Literary Notices. Ixxix 



avoid a chance wound across it which is always much graver than a 

 longitinal section. The lengthening should be performed upon the 

 member when extended in order to prevent the nerve sheath of the 

 nervous cord from becoming much loosened. If the limb is not 

 placed in extension the bending of the joints will allow the formation 

 of a rather long loop in the course of the nerve and all that portion 

 will remain isolated from the sheath and, consequently, will receive 

 very little nutrition. 



In some nerves, as the sciatic, the same operation may be em- 

 ployed without incision of the soft tissues, or a section of any sort. 

 The performance of this operation is more simple than the preceding 

 one : it is enough to chloroform the patient, to extend the leg over 

 the thigh and produce the flexion of the thigh over the pelvis until the 

 right angle is passed. 



Trombetta is very partial to this operation, which is very easy 

 of execution and which, if it fails, allows the surgical operation. 



Verneuill has desired to replace stretching by nerve friction (neu- 

 rotripsia) which consists in rubbing the nerve after its isolation be- 

 tween the finger and a resisting instrument ; but this operation has 

 not yielded the results that its inventor expected. 



Experiments and clinical observations have demonstrated that the 

 stretching of a mixed nerve produces functional disturbances of the 

 sensitive fibres, in such a manner that anesthesia may intervene in the 

 region innervated by the nerve while motor power remains intact; a 

 very violent stretching naturally suppresses all the function of the 

 nerve. 



As Vogt has shown, every stretching is accompanied by a separa- 

 tion of the sheath and by very trifling hemorrhages. He concludes that 

 disturbances of nutrition of the nerve are produced by rupture of its 

 veins. Nevertheless, the nervous fibres themselves are changed by 

 even slight stretchings ; many of them break and afterwards there 

 comes a double process of degeneration and of regeneration which 

 has been studied by Withowski, Quinquand, Schewing and various 

 others ; in rare cases has a scleroris been observed of the connective 

 tissues, an interstitial neuritis. 



The real difference between stretching and neurotripsia is met in 

 the influence which the stretching of a nerve has upon the nerve cen- 

 ters, as Tarchanoff, Laborde, Brown-Sequard, and Quinquand have 

 proved. 



Thus authors experimented upon animals and have observed : 

 (i), that the stretching of the right iciatic nerve produces anesthesia 



