IV. Nerves.
1908. A portion of the lower jaw, removed from the articulation to about one-fourth of an inch beyond the angle, in a case of very intense neuralgia.
The patient was a man, thirty-two years of age, who had suffered the greatest agony from the disease, for twelve or thirteen years. About the year 1860 the infra-orbital and one other nerve of the face were divided. In 1861 and again in 1863 a portion of the lower jaw and of the nerve were removed at the hospital; and in 1864 the facial nerve was freely divided. June 24th, 1869, he again entered the hospital (140, 183). On the 30th the bone was removed; and the nerve, as nearly as possible, to its exit, from the base of the skull; the hemorrhage being very copious. There was a loss of motion and sensibility in the side of the face; and on the 3d of July, and again on the 4th, there was a return of very severe pain. There was no more, however, after this last date, and on the 13th he was discharged.
The surface of the bone is somewhat irregular, but healthy, and the opening that resulted from the former operations is about ⅞ by ⅙ in. Dec. 9th, the man reports no pain since operation, but face continiues paralyzed. 1869. Dr. R. M. Hodges.
1909. Neuromatous tumors about a stump.
The patient was a young man, eighteen years of age, who had his arm amputated when he was nine years old. For the first two years he had a good stump, and then the bone began to project. On admission into the hospital (115, 54), the integument was thin, and shining over it to the extent of an inch, but the cicatrix was not involved. There was severe pain, and the tumors were easily felt. Two inches and a half of the bone were removed, with a part of the integument, the bone tapering to a point. All of the nerves, terminated in large bulbous tumors; and a bursa over the end of the bone contained a great number of minute loose bodies. The relief was perfect.
Dr. H. regarded this, not as a common conical stump, but as a case in which the bone grew with the lad's growth;
