A special case of phantom limb pain.

A farmer underwent disarticulation at the right shoulder followed by numerous skin grafts. After one of these grafts a phantom hand cramp developed, which disappeared on treatment of trigger points under a split thickness grafted, scarred area on the chest wall. Each phantom finger relaxed on injection of a definite area: i.e. the 'fingers' could be mapped out on the chest wall which was devoid of normal epicritic sensibility. The discussion points out the error of central versus peripheral theories of etiology and an approach toward understanding the patient as a psychophysic entity is stressed. The special characteristics of phantom limb pain are outlined, with emphasis on its remarkable response to psychic and physical factors.