Clinical notes on nerve disorders in surgical practice / by George Wherry.

  • Wherry, George, 1852-1928.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Clinical notes on nerve disorders in surgical practice / by George Wherry. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    molar on left side have not appeared—otherwise there is no- thing noteworthy; the teeth are well formed, but a good deal decayed on both sides of the mouth. It is difficult to explain the ulceration of eyelids which has taken place in this case after excision of the globe three years unless the old ‘ trophic view is to be held with regard to the lids as well as to the eyeball, and that both are influenced by the Gasserian ganglion. The absence of protective sensitive- ness will more easily explain the loss of the globe than that of the lid margins. Cases XV—XVIII.—Paralysis of the infraorhital nerve. (1) A young man received a violent blow at football from another player’s elbow on the left malar prominence. Immedi- ately after the injury the upper lip and cheek of that side became numb and so remained. The following day, when first seen, there was a depression of the malar prominence, and on passing the finger along the lower ridge of the orbit it at once detected a fracture, running down probably to the infraorbital foramen. There was soon sub-conjunctival ecchymosis, and all sensation was absent in the parts supplied by the infraorbital branch of the fifth nerve; the gums and teeth were said to feel dead. The fracture was firmly impacted, and the patient did not wish any attempt made to remedy the deformity. (2) A very similar accident occurred in another case at foot- ball, with the same sinking of the malar prominence, and a crag of bone could be felt when the finger passed along the lower edge of the orbit from the malar to the nasal process. There was numbness of the cheek, but this passed away in time. The zygomatic arch was also thought to be broken ; the fracture was firmly fixed and the deformity was permanent. In these two cases there was not more pain or bruising than is usual in a bad black eye, and no general disturbance or shock. (3) In a third case there was a remarkable circumorbital ring of ecchymosis, and another ring of ecchymosis round the ear, after a blow upon the cheek in a middle-aged man. Head symptoms were severe—stupidity alternating with delirium, retention of urine, &c.