Page:Brain Volume 31 Part 3.pdf/6

 striking feature is the absence of the normal elasticity, which is in remarkable contrast with the rest of the skin. The affected parts do not sweat, while the rest of the hand is permanently slightly moist."

From the time of the operation until the removal of the splint (May 23), the borders of the loss of sensation on the forearm underwent no material change. But H.'s skin has always been peculiarly susceptible to the action of chemical antiseptics, and the necessary cleansing at the time of the operation led to desquamation to within about 3 in. to 4 in. of the wrist. Fortunately, the hand had entirely escaped their action.

On the extensor aspect of the forearm, the loss of all forms of cutaneous sensation was bounded for the greater part by a definite line. Towards the radial aspect, the loss of sensation merged more gradually into parts of normal sensibility. The borders formed a sinuous line, seen on figs. 3 and 4. Over the greater part of the forearm, the loss of sensation to prick was less extensive than that to cotton wool; but nearer to the wrist, the reverse condition seemed to exist.



The extent of the cutaneous analgesia on the hand was slightly less than that of the loss of sensation to cotton wool and von Frey's hairs, and to these stimuli all the boundaries were sharply defined, except at the base of the index and middle fingers.

The splint was removed on May 23, and it was then possible to wash the arm vigorously and to remove the loose scales of epithelium. We then discovered that the loss of sensation to prick was everywhere coterminous with, or slightly less extensive than, the loss to cotton wool,