664 HUBER. [Vol. XL 



some other path than the injured nerve (in the first the median 

 and in the second the ulnar). The reported cases, where, after 

 section of one or even two of the arm nerves, sensation was 

 not at all or only partially impaired, would lend credence to 

 such a statement. 



Of the four cases classed as failures, two (Nos. i and 2) are 

 reported by Albert. In one of these, the case was dismissed 

 ten days after the operation ; in the other the implanted seg- 

 ment came away in a necrosed state. In Kaufmann's case 

 (No. 3) the operation was followed by fever, probably due to 

 suppuration. The case was not observed for a time long 

 enough to admit of regeneration of the peripheral end. In 

 Vogt's case (No. 6) the implantation was made 15 months 

 after the injury to the radial, and, after vivifying the ends, 

 they were 12 ctm. apart. The operation was followed by 

 suppuration. The fate of the implanted nerve is not noted ; 

 its connection with the radial may have been lost. The report 

 extends only two months after the implantation, which, judging 

 from the results obtained in other operations on injured nerves, 

 is not long enough to admit of regeneration. 



Of the reported cases, the percentage of recoveries is nearly 

 as large for secondary as for primary operations. No attempt 

 is here made to give the average time required for the return 

 of sensation and motion after implantation. The small number 

 of cases at my disposal did not seem to me large enough to 

 warrant such an attempt. 



Very little need here be added to what has already been 

 given in the table concerning the other nine cases in which 

 operative means other than implantation were resorted to.- I 

 would, however, beg indulgence for again referring to the two 

 cases of nerve grafting (Nos. 19 and 20) reported by Despres 

 and Gunn, as their interpretation of the results obtained seems 

 to me wholly unwarranted. In Despres' cases the peripheral 

 median was grafted on to the ulnar ; the wound does not seem 

 to have healed by first intention. Six days after the operation 

 there was some return of sensation to the middle and index 

 fingers, and, at the end of four weeks, the sensibility in these 

 fingers over the two proximal phalanges would seem to be 



