We present here a case of causalgia which has intrigued us by its bizarre course and long duration and has taught us a lesson that we want to share.
The patient was a 74-year-old veteran; in 1918 he had been hit near the left elbow by shrapnel which had slightly damaged bones, muscles, and the median nerve, and severed his ulnar nerve. The latter nerve was successfully grafted four months later. In spite of some deformity and limitation of movement, the left arm regained good function, and the patient led an active life as a farmer.
A few weeks after surgery, a throbbing, burning pain of the whole left upper extremity, especially along the ulnar side, developed. The patient sought no help, kept on working, and over the years the pain eventually subsided.
It suddenly recurred in 1956, and rapidly progressed to the point where it kept the patient awake