Neurectasy, or nerve-stretching for the relief or cure of pain. Being the Bradshaw lecture delivered at the Royal College of Surgeons of England on 6th December 1883 / With 12 illustrations by Victor A.H.Horsley.

  • Marshall, John.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Neurectasy, or nerve-stretching for the relief or cure of pain. Being the Bradshaw lecture delivered at the Royal College of Surgeons of England on 6th December 1883 / With 12 illustrations by Victor A.H.Horsley. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    tubing is strongly attached, and is tightly closed below ; both contain a coloured fluid which reaches a certain level in the glass tube. When I stretch the elastic tube, thus, you per- ceive that the fluid descends; so that given an elastic tube of a certain length and diameter, when it is elongated and narrowed by being stretched, its total capacity becomes greater than it was in the unstretched condition. Applying this to what may happen within a nerve, it would seem that the perineurial channels, although diminished in their trans- verse diameter, might be so much elongated when stretched, that their total capacity would be increased, not diminished. So, also, with regard to the tubules; for I assume that what is physically true on a large scale must be true on a small one. These microscopic tubules being elongated would really have a greater internal capacity than when in their natural condition; and if this be so, we can understand that this stretching may take place without any absolute compression. But, on the whole, one may conceive that here there is a sort of struggle between two conditions, a lateral narrowing pro- ducing a transverse compression, and an elongation producing a longitudinal expansion. There would occur a narrowing of the tubule itself, and a stretching out of its soft contents to fill it, whilst in itself it becomes more capacious, and the result, as we can readily understand, would be such as to shatter—if I may use the phrase—the delicate medullary substance into fragments, and so to produce the temporary destruction of its continuity represented in the diagram, e. (Appendix, p. 34.) 5. Effects of stretching on the nutrition of living nerves.— If we next proceed to inquire as to what further happens to a living nerve which has been stretched, we find that the structural changes just described are followed by nutritive disturbances, ending in degenerations, of which I may now take account before I speak of the effects of stretching on the physiological properties or functions of the nerve concerned. First, the sheath becomes hyperaemic, and charged with little ecchymoses and even larger haemorrhages; it is then infiltrated, suffers from proliferation of its elements, and is swollen; its