692 HUBER. [Vol. XI. 



to the accompanying nerve trunk, Tillmanns' suggestion was made use of 

 in this operation. The longer central stump of the median was sutured to 

 the longer peripheral stump of the ulnar. The short central stump of the 

 ulnar was grafted (stitched) to the central median, and fhe short peripheral 





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6' 



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Fig. 3. — a, central ulnar stump ; a, peripheral ulnar stump : b, central median stump ; b', peripheral 

 median stump ; c, cross-suture of central median and peripheral ulnar segment ; e, grafting of 

 peripheral end of central ulnar segment to median ; /, grafting of central end of peripheral 

 median stump to ulnar. 



stump of the median to the peripheral ulnar as shown in Fig. 3. The 

 connective tissue was carefully stitched over the nerves by means of 

 numerous buried catgut sutures, and the skin wound closed with silk 

 sutures. 



Dec. 14, 1893. Nearly the entire wound healed by first intention. 

 Examination. — May 30, 1894 (1S2 days after operation). 



On laying bare the nerves in the arm, the following conditions were met 

 with : — 



The central median stump was found united to the peripheral segment 

 of the ulnar. The central ulnar stump was fixed to the median by means 

 of connective tissue, and on careful dissection was found to end in a bulb. 

 The peripheral median was attached to the peripheral ulnar. 



Physiological examination gave the following results : — 



(i) Electrical stimulation by induction shocks at 15 ctm. S. C. of 

 peripheral ulnar below its junction with median, excited strong contraction 

 in muscles supplied by ulnar, and much pain, as shown by the well-developed 

 reflexes. 



(2) Stimulating the central median above junction with the ulnar, with 

 induction shocks at 15 ctm. S. C, gave strong contraction of flex. carp. ul. 

 and flex. prof, dig., as could easily be seen on observing these muscles after 

 their exposure. 



(3) Direct stimulation of the muscular branches to the above muscles 

 excited contraction. 



