123 Quoted by Poore, loc. cit.
124 “Der Schreibekrampf,” rev. in Schmidt's Jahrbuch, Bd. cxv., p. 136, 1862.
Very few would be willing to repeat the experiment in a true case of copodyscinesia after the failures above enumerated, for the temporary rest given the muscle does not prove of any more service than rest without tenotomy, which has failed in all the more advanced cases, which are the only ones where tenotomy would be thought of.
Nerve-Stretching.—It is curious that no cases have been reported (at least I have not been able to discover them) of nerve-stretching for aggravated cases of copodyscinesia, as the operation has been performed in several cases of local spasm of the upper extremity following injuries to the nerves.
Von Nussbaum125 alone mentions the operation, and states that it has been of no avail, but gives no references; he previously126 stretched the ulnar nerve at the elbow and the whole of the brachial plexus for spasm of the left pectoral region and of the whole arm, following a blow upon the nape of the neck; the patient made a good recovery.
125 Aerztliches Intelligenzblatt, Munich, Sept. 26, 1882, No. 39, p. 35.
126 London Lancet, vol. ii., 1872, p. 783.
This operation, according to an editorial in the American Journal of Neurology,127 has been performed seven times for spastic affections of the arm with the following results: 2 cures (1 doubtful), 3 great improvement, and 2 slight relief.
127 Am. Journ. of Neurology and Psychiatry, 1882.
This procedure would seem to be indicated in those cases of copodyscinesia where spasms are present which have a tendency to become tonic in their character, where other means of treatment have failed. One such case has fallen under the writer's notice, which, on account of its singularity and the rarity of the operation, seems worthy of record. The patient is a physician in large practice, and his account, fortunately, is more exact than it otherwise would be: