No. 3.] PERIPHERAL NERVES. 69 1 



from the peripheral stump and of equal length, were brought together, 

 sutured by means of a direct catgut suture, and wound closed. 

 Exainination. — July 31, 1894 (147 days after). 



Electrical stimulation of the ulnar below flaps excited no contraction and 

 no reflexes. The same negative results were obtained when stimulating 

 above the flaps, and when stimulating the muscular branch to flex. carp. ul. 



The nerve was hardened in Miiller's fluid, and stained in anilin blue and 

 safranin. 



{e) Nerve Grafting. 



Experiment 4g. — Nov. 25, 1893. 



Full-grown white bulldog. Hypodermic injection of | grm. morph. 

 sulph. 



Operation. — The ulnar and median nerves of the left arm were exposed, 

 4 ctm. removed from the median, and the central end of peripheral median 

 stump was stitched by means of three catgut sutures to the accompanying 

 ulnar. Before stitching, a small area of the trunk of the ulnar was denuded 

 of its connective tissue sheath. The central median stump was allowed to 

 end free in the wound. The wound was closed with catgut and silk 

 sutures. 

 Examination. — April 23, 1894 (149 days after). 



After removing the skin and subcutaneous connective tissue, the periph- 

 eral median stump was found to be firmly united to the accompanying 

 ulnar. The central median stump terminated in a large bulb. 



Electrical stimulation of the peripheral median showed it to be degener- 

 ated ; no contraction of muscles supplied, and no reflexes were observed. 



(/) L^ti^vant's and Tillmanns' Operation, that is, Cross- 

 Suturing THE Long Ends and Grafting the Short Ends of 

 Two Parallel Nerves Cut at a Different Level. 



Experiment ^o. — Nov. 29, 1893. 



Young mastiff about one year old. | grm. morph. sulph., followed by 

 ether. 



Operation. — The ulnar and median were exposed. From the two 

 nerves were exsected segments 4 ctm. long. The portions removed were 

 taken from different levels of the two nerves. As will be seen from Fig. 3, 

 the ulnar was divided much higher up than the median, and as the segments 

 removed from the two nerves were of about the same length, the peripheral 

 stump of the ulnar was longer than that of the median. In cases where, 

 as in the present experiment, an incision passes obhquely over two nerves 

 having a parallel course, and where so much nerve substance is lost that 

 the respective ends cannot be brought together, Tillmanns recommends a 

 " cross-suturing " of the longer ends, and a grafting of the shorter stumps 



