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Updated: May 1, 2025
The special risks of incised wounds are: division of large blood vessels, leading to profuse hæmorrhage; division of nerve-trunks, resulting in motor and sensory disturbances; and division of tendons or muscles, interfering with movement. Treatment. If hæmorrhage is still going on, it must be arrested by pressure, torsion, or ligature, as the accumulation of blood in a wound interferes with union.
That powers so rare do not originate in the bones, ligaments, muscles, or fats, does not need argument; that when the nerve-trunks that supply the arm or leg are severed power of movement and feeling is lost, is known to all; and equally would the power of the stomach be abolished were the nerve-trunks cut off.
In the large nerve-trunks of the limbs he has worked out the exact position of the bundles for the various groups of muscles, so that in a cross section of a particular nerve the component bundles can be labelled as confidently and accurately as can be the cortical areas in the brain.
Surmising that the nerve must have been injured in some way, he made careful inquiries of the patient, who recalled that he had been thrown from his chariot some time before, striking and injuring his back. Acting upon this information, Galen applied stimulating remedies to the source of the nerve itself that is, to the bundle of nerve-trunks known as the brachial plexus, in the shoulder.
For example, trophic ulcers are liable to occur in injuries or diseases of the spinal cord, in cerebral paralysis, in limbs weakened by poliomyelitis, in ascending or peripheral neuritis, or after injuries of nerve-trunks.
Now, let us substitute for this inverted tree the nervous system of a man, and remember that the electric current moves from the positive to the negative pole as nearly in straight lines as it can where there are good conductors, such as the nerves and muscles, and it will at once appear that, in treating the lower limbs, if we place our N. P. at the coccyx, and then manipulate with P. P. over the feet and legs, our electric lines are running from all the surface extremities of the nerve ramifications, wherever the P. P. is moving, directly into and along these fine ramifications, and, through the larger nerve-branches, up to the stationary N. P. Or, if we treat the trunk of the body by placing the N. P. on the spine, near its upper end, and then manipulate with P. P. from the lower part upward over the back, sides, abdomen and chest, our current strikes into the surface extremities of the nerves at every point where the electrode touches, and makes its way upwards, along the nerve-lines, to the great spinal cord under the N. P. thus replenishing with fresh electricity all the ganglions, plexuses and nerve-trunks along the way.
While they originate from the ossifying junctions of the long bones, they tend, as the shaft increases in length, to project from the surface of the bone at some distance from the ossifying junction and to "point" away from it. They may cause symptoms by "locking" the adjacent joint or by pressing upon nerve-trunks or blood vessels.
The nerve-cell whose body is in the top of the brain may have an extension or arm which may reach practically to the end of the spinal cord, and there make communication with another cell whose arm, in turn, may reach as far as the toe. Such nerve arms or extensions constitute the nerve-fibres, and bundles of these nerves, or nerve-trunks.
If at the same time important nerve-trunks are lacerated, so that the function of the limb would be seriously impaired, it is not worth running the risk of attempting to save it. If, in addition, there is extensive destruction of large muscular masses or of important tendons, or comminution of the bones, amputation is usually imperative.
With the limb still elevated the tourniquet is firmly applied, a part being selected where the vessel can be pressed directly against a bone, and where there is no risk of exerting injurious pressure on the nerve-trunks.
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