unk was
divided. This was no doubt to be explained on the theory that the
contiguous portion of the nerve suffered less when tension and
resistance were lessened by complete severance of the cord.

_The treatment_ of slight nerve contusion was simple; rest alone was
necessary, and in the course of hours or days paralysis was recovered
from. The symptoms were most troublesome in patients of a neurotic
temperament, or those who had suffered from severe systemic shock.

In severe concussions and contusions the first care had to be devoted to
the discrimination of the lesion from that of division. A period of rest
then needed to be followed by one of massage and movement, to maintain
the nutrition of the muscles. In a considerable portion of the cases a
stage of neuritis had to be expected. In all cases, either of severe
concussion, contusion, or complete section, accompanied by the fracture
of a bone, especial care was necessary that the bandaging and fixation
of the limb were not sufficiently tight to add the dangers of muscular
ischaemia to those of the nerve injury already present.

Neuritis, whether dependent on local injury, implication in the scar,
pressure from callus, or of the ascending variety, needed the same
treatment: rest, preservation of the limb from cold or damp, and the
local application of anodynes, as belladonna, or hot laudanum
fomentations. In some cases a general anodyne, as morphia, was
preferable; then always to be used with caution, as the patients soon
craved inordinately for it, and were unwilling to give it up. Later,
local blisters in the line of the nerve trunk, careful massage and
exercise when muscular and cutaneous tenderness had subsided, the
application of the continuous current to the nerves, and perhaps
faradisation of the muscles, were all useful.

Splints were often temporarily required to resist contracture, or the
assumption of false positions; in either case they needed to be
frequently removed, and movement &c. made, in order to avoid any chance
of troublesome stiffness.

_Operative treatment._--Early interference was only warranted by
positive knowledge that some source of irritation or pressure could be
removed; thus a bone spicule, or a bullet, or part of one, particularly
portions of mantles.

In case of contusion the expiration of three months is the earliest date
at which any operation should be taken into consideration, and
interference is only then advisable if the