temperature, which may amount to 8 or 10 F., the parts becoming pale
and cold. Sometimes the hyperaemia resulting from vaso-motor paralysis is
more persistent, and is associated with swelling of the parts from
oedema--the so-called _angio-neurotic oedema_. The vascularity varies with
external influences, and in cold weather the parts present a bluish
appearance.

_Trophic Phenomena._--Owing to the disappearance of the subcutaneous
fat, the skin is smooth and thin, and may be abnormally dry. The hair is
harsh, dry, and easily shed. The nails become brittle and furrowed, or
thick and curved, and the ends of the fingers become club-shaped. Skin
eruptions, especially in the form of blisters, occur, or there may be
actual ulcers of the skin, especially in winter. In aggravated cases the
tips of the fingers disappear from progressive ulceration, and in the
sole of the foot a perforating ulcer may develop. Arthropathies are
occasionally met with, the joints becoming the seat of a painless
effusion or hydrops, which is followed by fibrous thickening of the
capsular and other ligaments, and terminates in stiffness and fibrous
ankylosis. In this way the fingers are seriously crippled and deformed.

#Treatment of Divided Nerves.#--The treatment consists in approximating
the divided ends of the nerve and placing them under the most favourable
conditions for repair, and this should be done at the earliest possible
opportunity. (_Op. Surg._, pp. 45, 46.)

#Primary Suture.#--The reunion of a recently divided nerve is spoken of
as primary suture, and for its success asepsis is essential. As the
suturing of the ends of the nerve is extremely painful, an anaesthetic is
required.

When the wound is healed and while waiting for the restoration of
function, measures are employed to maintain the nutrition of the damaged
nerve and of the parts supplied by it. The limb is exercised, massaged,
and douched, and protected from cold and other injurious influences. The
nutrition of the paralysed muscles is further improved by electricity.
The galvanic current is employed, using at first a mild current of not
more than 5 milliamperes for about ten minutes, the current being made
to flow downwards in the course of the nerve, with the positive
electrode applied to the spine, and the negative over the affected nerve
near its termination. It is an advantage to have a metronome in the
circuit wher