The practice of surgery . ed. Not unfre-quently, in cases of injury, there may be no room for selection; theextent of the accidental wound precluding all attempts at regular ope-ration, and compelling the surgeon to shape his flaps according to whatmay be, perhaps, quite an original mode of procedure. Affections of Stumps. Neuralgia of the stump is no unfrequent result of amputation, how-ever skilfully conducted {Principles, 3d Am. Ed. pp. 398 and 585). Itis most commonly observed after amputation below the knee. If nochange of structure in the nerve can be detected, the treatment mustbe such
The practice of surgery . ed. Not unfre-quently, in cases of injury, there may be no room for selection; theextent of the accidental wound precluding all attempts at regular ope-ration, and compelling the surgeon to shape his flaps according to whatmay be, perhaps, quite an original mode of procedure. Affections of Stumps. Neuralgia of the stump is no unfrequent result of amputation, how-ever skilfully conducted {Principles, 3d Am. Ed. pp. 398 and 585). Itis most commonly observed after amputation below the knee. If nochange of structure in the nerve can be detected, the treatment mustbe such as is suitable for neuralgia in general; and, of the remediesusually found most useful, iron internally, and the light application ofnitrate of silver to the part, may be specially mentioned. If neuromataplainly exist, entangled with the dense cicatrix, they ought to be re-moved ; and, for this purpose, a repetition of the amputation on a minorscale is usually necessary; care being taken in the fashioning of the Fig. Neuromata of Stump, after amputation of tbe arm. A large neuromatous mass at a; opposite b the tumors are more denned. stump, and in the after-treatment of it, that the nerves be not ao-ainsimilarly circumstanced. Not unfrequently, however, notwithstandingevery care, neuralgia returns—obviously dependent on a general morethan on a local cause {Principles, 3d Am. Ed. p. 590). The neuralgicpart should not be pressed upon in the adaptation of any artificial from the stump seldom follows a well-conducted flap-ope-ration. It is most likely to occur when section has been made in thedense part of a bone, as in the middle of the femur. The sequestrummay consist of a mere scale from the sawn surface; or it may be ofsome length—involving the whole thickness of the bone at its lower AFFECTIONS OF STUMPS. 705 part, and tapering, upwards, of a cancellous texture. Healing of thewound is necessarily delayed until detachment and extrusion of thesequestru
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