SECTION III. 



DISEASES OF THE PERIPHERAL NERVES. 



CHAPTEK I. 



INFLAMMATION OP THE NERVES NEUBITTS. 



ETIOLOGY. Inflammatory disturbances of nutrition rarely occur in 

 (lie peripheral nerves. They sometimes affect the nerve-filaments, 

 sometimes the neurilemma. The first form ranks among parenchyma- 

 tous inflammations, and ends in the destruction of the nerve-medulla 

 to a fine granular, fatty detritus. In the second form there is an inter- 

 stitial exudation, and a proliferation of connective tissue, by which the 

 neurilemma is decidedly thickened. There is rarely any formation of 

 pus. "We shall hereafter speak of the diffuse hyperaemia of the neu- 

 rilemma of a wounded nerve, without any perceptible exudation, 

 observed in some cases of tetanus. 



Among the exciting causes of neuritis, the most important are 

 injuries of the nerves, particularly punctured wounds, contusions, or 

 lacerations. In other cases neuritis is due to the propagation of in- 

 flammation from neighboring organs. Lastly, some few cases of spon- 

 taneous or so-called rheumatic inflammation are said to have been 

 observed. 



ANATOMICAL APPEARANCES. Inflammation of the neurilemma is 

 characterized by a more or less intense redness, which sometimes de- 

 pends on overfulness of the blood-vessels, sometimes on the presence 

 of small extravasations. The neurilemma also appears relaxed, swol- 

 len, and infiltrated. If the neuritis has taken on an acute course, and 

 led to suppuration, there is usually more or less pus in the loose con- 

 nective tissue around the nerve. When the disease is chronic, the 

 neurilemma usually appears much thickened, hard, and firmly adherent 

 to the surrounding parts. 



Inflammation of the nerve-substance is shown by its redness, swell- 

 ng, and relaxation ; in severe cases it is transformed to a red pulp 



