The Atlantic Monthly, Volume 18, No. 105, July 1866. Various

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СКАЧАТЬ to my left shoulder, as on that side there remained five inches of the arm bone, which I could move to a moderate extent. The hope proved illusory, as the stump was always too tender to bear any pressure. The hospital referred to was in charge of several surgeons while I was an inmate, and was at all times a clean and pleasant home. It was filled with men who had lost one arm or leg, or one of each, as happened now and then. I saw one man who had lost both legs, and one who had parted with both arms; but none, like myself, stripped of every limb. There were collected in this place hundreds of these cases, which gave to it, with reason enough, the not very pleasing title of Stump-Hospital.

      I spent here three and a half months, before my transfer to the United States Army Hospital for nervous diseases. Every morning I was carried out in an arm-chair, and placed in the library, where some one was always ready to write or read for me, or to fill my pipe. The doctors lent me medical books; the ladies brought me luxuries, and fed me; and, save that I was helpless to a degree which was humiliating, I was as comfortable as kindness could make me.

      I amused myself, at this time, by noting in my mind all that I could learn from other limbless folk, and from myself, as to the peculiar feelings which were noticed in regard to lost members. I found that the great mass of men who had undergone amputations, for many months felt the usual consciousness that they still had the lost limb. It itched or pained, or was cramped, but never felt hot or cold. If they had painful sensations referred to it, the conviction of its existence continued unaltered for long periods; but where no pain was felt in it, then, by degrees, the sense of having that limb faded away entirely. I think we may to some extent explain this. The knowledge we possess of any part is made up of the numberless impressions from without which affect its sensitive surfaces, and which are transmitted through its nerves to the spinal nerve-cells, and through them, again, to the brain. We are thus kept endlessly informed as to the existence of parts, because the impressions which reach the brain are, by a law of our being, referred by us to the part from which they came. Now, when the part is cut off, the nerve-trunks which led to it and from it, remaining capable of being impressed by irritations, are made to convey to the brain from the stump impressions which are as usual referred by the brain to the lost parts, to which these nerve-threads belonged. In other words, the nerve is like a bell-wire. You may pull it at any part of its course, and thus ring the bell as well as if you pulled at the end of the wire; but, in any case, the intelligent servant will refer the pull to the front door, and obey it accordingly. The impressions made on the cut ends of the nerve, or on its sides, are due often to the changes in the stump during healing, and consequently cease as it heals, so that finally, in a very healthy stump, no such impressions arise; the brain ceases to correspond with the lost leg, and, as les absents ont toujours tort, it is no longer remembered or recognized. But in some cases, such as mine proved at last to my sorrow, the ends of the nerves undergo a curious alteration, and get to be enlarged and altered. This change, as I have seen in my practice of medicine, passes up the nerves towards the centres, and occasions a more or less constant irritation of the nerve-fibres, producing neuralgia, which is usually referred to that part of the lost limb to which the affected nerve belongs. This pain keeps the brain ever mindful of the missing part, and, imperfectly at least, preserves to the man a consciousness of possessing that which he has not.

      Where the pains come and go, as they do in certain cases, the subjective sensations thus occasioned are very curious, since in such cases the man loses and gains, and loses and regains, the consciousness of the presence of lost parts, so that he will tell you, "Now I feel my thumb,—now I feel my little finger." I should also add, that nearly every person who has lost an arm above the elbow feels as though the lost member were bent at the elbow, and at times is vividly impressed with the notion that his fingers are strongly flexed.

      Another set of cases present a peculiarity which I am at a loss to account for. Where the leg, for instance, has been lost, they feel as if the foot was present, but as though the leg were shortened. If the thigh has been taken off, there seems to them to be a foot at the knee; if the arm, a hand seems to be at the elbow, or attached to the stump itself.

      As I have said, I was next sent to the United States Army Hospital for Injuries and Diseases of the Nervous System. Before leaving Nashville, I had begun to suffer the most acute pain in my left hand, especially the little finger; and so perfect was the idea which was thus kept up of the real presence of these missing parts, that I found it hard at times to believe them absent. Often, at night, I would try with one lost hand to grope for the other. As, however, I had no pain in the right arm, the sense of the existence of that limb gradually disappeared, as did that of my legs also.

      Everything was done for my neuralgia which the doctors could think of; and at length, at my suggestion, I was removed to the above-named hospital. It was a pleasant, suburban, old-fashioned country-seat, its gardens surrounded by a circle of wooden, one-story wards, shaded by fine trees. There were some three hundred cases of epilepsy, paralysis, St. Vitus's dance, and wounds of nerves. On one side of me lay a poor fellow, a Dane, who had the same burning neuralgia with which I once suffered, and which I now learned was only too common. This man had become hysterical from pain. He carried a sponge in his pocket, and a bottle of water in one hand, with which he constantly wetted the burning hand. Every sound increased his torture, and he even poured water into his boots to keep himself from feeling too sensibly the rough friction of his soles when walking. Like him, I was greatly eased by having small doses of morphia injected under the skin of my shoulder, with a hollow needle, fitted to a syringe.

      As I improved under the morphia treatment, I began to be disturbed by the horrible variety of suffering about me. One man walked sideways; there was one who could not smell; another was dumb from an explosion. In fact, every one had his own grotesquely painful peculiarity. Near me was a strange case of palsy of the muscles called rhomboids, whose office it is to hold down the shoulder-blades flat on the back during the motions of the arms, which, in themselves, were strong enough. When, however, he lifted these members, the shoulder-blades stood out from the back like wings, and got him the soubriquet of the Angel. In my ward were also the cases of fits, which very much annoyed me, as upon any great change in the weather it was common to have a dozen convulsions in view at once. Dr. Neek, one of our physicians, told me that on one occasion a hundred and fifty fits took place within thirty-six hours. On my complaining of these sights, whence I alone could not fly, I was placed in the paralytic and wound ward, which I found much more pleasant.

      A month of skilful treatment eased me entirely of my aches, and I then began to experience certain curious feelings, upon which, having nothing to do and nothing to do anything with, I reflected a good deal. It was a good while before I could correctly explain to my own satisfaction the phenomena which at this time I was called upon to observe. By the various operations already described, I had lost about four fifths of my weight. As a consequence of this, I ate much less than usual, and could scarcely have consumed the ration of a soldier. I slept also but little; for, as sleep is the repose of the brain, made necessary by the waste of its tissues during thought and voluntary movement, and as this latter did not exist in my case, I needed only that rest which was necessary to repair such exhaustion of the nerve-centres as was induced by thinking and the automatic movements of the viscera.

      I observed at this time also, that my heart, in place of beating as it once did seventy-eight in the minute, pulsated only forty-five times in this interval,—a fact to be easily explained by the perfect quiescence to which I was reduced, and the consequent absence of that healthy and constant stimulus to the muscles of the heart which exercise occasions.

      Notwithstanding these drawbacks, my physical health was good, which I confess surprised me, for this among other reasons. It is said that a burn of two thirds of the surface destroys life, because then all the excretory matters which this portion of the glands of the skin evolved are thrown upon the blood, and poison the man, just as happens in an animal whose skin the physiologist has varnished, so as in this way to destroy its function. Yet here was I, having lost at least a third of my skin, and apparently none the worse for it.

      Still more remarkable, however, were the physical changes which I now began to perceive. I found to my horror that at times I was СКАЧАТЬ