DISEASES OF THE PERIPHERAL NERVES. 



temperature in paralyzed regions depends upon a retardation of the 

 circulation. The quicker new blood reaches the peripheral region, 

 which is constantly giving off heat, so much the less readily does it 

 become cooled. On the other hand, the slower new warm blood enters 

 the part, so much the sooner will its temperature assimilate itself to 

 that of the surrounding region. Retardation of the circulation seems 

 to me to be dependent upon a contraction of the arteries ; at all events, 

 the pulse is often smaller upon the palsied side than upon the sound 

 one. We are as yet unable to account for this narrowing of the artery 

 upon the paralyzed side. When a palsied part becomes inflamed, an 

 elevation of its temperature is observed in it, instead of a depression. 



We do not attempt to decide whether the incomplete anaesthesia, 

 which usually develops by degrees in palsied parts (even where origi- 

 nally the disease has been a motor paralysis), depends upon retarda- 

 tion of the circulation, or whether it is to be ascribed to a transmission 

 of the passive condition, through the ganglion-cells, from the motor to 

 the sensory fibres. 



The course of peripheral palsy exhibits great variety, according to 

 the cause which produces it. Where a nerve has been cut through, 

 the interrupted connection not unfrequently becomes restored, and the 

 palsy gradually and completely disappears. If, however, a large por- 

 tion of a nerve be destroyed, the palsy remains stationary throughout 

 life. The progress of rheumatic palsy usually is favorable, and it gen- 

 erally terminates in complete recovery. This is also the case with the 

 exhaustion of irritability resulting from convulsions, and from the in- 

 complete traumatic palsy caused by slight injuries. The paralysis 

 which sometimes remains after recovery from typhus also admits of 

 favorable prognosis, while that arising from lead-poisoning is exceed- 

 ingly intractable, and often proves incurable. 



TREATMENT. The fulfilment of the causal indication in peripheral 

 palsy is but rarely possible, and even then is seldom followed by bene- 

 ficial results. Thus the extirpation of a tumor, which has caused pa- 

 ralysis by pressure upon a nerve, scarcely ever restores normal motion 

 of the part. 



Rheumatic paralysis forms an exception to this rule, when not of 

 too long standing, as a proper treatment of the primitive disease in 

 such cases often furnishes the best results. However, this is not to 

 be anticipated from the use of those very uncertain remedies, colchi- 

 cum, quina, and aconite, but rather from the methodical employment 

 of warm baths. Every year troops of paralytic patients, curable and 

 incurable, crowd to Teplitz, Wiesbaden, Wildbad, or Pfaffers. The 

 reputation which these watering-places enjoy, especially in the treat- 

 ment of palsy, is mainly due to their really surprising efficacy in rheu 



