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Updated: May 18, 2025
If, in his experimental animals, he carefully sought for the cut end of the nerve-trunk in the wound that had been infected, and injected the antitoxin directly into that, the disease was stopped. Or it might even be "headed off" by the crude method of cutting directly across the nerve-trunk at a point above that yet reached by the infection.
In the living subject, by using a fine needle-like electrode and a very weak galvanic current, he has been able to differentiate the nerve bundles for the various groups of muscles. In several cases of spastic paralysis he succeeded in picking out in the nerve-trunk of the affected limb the nerve bundles supplying the spastic muscles, and, by resecting portions of them, in relieving the spasm.
In nerve lesions, such as a divided nerve-trunk, the nails are apt to suffer, becoming curved, brittle, or furrowed, or they may be shed. Onychia is the term applied to an infection of the soft parts around the nail or of the matrix beneath it. The commonest form of onychia has already been referred to with whitlow.
The features are those of a rapidly growing sarcoma involving a nerve-trunk, with agonising pain and muscular cramps, followed by paralysis from destruction of the nerve fibres. The removal of the tumour is usually followed by recurrence, so that high amputation is the only treatment to be recommended. Metastasis to internal organs is exceptional.
The treatment is conducted on the same lines as sarcoma in other situations; the insertion of a tube of radium after removal of the tumour diminishes the tendency to recurrence; a portion of the nerve-trunk being sacrificed, means must be taken to bridge the gap.
The peripheral end is completely degenerated, and is represented by a fibrous cord, the cut end of which is often slightly swollen or bulbous, and is also incorporated with the scar tissue of the wound. #Clinical Features.# The symptoms resulting from division and non-union of a nerve-trunk necessarily vary with the functions of the affected nerve. Sensory Phenomena.
Inflammation involving a nerve-trunk may cause a boring or a tingling pain; while the implication of a serous membrane such as the pleura or peritoneum gives rise to a pain of a sharp, stabbing character. Interference with the function of the inflamed part is always present to a greater or less extent.
The spinal marrow, or that portion of the nervous system which lies outside of the head, is at the same time a great nerve-trunk and a centre for reflex action of the muscles of the body. But the development of these distinct portions and the division of labor between them must have been a long and gradual process.
As regards treatment, there is no indication for surgical interference except when one or other tumour is a source of disability as by pressing upon a nerve-trunk or by locking a joint, in which case it is easily removed by chiselling through its neck. [Illustration: FIG.
Injuries of nerves resulting from #gun-shot wounds# include: those in which the nerve is directly damaged by the bullet, and those in which the nerve-trunk is involved secondarily either by scar tissue in its vicinity or by callus following fracture of an adjacent bone. The primary injuries include contusion, partial or complete division, and perforation of the nerve-trunk.
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