Bauhaus-Universität Weimar

510 
SENSATIONS REFERRED TO THE 
of it can be of no service; for the stump remaining in connection 
with the brain, and containing in itself all the primitive fibres dis¬ 
tributed in the branches of the nerve to the skin, gives rise, as we 
know, when irritated, to the same sensations as are felt when the 
peripheral parts themselves are affected. It is rarely that division 
of the nerve, or removal of a part of it, relieves the neuralgic pain; 
such a result can occur only when the cause of4 the disease is seated 
in the branches, not in the trunk of the nerve. 
Division of a nerve, then, merely prevents the possibility of ex¬ 
ternal impressions on the cutaneous extremity of its fibres being 
felt; the impressions being no longer communicated to the brain. 
But the same sensations which were before produced by external 
impressions may arise from internal causes, as long as the primi¬ 
tive fibres of the trunk remain in connection with the brain or 
spinal cord. 
When a nerve—of a finger, for example—is accidentally divided, 
the paralysed portion of the finger, although insensible to external 
stimuli, becomes the seat of pain, during the existence of inflamma¬ 
tion in the wound. When the inflammation has subsided, the sense 
of pain ceases, and the part remains quite devoid of sensation. 
The observations of Gruithuisen with respect to these phenomena 
in his own person, which were related at page 132, are particularly 
interesting. Sir Everard Home (Philos. Transact.) relates a case 
in which a nerve of the face was divided for neuralgia, and where, 
the wound not uniting by the first intention, the inflammatory state 
of the divided extremities of the nerve, gave rise to attacks similar 
to those suffered before the operation; though, when the wound had 
completely healed, there was no return of the pain. 
The phenomena attending the state of a limb “asleep,” in conse¬ 
quence of pressure on the nerves, are of a similar kind. The pressure 
puts a stop to the nervous communication from the periphery to the 
brain; but the same pressure, by affecting the upper part of the 
nerve, gives rise to the sensation of “creeping” (“formicatio”) 
and pricking in the limb, which has lost its sensibility to external 
impressions. 
The sensation of creeping in the surface frequently attends affec¬ 
tions even of the origins of the nerves from the spinal cord or brain, 
or of these latter organs themselves. When the sensation of tin¬ 
gling is felt in the skin, it is impossible to know whether the cause of 
it is seated in the skin, in the nerves themselves, or at the origin of 
their fibres from the spinal cord. It is frequently the spinal cord 
itself. In nearly all diseases of the spinal cord, tingling in the skin 
is a symptom; the tingling is also frequently felt in the paralysed 
parts which receive their nerves from the cord below the seat of the 
disease; in tabes dorsalis there is formicatio or tingling, not merely in 
the mesial line of the back, but in the skin of the whole body, or of 
its lower half. 
From the foregoing remarks it will be conceived that the aura 
epileptica, (a kind of “formicatio”) which is felt in the extreme 
parts of the body before an attack of epilepsy, has its cause and true
        

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