Herpes zoster and the limb plexuses of nerves / by James MacKenzie.

  • Mackenzie, James.
Date:
[between 1890 and 1899?]
Catalogue details

Licence: Public Domain Mark

Credit: Herpes zoster and the limb plexuses of nerves / by James MacKenzie. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    12/22 (page 10)
    with the results obtained by Herriiigham from numerous dissections. In a case of tumour of the neck recorded by Buckley,^ where there was an herpetic eruption, which occupied a similar area, the tumour was so situated that it would affect the fifth and sixth cervical nerves at their roots. According to Herringham, the seventh cei'vical nerve is distributed to the fingers and hand, and the eighth cervical to the little and ring fingers, the ulnar border of the hand, and frequently also the forearm. I cannot find satisfactory accounts of cases where the eruption was limited to these areas, but they are found associated with the eruption produced by disease of neighbouring spinal nerves. Thomson describes a case ^ where the eruption involved the areas of skin supplied by the internal cutaneous nerve of the right brachial plexus, where there were also two groups of vesicles on the palm of the hand. Stopin ^ describes a case with the eruption in almost the same situation, namely, above the internal condyle of the humerus, on the inferior internal part of the forearm, and immediately above the carpus. In both these cases the first dorsal nerve is evidently aff'ected. Herringham observed that in the majority of cases the internal cutane- ous nerve was made up of fibres from the first dorsal root. The area thus described as being supplied by the eighth cervical and first dorsal nerves is also practically that found anesthetic by Horsley, in a case where he divided the posterior roots of the eighth cervical and first dorsal nerves.* It is to be noted that in cases of herpes occupying any area supplied by the nerves from the fifth cervical to the first dorsal there is no associated eruption on the trunk. It is usually assumed that the posterior primary divisions of the lower three cervical nerves contain no cutaneous branches, but in the eleventh edition of Gray's Anatomy there is recorded the result of some dissections, which demonstrated that these nerves did give off cutaneous filaments. It is also generally assumed that the intercostal branch of the first dorsal nerve contains no cutaneous filament, but Swan distinctly states that there is such a supply.^ In no reliable account, of the many I have read, has there been any record of the eruption occurring on the trunk, either in front or behind, where herpes zoster affected the nerves from the fifth cervical nerve to the first dorsal. When the eruption is due to disease of the second dorsal root it may occupy the chest in front and behind, as well as the inner aspect of the upper arm (Fig. 5).^ ^ American Journal of Medical Sciences, July 1876. - British Medical Journal, 26th Aisril 1890. ^ Loc. cit., Observation iii. ■•Gowers, W. R., Diseases of the Nervous System, London, 1891, 2nd ed., vol. i., p. 81. 5 Swan, J. A., Demonstration of the Nerves of the Human Body, London, 1834, p. 73. Von Barensprimg, loc. cit., 1861, Bd. ix., p. 84.