114 'Journal of Comparative Neurology and Psychology. 



ouglilj irrigated. No attempt at this time was made to discover 

 nerve lesions. The wound healed by first intention. The day follow- 

 ing the accident I saw the patient. So far as he could tell the 

 thumb felt "dead" on the volar side, but there was no loss of sensation 

 in the forefinger. The second, ring and little fingers also felt ''dead". 

 The area of anaesthesia to light touch, which was discovered at this 

 time was over the ulnar j^art of the hand, back and front, and in- 

 cluded the three fingers mentioned. I did not make careful notes 

 of the condition at the time, and the accurate comparison of the 

 anesthetic area at this time with what was found later can not be 

 made. Following the accident the feeling in the thumb improved, 

 but the sensation ability of the forefinger decreased. On August 

 12th, an exploratory operation was performed by Dr. G. T. Vaughan. 

 The ulnar nerve was found divided near the olecranum ; the median 

 nerve was nicked, and there were excrescences or clubbed swellings 

 on both edges of the nick. The ulnar nerve was brought together 

 with sutures, the swellings on the median nerve were cut away 

 and pieces of fascia were placed around the nerves to j^revent the 

 ingrowth of any scar tissue from neighboring parts. The results 

 of my later examinations show that, in all probability, the medial 

 antibrachial nerve was severed. This was not examined at the 

 time of the operation. Immediately following the operation there 

 was further improvement in the condition of the thumb, but the 

 patient thinks this improvement was not marked. I did not examine 

 the patient again until October 6th. 



At the time of the first careful examination, I found the following 

 condition: The little and ring fingers were totally anesthetic to 

 all forms of stimuli, heat and cold, light touch and pressures. The 

 middle and forefingers were anesthetic for all forms of stimuli over 

 the two distal joints, both on the back and palmar parts. The 

 palmar area corresponding to these two fingers was insensitive to 

 light touch, but pressures could be appreciated and well localized. 

 Pricks of a pin were painful. Up to this time there had appeared 

 from time to time painful sensations following movements of the 

 arm at the elbow, localized poorly, but apparently over the knuckles 

 of the middle, ring and little fingers and over the palm at the place 



