1862.] 91 



remained spread out without there being any power of bringing them 

 together. 



After fifty-two minutes the freezing mixture was withdrawn, and 

 the skin at the elbow, which was completely frozen, was allowed to 

 thaw. During this process the arm and hand became[rapidly very pain- 

 ful upwards and downwards in the course of the nerve, the pain even 

 extending to the chest, where there was a feeling of great uneasiness 

 and constriction. At the same time the heart's action was so much 

 lowered as to threaten immediate syncope, which was, however, pre- 

 vented by a free administration of ammonia and spirits. An hour 

 after the removal of the freezing mixture the temperature (Cent.) 

 was as follows : 



o 



Left hand, between the index and median 20*5 



between the little and ring fingers. ... 21-2 



Right hand, between the index and median .... 21*8 



between the little and ring fingers . , 21 -8 



September 1 6th. Over the skin which had been frozen there was 

 vesication and inflammation of the subcutaneous tissue, which was 

 swollen around the part blistered to the extent of 2 or 3 inches over 

 the arm and forearm. Over the prominent parts of the elbow-joint 

 the bones were very tender on pressure. The ulnar nerve was like- 

 wise exceedingly painful to the touch up the arm and down the 

 forearm and the hand. The brachial plexus was very tender at 

 some points. Over the little finger and the inner side of the ring 

 finger the skin was nearly insensible. Friction over these parts 

 caused a sensation of heat, pricking, and discomfort. The tempera- 

 ture of these parts was not more elevated than other parts of the 

 hand. The paralysis of the muscles of the hand was in the same 

 condition as on the 14th. The two points of compasses, when more 

 than an inch apart, were felt as one over the palmar surface of the 

 little finger. 



September 17th. Paralysis and anaesthesia the same as the day 

 before. The hypersesthesia of the ulnar nerve was diminished. 



September 22nd, one week after application of ice. Consider- 

 able and constant hypereesthesia is experienced in the little finger 

 and down the ulnar side of the hand. The power of motion is some- 

 what restored, but neither the little nor any of the other fingers can 



