. Medical and surgical therapy. surrounding the nerve, to whichHenri Claude, Vigouroux and have justly ascribed import-ance. The fibro - sclerotic reaction isalways very marked along thecourse of the projectile through the tissues, and in-creases when protracted suppuration has occurredin the wound, or when the injury to the nerve isserious, and is most marked when, in addition, ablood-vessel is wounded. The exuberant lardaceous cicatricial tissue literallystifles what remains of the nerve cords and the blood-vessels. Frequently the nerve becomes adherent to theblood-vessels and the mu
. Medical and surgical therapy. surrounding the nerve, to whichHenri Claude, Vigouroux and have justly ascribed import-ance. The fibro - sclerotic reaction isalways very marked along thecourse of the projectile through the tissues, and in-creases when protracted suppuration has occurredin the wound, or when the injury to the nerve isserious, and is most marked when, in addition, ablood-vessel is wounded. The exuberant lardaceous cicatricial tissue literallystifles what remains of the nerve cords and the blood-vessels. Frequently the nerve becomes adherent to theblood-vessels and the muscles. In addition, therefore, to the essential obstacleswithin the nerve itself which oppose its rcgenera- FiG. 14. Small neuroma withfibrous core. a, afferent fibres ; b,other fibres; c, de-generated efferentfibres. (AfterPierre Marie andPoix.) •250 TREATMENT AND REPAIR OF NERVE LESIONS tion, we must bear in mind that there are lesser im-pediments, but not the less real, engendered by theinjuries to the surrounding Fig. 15.—Small intra-nervous micro&copic neuroma, (Cameralucida, obj. 4, oc. 1.) The medullated fibres spread out in bundles, to join up again further ouleaving the small neuroma. Some intra-nervous neuromata oflarger size have the same structure, a, afferent end; 6, neuro-matous swelling ; c, efferent end. (After Pierre Marie and Foix.) CHAPTER II RECOVERY OF SENSIBILITY The EngHsh neurologist, Henry Head, performed amost interesting experiment in 1903. He caused hisradial nerve to be divided and immediately sutured(the anterior branch and external cutaneous divisionin the neighbourhood of the elbow). In conjunctionwith W. H. Rivers he studied the nature and dura-tion of the alteration of sensation as well as all thevarious stages during the recovery of sensation.^ Our observations, which were made on a largenumber of wounded, have shown us that in the largemajority of cases the various stages in the restorationof sensation are identical with those d
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