Case of a wounded nerve, followed by severe consequences, and cured by removing the wounded portion of the nerve / [George Bell].

  • Bell, George
Date:
[1826]
Catalogue details

Licence: Public Domain Mark

Credit: Case of a wounded nerve, followed by severe consequences, and cured by removing the wounded portion of the nerve / [George Bell]. Source: Wellcome Collection.

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    In the mean while, I am persuaded that the faithful narrative of unequivocal cases, may, in this, as in other subjects, inc uce practitioners to bring forward those of the same kind they have met with, and thus form a body of detached information which may be classed, when our knowledge is more matured. With this view I am induced to offer the history of a case, wheie, have every reason to believe, a nerve was punctured in the opera- lion of bleeding, where the symptoms soon became extremely urgent and interesting, and where a cure was effected by a com¬ plete division and removal of the parts surrounding the wound. On the 7th July 18085, I was desired by Dr James Hamil¬ ton Professor of Midwifery in this University, to visit, witr him, a young woman, who had been bled ten days before in tin median cephalic vein oi the right arm. . When I saw her, the tendon of the biceps was much con tracted, and the fore-arm bent to an acute angle with the arm The fingers also were firmly clenched, and she could neithe: allow them or the arm to be extended, without suffering tin most excruciating pain. On examining the arm, no swelling o it was perceptible; and the wound of the vein was completely healed ; but when this spot was even gently pressed, she com plained of great uneasiness. The pain wras not confined, how ever, to the neighbourhood of the wound, but extended dowi the fore-arm, to the very tips of the fingers, and stretched up wards along the inside of the arm to the axilla, thence to th clavicle, pectoral muscle, and even the short ribs. The pain was, to a certain extent, constant, but occasional! considerable exacerbations were experienced ; and at these time she was seized with startings, tremors, and subsultus tendmun. and other nervous symptoms, The pulse was 110, she wa hot and restless,-—her tongue dry and parched, she had a g( neral uneasiness over her whole body ; in short, all the symptom of fever. As she was of an irritable habit, and easily affected b slight impressions, and every internal medicine and external ay plication that Dr Hamilton could think of had been used, witl out producing any sensible good effect before I saw her, thei was much reason to apprehend that tetanus or locked jaw \voul soon supervene, unless relief were obtained from the dfvision < the nerve which we had no doubt had been wounded. As I was obliged to perform the operation by candle ligh when it would be extremely difficult, if not impossible, to di sect from the neighbouring parts so minute a nerve as th; which probably was wounded, I determined to remove a cons derable portion of the vein which had been opened, so that might be certain of including the injured nerve within the tv incisions. I was induced to adopt this plan from another consideratk