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Experiments on the Restoration of Paralysed Muscles by Means of 

 Nerve Anastomosis* Part II. — Anastomosis of the Nerves 

 supplying Limb Muscles. 



By Robert Kennedy, M.A., D.Sc, M.D., St. Mungo Professor of Surgery in 



the University of Glasgow. 



(Communicated by Prof. J. G. McKendrick, F.R.S. Received November 25, 1913, — 



Read January 22, 1914.) 



(Abstract.) 



The part of the research into the anastomosis of nerves dealt with in this 

 paper has reference to the restoration of function of a group of muscles in the 

 limb. Following the early experiment of Flourens, several workers (Rawa, 

 Stefani, Howell and Huber, Cunningham, and the author) published investi- 

 gations on the effects of nerve crossing, or the division of two nerves in the 

 limb and cross suture of the ends. 



These investigations, while showing that restoration of function can take 

 place through the composite nerve, and that even in the cerebral cortex the 

 areas associated with flexion and extension become interchanged, left it 

 doubtful whether in the event of one nerve being eliminated, the muscles 

 supplied by it could be innervated by a neighbouring motor nerve, which at 

 the same time could continue also to supply the muscles proper to it, 

 performing thus a double function. 



The subject was investigated from this point of view by Kilvington, who 

 published a series of experiments in which the external popliteal nerve was 

 cut and the peripheral segment anastomosed to the internal popliteal, and 

 vice versd. He reports recovery of function after this procedure. 



Doubt, however, still remains as to the possibility of an extensor and 

 flexor group of muscles recovering the capacity of performing co-ordinated 

 movements under such conditions, as in the case of the hind limb of the dog 

 even when the sciatic nerve cut high in the thigh has not united, the animal 

 is able to use the leg in walking, the chief defect being that it walks on the 

 dorsum of the paw. Also, in these circumstances, the foot is sometimes, 

 possibly by accident, placed plantar surface down. Therefore the reported 

 recoveries after such experiments leave doubt whether the recovery is real or 

 apparent. In addition, it is impossible to investigate the changes in the 



* The expense of this research has been defrayed by a Government Grant from the 

 Royal Society. 



VOL. LXXXVII. — B. 2 C 



