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 the 6th December 1883 / by John Marshall ; with an appendix by the author, dated March 1887 and 12 illustrations by Victor A.H. Horsley.

  • Marshall, John, 1818-1891.
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 the 6th December 1883 / by John Marshall ; with an appendix by the author, dated March 1887 and 12 illustrations by Victor A.H. Horsley. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    was noticed quite independently by Mr. Horsley, and for that reason I show this diagram, b, which has been drawn under his instructions. We further find, that in a stretched nerve, as shown in c and D, there is a puckering of the tubular sheath, the regular nodal constrictions are obliterated, and an appearance of a commencing cleavage or segmentation becomes recognisable. Supposing the stretching process to be carried a little further as represented in b, not only the nodal constriction, but the segmentation of the medullary substance disappears, this becoming broken up into irregular masses; whilst, as most authorities state, the tubular sheath may remain unrup- tured, and the axis-cylinder entire, though no doubt they may both be broken across. Marcus and Wiet have actually noticed the breaking of the axis-cylinder, but rupture of the fine hyaline sheath has been recorded by many microscopists. These observations have been made not only upon nerves which have been dead for some time, but also upon the nerves of animals quite recently killed. Here, then, we have a series of note- worthy changes demonstrated to be produced upon a nerve by stretching it in various degrees. It may be permitted tne in this place briefly to mention an experiment which bears on the question of the kind of compression which the fasciculi and the tubuli of a stretched nerve must undergo. Evidently the channels formed in the perineurium and epineurium for the protection of the fasciculi of tubules are narrowed, the lymph spaces around these fasciculi disappear, and the fasciculi themselves are com- pressed as well as subjected to longitudinal tension. Now, these same channels of course resemble tubes; and so likewise the fine hyaline sheaths of the separate nerve-fibres are elastic hollow tubes enclosing the medullary sheath and axis-cylinder. Hence it occurred to me to ask, what happens when a more or less elastic tube is elongated ? Is its original total capacity increased or diminished ? You will probably think neither the one nor the other, and that is what I supposed. But a very simple experiment will show you that when I extend an elastic tube its total capacity is increased. Here is a glass tube to the lower end of which a piece of elastic