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At Arras he had got a bit of shrapnel in his thigh, which had played the deuce with the sciatic nerve, and he was still on crutches. We spun over ridges of moorland, always keeping northward, and brought up at a pleasant white-washed house close to the sea. Colonel Broadbury ushered me into a hall where a small fire of peats was burning, and on a couch beside it lay a slim, pale-faced young man.
The new restlessness, which he had come so far to quiet, broke over him in miserable, taunting waves. Why was he here on the sofa instead of out there in the rain? The war? But he was too inherently honest to blame the war. It was, perhaps, responsible for the present state of his sciatic nerve but not for the selling of his birthright of sturdy youth. The causes of that lay far behind the war.
Baly mentions a case of epilepsy occasioned by irritation in the socket of a tooth. Webber reports a case of epilepsy due to phimosis and to irritation from a tooth. Beardsley speaks of an attempt at strangulation that produced epilepsy. Brown-Sequard records an instance produced by injury to the sciatic nerve. Doyle gives an account of the production of epilepsy from protracted bathing in a pond.
Thus the fibers which pass out from the sacral plexus in the loins, and extend by means of the great sciatic nerve and its branches to the ends of the toes, may be more than a yard long. Remarkable instances are cited to illustrate the imperative demand for sleep.
This is especially the case along the course of the sciatic nerve and all its branches, where the pulse of pain is so agonizing that the sufferer can not keep his legs still for an instant. There is occasionally severe pain of this kind in the arms also, but this is very rare.
It is a still more interesting fact, 'that the sciatic nerve in the congenitally toeless animal has inherited the power of passing through all the different morbid states which have occurred in one of its parents from the time of the division till after its reunion with the peripheric end.
#Gluteal Aneurysm.# An aneurysm in the buttock may arise from the superior or from the inferior gluteal artery, but by the time it forms a salient swelling it is seldom possible to recognise by external examination in which vessel it takes origin. The special symptoms to which it gives rise are pain down the limb from pressure on the sciatic nerve, and interference with the movements at the hip.
These observations are not uninteresting, when we recollect that a solution of the upas-poison poured upon the sciatic nerve, or insinuated into the texture of the nerve, produces also a sensible effect on the irritability of the organs by immediate contact with the medullary substance.
Before degenerative changes take place in the nerve substance, in such cases, pressure may completely paralyze a nerve when it is so situated. Melanotic tumors in the paraproctal tissue in some cases, because of the large size of the new-growths, cause paralysis of the sciatic nerve.
With reference to injuries to the sciatic nerve, Kuster mentions the case of a strong man of thirty, who in walking slipped and fell on his back. Immediately after rising to his feet he felt severe pain in the right leg and numbness in the foot. He was unable to stand, and was carried to his house, where Kuster found him suffering great pain.
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