It  is  much  more  common  for  the  nerve  to  suffer  in  long-continued  flexion
of  the  elbow,  without  external  pressure ;  and  from  this  cause  the  nerve  is
sometimes  paralyzed  during  sleep.  I  have  three  times  seen  a  sleep-palsy  of
the  ulnar  nerve.  The  tension  may  set  up  neuritis,  and  is  especially  effective
if  the  resistance  of  the  tissues  to  morbid  influences  is  lessened  by  general  ill-
health.  Many  persons  must  have  noticed  that  if,  when  out  of  health,  they
sleep  with  the  elbow  bent,  they  wake  with  tingling,  and  even  loss  of  feeling,
in  the  region  supplied  by  the  ulnar  nerve,  although  this  may  not  happen
when  they  are  in  good  health.  If  the  ill-health  is  profound,  as  in  an  acute
illness,  local  neuritis  of  considerable  intensity  may  be  set  up.  Thus  a  lady,
a  few  days  after  childbirth,  who  was  prostrated  by  a  long,  exhausting  labor,
noticed  tingling  in  the  side  of  the  hand,  and,  whenever  she  bent  her  elbow,
a  sensation  "as  if  she  had  knocked  her  funny  bone."  Paralysis  of  the
muscles  .supplied  by  the  ulnar  nerve  followed  in  a  few  hours,  and  in  a  fort-
night there  was  distinct  wasting.  When  I  saw  her,  six  months  later,  the  ulnar
nerve  behind  the  elbow  was  distinctly  thickened.  She  had  had  a  similar,
but  more  transient,  attack  after  a  previous  confinement.  Another  patient
had  a  similar  palsy  during  the  course  of  typhoid  fever.  Bernhardt  has
described  a  case  of  palsy  of  both  ulnar  nerves  during  the  course  of  typhoid.
In  such  conditions,  not  only  is  the  tissue  health  lowered,  but  warning  sensa-
tions are  often  unperceived.
