Jules Tinel

1879-1952

Tinel was a French neurologist who wrote an excellent book on the effects of nerve injuries during the First World War, and from it one may judge how times have changed, for nerve suture is hardly mentioned. He had a research interest in the autonomic system, producing a thick volume on the subject; he was noted for the ingenuity of his apparatus, which was often constructed of Meccano.

He was born in Rouen, the fifth in a line of distinguished doctors. His father was Professor of Anatomy at Rouen. Tinel studied in Paris. It was when he was mobilised for the war that he found himself in a neurological unit and was able to study the long term effects of severe nerve injury. He gave the first account of paroxysmal hypertension due to phaeochromocytoma.

During the Second World War he had to leave the Hospital; his family were interned, and one son executed by the Gestapo because they had helped run an escape route.

Formication provoked by pressure.-;When compression or percussion is lightly applied to the injured nerve trunk, we often find, in the cutaneous region of the nerve, a creeping sensation usually compared by the patient to that caused by electricity.

Formication in the nerve is a very important sign, for it indicates the presence of young axis-cylinders in process of regeneration.

This formication is quite distinct from the pain on pressure, which exists in nerve irritations. Tenderness, indicating irritation of the axis-cylinders and not their regeneration, is almost always local, perceived at the very spot where the nerve is compressed, or at least magnified at this spot; it always co-exists with the pain in the muscular bellies under pressure, which are, very often, more tender than the nerve.