Surgical cases. Neuralgia of stump after amputation--secondary amputation--return of the neuralgia / [James Duncan].

  • Duncan, James, 1810-1849
Date:
1844]
Catalogue details

Licence: Public Domain Mark

Credit: Surgical cases. Neuralgia of stump after amputation--secondary amputation--return of the neuralgia / [James Duncan]. Source: Wellcome Collection.

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    [EXTRACTED FROM THE NORTHERN JOURNAL OF MEDICINE,] SURGICAL CASES. i NEURALGIA OF STUMP AFTER AMPUTATION-SECONDARY AMPUTATION-RETURN OF THE NEURALGIA. BY JAMES DUNCAN, M.D., Fellow of the Royal Colleges of Surgeons of England and Edinburgh, one of the Surgeons to the Royal Infirmary, Edinburgh. J. R., set. forty-five, an Irishman, was admitted into the Royal Infirmary, under my care, on August 30, 1843. He had been employed on the Edinburgh and Glasgow Rail¬ way, and in August 1840 one of the carriages passed over the limb, tearing it off immediately above the ankle, and other¬ wise injuring it severely. The extremity had in consequence been amputated by Dr Hamilton of Falkirk a little below the knee-joint. The case had gone on remarkably well until about six weeks after the operation, when the stump became the seat of slight neuralgic pains. These continued to increase, notwith¬ standing a variety of medical treatment, and at last they became such a source of annoyance and distress to him, that he was ob¬ liged to abandon the situation on the railway, to which he had returned some time after the operation. . When admitted under my care, the pain was described by him as being exceedingly severe, more particularly during the night, and such as almost altogether to banish sleep. There was not the slightest reason to believe that the patient feigned; his employment was by no means an arduous one, he had a family depending upon him for support, and, above all, his appearance was that of a person worn out by continued suffering. When admitted, the stump was carefully examined, under the belief that the pains might depend upon the divided ends of the nerves being either injuriously involved in the cicatrix, or applied over the ends of the bones. Nothing of this kind, however, could be discovered, no enlargements of the extremities of the nerves could be made out, and altogether the stump was as well formed and apparently as serviceable a one as could be met with. In addition, the pain was not confined to any particular spot, but affected the whole stump below the knee, very slight pressure on any point producing very acute pain.