the cases bore a very marked resemblance in character to those
in which paralysis results from tight constriction of the limb, as in
the arm after the application of an Esmarch's tourniquet.
_Laceration._--If incomplete, the signs corresponded very nearly to
those of severe contusion, since partial section is impossible without
the occurrence of the latter. The condition indeed was only to be
distinguished by the partial nature of the recovery, and even this
latter might be only more prolonged.
The same remarks hold good with regard to perforation of the nerve
trunks; but, as regards function, these injuries are not so serious in
prognosis as very much more limited transverse divisions or mere
notching, and in some cases the disturbance of function was by no means
profound or prolonged.
Absolute loss of reaction to electrical stimulus from above was the only
pathognomonic sign of actual section, unless the position of the nerve
was such as to allow of palpation, when the presence of a bulbous end at
once settled the difficulty. In many cases of superficial tracks with
division of such nerves as the long or short saphenous, the early
development of bulbs in the course of the trunks gave positive
information, and these were often observed.
_Traumatic neuritis._--This was a common sequence of contusion of the
nerve itself, or of its subsequent inclusion in a cicatrix or callus. It
was evidenced by hyperaesthesia both superficial and deep, pain,
contracture, wasting of the muscles, local sweating, and the development
of glossy skin.
Examples of this condition were seen in the case of nearly every nerve
in the body. In frequency of occurrence, degree of severity, and in its
selection of individual nerves considerable variation was met with. With
regard to the two former points, personal idiosyncrasy, and degree of or
peculiarity in the nature of the injury, are the only explanations I can
suggest. Perhaps in some instances exposure to wet or cold in the early
stages of the injury was of some import. Thus, I saw several severe
cases of musculo-spiral neuritis in men who were wounded during the
trying and wet march on Bloemfontein. I did not observe that suppuration
or wound complications seemed important explanatory moments, as most of
the cases occurred in wounds that healed rapidly.
With regard to the question of selection; the same nerves that appear
particularly liable to suffer from idiopathic inflammations,
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