Aids to the Investigation of Peripheral Nerve Injuries. Medical Research Council: Nerve Injuries Research Committee. His Majesty's Stationery Office: 1942; pp. 48 (iii) and 74 figures and 7 diagrams; with Aids to the Examination of the Peripheral Nervous System. By Michael O'Brien for the Guarantors of Brain. Saunders Elsevier: 2010; pp. [8] 64 and 94 Figures

Abstract

It was at the request of William Hammond (1828–1900), Surgeon-General of the United States Army, that, in 1863, Silas Weir Mitchell (1829–1914) and Dr George Morehouse (1829–1905) established a 400 bed hospital at Christian Street (moving later to Turner’s Lane) in Philadelphia to which was referred ‘a vast collection of wounds and contusions of nerves including all the rarest forms of nerve lesion of almost every great nerve in the human body’ suffered during the American Civil War. Writing in 1917, Jules Dejerine (1849–1917) introduced to the medical public the work of his pupil Jules Tinel (1879–1952) on Nerve Wounds : ‘all surgeons and neurologists still remember how surprised they were during the early months of the War, at the numerous cases of peripheral nerve wounds brought into our hospitals… we had… to connect each of the symptoms with the determining lesion… my pupils and myself have been enabled to set up the main syndromes of nerve interruption, of compression, irritation or regeneration, and the syndromes of dissociated or partial lesions’. And lest any reader doubted wherein lay the authority for Dr Tinel’s work, Professor Dejerine points out that ‘ … written, so to speak, in my very presence, it is a faithful resume of the investigations entered upon in my service by all my fellow-workers of the Charcot Clinic’. Of the 639 cases, 408 affect the arm (in descending order of frequency—musculo-spiral, ulnar, median, combined lesions, brachial plexus, circumflex and musculo-cutaneous nerves) and 231 affect the leg (sciatic, external popliteal, internal popliteal, posterior tibial, long saphenous, anterior crural, short saphenous, lumbo-sacral plexus, musculo-cutaneous, anterior tibial, external cutaneous, ilio-inguinal and obturator nerves, respectively). Major Gordon Taylor [Sir Gordon Gordon-Taylor, KBE, CB, MD, FRCS (1878–1960), surgeon to the Middlesex Hospital, London] had with him a copy while serving with the British …