Introduction

Abstract

In 1926, a physician, who had long been a close friend of mine, lost his left arm as a result of gas bacillus infection. The arm was removed by a guillotine type of amputation close to the shoulder and for some three weeks the wound bubbled gas. It was slow in healing and the stump remained cold, clammy, and sensitive. He sweated more from the axilla of the involved side than on the normal side, and often his shirt and the top of his trousers were damp with perspiration. At times the stump would jerk uncontrollably or, after a period of quiet, flip suddenly outward. He suffered a great deal of pain and submitted to a reconstruction operation and the removal of neuromas, without any relief. In spite of my close acquaintance with this man, I was not given a clear-cut impression of his sufferings until a few years after the amputation, because he was reluctant to confide to anyone the sensory experiences he was undergoing. He had the impression, that is so commonly shared by layman and physician alike, that because the arm was gone, any sensations ascribed to it must be imaginary. Most of his complaints were ascribed to his absent hand. It seemed to be in a tight posture with the fingers pressed closely over the thumb and the wrist sharply flexed. By no effort of will could he move any part of the hand. All the movements of the stump seemed to alter the position in space of the phantom member.