Bellows Falls times. [volume] (Bellows Falls, Vt.) 1856-1965, 1899-08-12
AN ANIMALS NERVES.
THEY HAVE BEEN GRATED TO
MANS. -

An Interesting Instance OF this Trans
pIantation-Out of Score of Cases No
Ono Recovered Entirely Muse ular Power
Improved In Four Gases.
In a certain proportion = cases of
injuries to nerves the ends cannot be
brought together and portion of
nerve obtained from one Of the lower
animals or from an amputated ltnb
has been implanted. DR.. r. Peterson
contributed an important article to
transplantation of nerves to the Amer
lean Journal of the Medical Sciences
which contains an original case and
an analysis of the small number Of
previously recorded oaseS.
A man. aged "a, was severely injured
In the right wrist by circular saw.
The ulnar artery and fievor tendons
we're severed. The latter were I'M
mediately sutured. He lost sensibility
in the hand and later there were tro-
phic changes skin. corrugated
nails and liberation of the skin. and
marked atrophy Of the small muscles.
Five months after the injury the d.
vided ends of the median nerve were
exposed. They were found to be
united by connective tissue. The prox-
imal end formed hard bulb. The
connective tissue and the bulb were
removed. leaving gap. So much
force was required Ito bring together
the cut ends that transportation OF
nerve was decided upon.
of young black hound were sutured
between the ends with kangaroo ten
don. A similar operation was per-
formed on the ulnar nerve. On the
following day distinct return Of sensi-
biIity in the thumb was found; the
fingers could not be tested without
disturbing the bandage. Two months
after operation the skin had lost its
shiny look and appeared normal and
the muscles, though still atrpphide,
we're regaining power. A month later
feasibility was complete except on the
dorsal surface Of the third phalanges
Of the second. third and fourth I'm
gers. The only anaesthetic areas on
the palmar aspect were on the second
and third phalanges Of the third and
fourth fingers and on the third
phalanx of the second finger.
| There are twenty recorded cases OF
transportation of nerves. The me-
dian nerve was operated on In seven
cases, the ulIiar in three, the median
and ulnar nerves in two, the musculo.
spiral nerve In seven, and the sciath
in one. There we're eight primary and
Twelve secondary operations. The time
from the injury to the operation var.
lied from forty eight hours to one ant
a quarter years. Eight out Of the
twelve cases of secondary operation
showed improvement in sensibility Of
motion, while only four out of eigh
cases of primary operation improved
The interval between the ends of the
divided nerves varied from three Il
ten centimetres, but distance did no
seem to affect the result. In nine
cases the transplanted segments wer'
from the sciatic nerves of dogs, II
three from rabbits, in one from kit
ten. In one from the spinal cord of {
| rabbit, and in five from recently am
putated limbs. In one case an inch O
the sciatic nerve which had been ex
cised was itself transplanted. In nine
cases catgut was used to unite the i'm
planted segments to the divided ends
in three silk, and in one kangaroo ten
don.
No case recovered entirely. Tn
nearest approach to complete recover.
took place in the case longest unde
observation, in which at the end o
| six years sensibility had entirely re
turned and the only weak muscle wa
the abductor pollicis. In three case
there was practically recovery of sen
sihility and motion and the hand wa
useful Sensibility completely return
ed in four cases, nearly completely il
| three cases, and was improved In fou
| cases. Muscular power improved IL
four cases. There was Improvement II
| either motion or sensibility in twelv
| cases, and no improvement in eithe
| in six cases. The average time II
which sensibility appeared after tn
| operation was about ten days; motion
returned in about two and q hal
/ ,,1-tho