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Study of Cutaneous Innervation in Congenital Anesthesia

ANDRE BOURLOND, MD; R. K. WINKELMANN, MD
Arch Neurol. 1966;14(2):223-227. doi:10.1001/archneur.1966.00470080107016.
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HISTOLOGIC STUDIES cannot separate easily the sensory and autonomic nervous tissues that appear to be mixed or to be in close proximity in the dermal layers of human skin. Specific techniques for demonstration of sensory and autonomic nerves have been proposed, but, ultimately, it is the relationship and intimate morphology that decide in which system a given structure is classified. When any technique is used, sensory fibers are seen in the dermal plexus supplying the Merkel, Meissner, mucocutaneous, Vater-Pacini end-organs. With some techniques autonomic networks are observed with some surety about the eccrine glands, larger vessels, and arrectores pilorum muscles. However, discrepancies in the literature make it evident that the tiny fibers, either isolated or in bundles, which are observed in the middle and upper dermis, cannot be classified with certainty. The nature and distribution of the sensory and autonomic fibers in the dermis could be decided reliably if a

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