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330
Original Articles and Clinical Cases

On the back of the hand, sensibility remained exactly in the condition described immediately after the operation. Over the whole area of cutaneous anaesthesia, pressure-touches were appreciated and well localized. Pain could be produced as easily by pressure with the algometer over the back of the affected as over similar parts of the normal hand. Electrical stimuli produced no sensation except when the muscles contracted; then the smallest visible movement was appreciated. To recognize pure movement, produced electrically, without a concomitant cutaneous sensation is a remarkable experience.

Fig. 6: To show the loss o£ sensation on June 14, 1903 (fifty days after the operation).

Though sensitive to the tactile and painful elements of pressure, and to the passive movement of muscles, the back of the hand was anaesthetic to all thermal stimuli; the tissues could be frozen firmly with ethyl chloride without the production of even the slightest sensation.

The first noticeable change in the extent of the loss of sensation was discovered on June 7, forty-three days after the operation. The borders of the area insensitive to cotton wool remained unaltered, but the cutaneous analgesia was distinctly less extensive, and no longer coincided