Severe spasmodic contraction of a finger cured by stretching the median nerve / by James Adams.

  • Adams, James.
Date:
[1908]
Catalogue details

Licence: In copyright

Credit: Severe spasmodic contraction of a finger cured by stretching the median nerve / by James Adams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    when freed the finger at once returned to its state of rigid contraction with the tip firmly fixed in the palm. Before admission the finger had been treated in various ways without success and after admission I tried internally anti- rheumatic and anti-gouty medicines and iodide of potassium in large doses ; also locally I ordered hot brine baths, liniments, ointments, massage, &c., as well as applying splints to the palmar surface by which I could keep the finger extended, but all without the least benefit. It was very painful to the patient to have it kept in a position of complete extension and it also proved useless, for when the splint was removed the finger at once re-contracted. After six weeks’ treatment with no result the patient begged me to amputate the finger as it was so inconvenient to her, besides preventing her from earning her living. Accordingly, in January, 1906, I removed the finger at the metatarso- phalangeal joint with the head of the metatarsal bone. The wound healed normally and quickly and in February she returned home to her work with a useful hand and with the rest of the fingers in a normal condition. For six months this continued, but in August the ring finger began to contract and in spite of treatment became as bad as the middle linger had been, and in November she was readmitted in order to have this finger also amputated. The condition, appearance, and symptoms were identical with those of the other finger. It was in a state of marked tonic contraction with its tip fixed and kept firmly in the palm. By no effort on her part could she move it, and I could only extend it by using much force and giving her great pain ; on my releasing it the finger returned at once to its vicious position like a strong spring set free. The finger was not swollen, red, or painful, and its sensation was normal, and the other fingers were normal in every way, as were the hand, the forearm, and the upper arm. The patient’s general health was excellent, her appetite was good, and she slept well. She is a placid, non neurotic type of woman, dark com- plexioned, well nourished, and is active and industrious. To remove a second finger from the hand of a woman of this class, already deprived of her other hand, would be indeed a serious misfortune for her. Instead of again putting her through a course of treatment I showed her at a meeting of the Eastbourne Medical Society, where she was examined thoroughly and with much interest by about 20 members who were present. A suggestion was made that stretching the median nerve might be beneficial and I readily