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Updated: June 24, 2025
Some weeks or months after the injury, the patient complains of increasing hyperæsthesia and of neuralgic pains in the course of the nerve. The nerve is very sensitive to pressure, and, if superficial, may be felt to be swollen. The associated muscles are wasted and weak, and are subject to twitchings. There are also trophic disturbances. It is rare to have complete sensory and motor paralysis.
Then begins the physical examination, the study of his sense organs and his nerves, of the motor inabilities, the pains, the local anæsthesias and paræsthesias, the disturbances of the reflexes, of the spasms, tremors, convulsions, and incoördinations, of the vasomotor and trophic disorders, and so on.
The acute bed-sore is a rapidly progressing form of ulceration, often amounting to gangrene, of portions of skin exposed to pressure when their trophic nerve-supply has been interfered with. [Illustration: FIG.
The author excludes syphilis, tuberculosis, rheumatism, gout, hemophilia, etc., and considers it to have been a trophic affection of cerebral origin. Cases of pneumonia osteoarthropathy simulating acromegaly have been reported by Korn and Murray. Megalocephaly, or as it was called by Virchow, leontiasis ossea, is due to a hypertrophic process in the bones of the cranium.
Sidis believes that "strong permanent impressions or suggestions made on the reflex organic consciousness of the inferior centers may modify their functional disposition, induce trophic changes, and even change organic structure" and this in a sentence is probably what lies behind all faith and mental healing.
The physiological effects of complete division are that the muscles supplied by the nerve are immediately paralysed, the area to which it furnishes the sole cutaneous supply becomes insensitive, and the other structures, including tendons, bones, and joints, lose sensation, and begin to atrophy from loss of the trophic influence.
The latter, much broader in scope than personal consciousness, has dependent on it the entire vegetative life circulation, trophic actions, etc. Here is the bold part of the hypothesis: Its authors suppose that the supremacy of the subliminal consciousness is a reversion, a return to the ancestral.
In the higher animals and in primitive man, according to them, all trophic actions entered consciousness and were regulated by it. In the course of evolution this became organized; the higher consciousness has delegated to the subliminal consciousness the care of silently governing the vegetative life. But in case of mental disintegration there occurs a return to the primitive state.
Earlier than that, in 1839, Nasse had discovered that a severed nerve cord degenerates in its peripheral portions. Waller discovered that every nerve fibre, sensory or motor, has a nerve cell to or from which it leads, which dominates its nutrition, so that it can only retain its vitality while its connection with that cell is intact. Such cells he named trophic centres.
Sensation is recovered first, but it seldom returns before three or four months. There then follows an improvement or disappearance of any trophic disturbances that may be present.
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