Page:The Atlantic Monthly, Volume 18.djvu/14

6 I spent here three and a half months, before my transfer to the United States Army Hospital for nervous diseases. Every morning I was carried out in an arm-chair, and placed in the library, where some one was always ready to write or read for me, or to fill my pipe. The doctors lent me medical books; the ladies brought me luxuries, and fed me; and, save that I was helpless to a degree which was humiliating, I was as comfortable as kindness could make me.

I amused myself, at this time, by noting in my mind all that I could learn from other limbless folk, and from myself, as to the peculiar feelings which were noticed in regard to lost members. I found that the great mass of men who had undergone amputations, for many months felt the usual consciousness that they still had the lost limb. It itched or pained, or was cramped, but never felt hot or cold. If they had painful sensations referred to it, the conviction of its existence continued unaltered for long periods; but where no pain was felt in it, then, by degrees, the sense of having that limb faded away entirely. I think we may to some extent explain this. The knowledge we possess of any part is made up of the numberless impressions from without which affect its sensitive surfaces, and which are transmitted through its nerves to the spinal nerve-cells, and through them, again, to the brain. We are thus kept endlessly informed as to the existence of parts, because the impressions which reach the brain are, by a law of our being, referred by us to the part from which they came. Now, when the part is cut off, the nerve-trunks which led to it and from it, remaining capable of being impressed by irritations, are made to convey to the brain from the stump impressions which are as usual referred by the brain to the lost parts, to which these nerve-threads belonged. In other words, the nerve is like a bell-wire. You may pull it at any part of its course, and thus ring the bell as well as if you pulled at the end of the wire; but, in any case, the intelligent servant will refer the pull to the front door, and obey it accordingly. The impressions made on the cut ends of the nerve, or on its sides, are due often to the changes in the stump during healing, and consequently cease as it heals, so that finally, in a very healthy stump, no such impressions arise; the brain ceases to correspond with the lost leg, and, as les absents ont toujours tort, it is no longer remembered or recognized. But in some cases, such as mine proved at last to my sorrow, the ends of the nerves undergo a curious alteration, and get to be enlarged and altered. This change, as I have seen in my practice of medicine, passes up the nerves towards the centres, and occasions a more or less constant irritation of the nerve-fibres, producing neuralgia, which is usually referred to that part of the lost limb to which the affected nerve belongs. This pain keeps the brain ever mindful of the missing part, and, imperfectly at least, preserves to the man a consciousness of possessing that which he has not.

Where the pains come and go, as they do in certain cases, the subjective sensations thus occasioned are very curious, since in such cases the man loses and gains, and loses and regains, the consciousness of the presence of lost parts, so that he will tell you, "Now I feel my thumb,—now I feel my little finger." I should also add, that nearly every person who has lost an arm above the elbow feels as though the lost member were bent at the elbow, and at times is vividly impressed with the notion that his fingers are strongly flexed.

Another set of cases present a peculiarity which I am at a loss to account for. Where the leg, for instance, has been lost, they feel as if the foot was present, but as though the leg were shortened. If the thigh has been taken off, there seems to them to be a foot at the knee; if the arm, a hand seems to be at the elbow, or attached to the stump itself.

As I have said, I was next sent to