646 HUBER. [Vol. XI. 



with the central end may be attained, and the central nerve 

 segment is not subject to further mutilation. 



Three experiments of Willard are interesting in this connec- 

 tion. In these ^ in., ^ in., and i^ in., respectively, were 

 removed from the sciatics of three dogs. The ends were split 

 longitudinally, the flaps turned on their base, and united with 

 chromatized catgut. The animals were killed on the tenth, 

 twenty-eighth, and forty-seventh days. The flap and the 

 peripheral part of the nerve were found degenerated. If I 

 understand Willard correctly, regeneration of the peripheral 

 end was not observed, although in the first experiment, the 

 fibres coming from above, separated into a fan-like expansion, 

 but did not reach the peripheral nerves. 



(/) Nerve Grafting. — Letievant further recommended that 

 the central end of the peripheral segment of a divided nerve, in 

 case it cannot be sutured to the central portion of the same 

 nerve, be fixed by means of sutures to an accompanying nerve. 

 He suggested that the uninjured nerve be denuded of its 

 epineurium at the site of suture. This method can, of course, 

 only give favorable results if, while the epineurium is being 

 removed from the uninjured nerve, some of its fibres are 

 divided. These, in regenerating, we can assume, may grow 

 into the grafted nerve. 



As far as I have been able to ascertain, the only experimen- 

 tal observations bearing on this method are reported by Moses 

 Gunn. At his request, Dr. W. H. Sheldon made a series of 

 operations on dogs, which involved the removal of a segment 

 from the ulnar nerve, and the grafting of its peripheral portion 

 to the accompanying median. He states, " that the operati^ons 

 were generally successful, and apparently indicate that through 

 the engrafted connection the parts supplied by the ulnar 

 received their innervation." In another experiment made by 

 Dr. Sheldon, where the ulnar was resected and not grafted, 

 sensation or motion in the parts supplied by this nerve were, 

 after the healing of the wound, in no way impaired. Gunn 

 concludes that this experiment destroys entirely the value of 

 the other. 



